Combined transoral and transnasal power-assisted endoscopic adenoidectomy by a StraightShot® microdebrider and Endoscrub® device

Objective: To describe a combined transoral and transnasal approach power-assisted endoscopic adenoidectomy by StraightShot® microdebrider and Endoscrub® device in children. Method: Transoral power-assisted endoscopic adenoidectomy using a 45°-curved cutting visor of a StraightShot® microdebrider (Medtronic Xomed, Jacksonville, FL, USA) is performed with an Endoscrub, irrigation device (Medtronic Xomed) attached to the rigid endoscope. The oscillating mode (1500 r.p.m.) of the microdebrider is selected. The dissection begins at the inferior pole of the adenoids and swifted upwards to the roof of the nasopharynx. Transnasal dissection of the choanal extension of the adenoids is achieved using a straight-cutting visor with the aid of a 0° rigid endoscope. Results: The technique was performed in 11 consecutive patients (six male and five female) in a 6-month period. The mean age of the patients was 6.9 years (range, 3–9 years). The main indication for surgery was obstructive sleep apnoea with huge obstructive adenoids and with choanal extension. The mean operative time was 4.8 min (range, 2–11 min). The mean blood loss was 12.8 mL (range, 4–16 mL). No intraoperative or postoperative complications were recorded. Conclusion: The described technique for dissection of adenoids in children is safe and is recommended for patients with large adenoids and with choanal extension. Chinese Abstract Figure Chinese Abstract.