マイクロデブリッダーによるアデノイド切除

Abstract

There are many different adenoidectomy methods. One of the most recent techniques is endoscopic adenoidectomy with a microdebrider. Between January and May in 2000, treatment employing endoscopic adenoidectory with a microdebrider was performed on 12 patients (10 male and 2 female) at Takatsuki Red Cross Hospital. The patients ranged from 4 to 9 years in age, with mean age at 5.6 years. All procedures were performed under general anesthesia via an endotracheal intubation. In this procedure, the patient was placed supine in Rose's position with the head extended and the mouth was opened with a Crow-Davis mouth gag. A 4.0 mm, 70 endoscope and drill bar of an XPS system were inserted transorally into the nasopharynx, and the main bulk of adenoid was removed. Next, a 2.7 mm, 0° endoscope was inserted transnasally. Residual adenoid at the superior portion of the nasopharynx was removed completely with the drill bar of the XPS inserted transorally. After the adenoidectomy was completed, gauze was inserted into the nasopharynx transorally to compress the wound and then removed, hemostasis was confirmed.All patients underwent complete resection of adenoid around the choana, torus tubarius and the superior portion of the nasopharynx and did not show any complications such as hemorrhage and nasopharyngeal incompetence during the course of surgery.Using this technique, the adenoids can be removed completely and safely without damaging other structures.