Microdebrider Adenoidectomy Technique

Adenoidectomy is a common surgery among children in the United States. Adenoid hypertrophy is associated with several disorders that impact childhood development, such as sleep disordered breathing, otologic disease, and gastroesophageal reflux disease (GERD). The gold standard treatment for these disorders has been surgical excision of the adenoid tissue. Several techniques have been employed in the past, including sharp dissection with curettes, monopolar suction cautery, coblation, and microdebrider excision. Each of these techniques has advantages and disadvantages with respect to operative time, intraoperative blood loss, and postoperative complications, the most important of which are postoperative bleeding, adenoid regrowth, and velopalatal insufficiency. Here, we describe the use of a microdebrider for excision of the adenoid and explore the advantages and disadvantages of this method. The microdebrider technique is effective and safe, particularly for ENT surgeons who have significant experience using the microdebrider. This technique allows for precise tissue excision without thermal injury to surrounding structures. It also allows for full visualization of the posterior nasopharynx due to the microdebrider's built-in suction mechanism, which keeps the field clear of any tissue debris or blood that may accumulate during the excision. This experience mirrors much of the literature on this subject, which demonstrates the similar effectiveness of the microdebrider technique when compared with others and has identified a decreased risk of postoperative bleeding and adenoid regrowth.