Defining the Surgical Limits of Adenoidectomy so as to Prevent Recurrence of Adenoids

Abstract

This study aims to define the surgical boundaries of adenoidectomy by demonstrating that recurrence of adenoids and its symptoms can be avoided if a complete adenoidectomy is performed, by following these surgical limits. A prospective descriptive study was carried out at Speciality ENT Hospital, Mumbai, India. Endoscopic adenoidectomy was performed in 83 patients using coblation technology. In all patients, adenoids were removed superiorly till the periosteum over the body of sphenoid; posteriorly till the pharyngobasilar fascia; laterally till fossa of Rosenmuller in the posterior part and till the torus tubarius in the anterior part; and inferiorly till the Passavant's ridge. The patients were followed up postoperatively and a nasal endoscopy was done at the end of 1 year to look for any recurrence or regrowth of adenoids, so as to determine the efficacy of the procedure. A total of 83 patients underwent adenoidectomy with a mean age of 12.80 years. 12 patients were lost to follow up. Of the remaining 71 patients, no patient showed any evidence of recurrence of adenoid on follow-up nasal endoscopy done at the end of 1 year. Recurrence of adenoid post adenoidectomy is not seen if there is complete removal of adenoids. So it is essential that all adenoid tissue be removed during adenoidectomy. The complete removal of adenoids can be ensured by following the surgical limits of adenoidectomy.

Keywords: Adenoid; Coblation; Pharyngobasilar fascia; Regrowth; Surgical limits.

Figures

Fig. 1

Delineating pharyngobasilar fascia

Fig. 2

Surgical boundaries of adenoidectomy