ENT Surgery: Adenoidectomy
High-Yield Revision for NEET PG
Adenoidectomy involves the surgical removal of the pharyngeal tonsils (adenoids), typically located in the nasopharyngeal roof.
1. Indications
- Chronic Adenoiditis/Hypertrophy: Leading to nasal obstruction, mouth breathing, and “adenoid facies.”
- Recurrent Otitis Media/OME: Due to Eustachian tube dysfunction caused by obstructive adenoid tissue.
- Obstructive Sleep Apnea (OSA): The most common indication in the pediatric population.
- Chronic Rhinosinusitis: Persistent or recurrent symptoms despite medical management.
2. Surgical Considerations
| Parameter | Detail |
|---|---|
| Instrument | Adenoid curette (e.g., La Force or Barnhill) or microdebrider. |
| Positioning | Rose position (neck extended). |
3. NEET PG High-Yield Pearls
- Adenoid Facies: Characterized by an open mouth, prominent upper incisors, high-arched palate, and dull facial expression due to chronic nasal obstruction.
- Complication: Nasopharyngeal stenosis (rare) or velopharyngeal insufficiency (post-op hypernasal speech), especially in children with submucosal cleft palate.
- Contraindication: Submucous Cleft Palate (absolute or relative, as removal can exacerbate speech hypernasality). Always inspect the palate before surgery.
- Bleeding: Primary hemorrhage is usually from the nasopharyngeal roof; posterior nasal packing or electrocautery is the management.