In this video, Mount Sinai pediatric and general otolaryngologists perform adenoidectomy on a patient with obstructive sleep apnea. The adenoids are lymphoid tissue similar to tonsils and are located at the back of the nose in between the eustachian tubes. When they enlarge, they may cause fluid in the ears, mouth breathing, snoring, and a stuffy nose. They are large most often in young children and tend to shrink before the child is 10 years old. Tonsillectomy and adenoidectomy (adenotonsillectomy when done together) is often first line treatment for children with obstructive sleep apnea. Surgery is typically done on an outpatient basis and patients go home the same day and are able to eat and drink most things. Surgery is not very painful.
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Aldo V. Londino III, MD Assistant Professor, Otolaryngology Mount Sinai Health System Michael A. Rothschild, MD Professor, Otolaryngology Mount Sinai Health System Daniel Alicea Delgado Assistant Professor, Department of Otolaryngology-Head and Neck Surgery Mount Sinai Health System Courtney T. Chou, MD Assistant Professor, Otolaryngology, Sleep Medicine New York Eye & Ear Infirmary of Mount Sinai Zan Mra, MD Assistant Professor, Otolaryngology Mount Sinai Brooklyn Isaac Namdar, MD Associate Professor, Otolaryngology Mount Sinai West Edward J. Shin, MD Professor, Ear, Nose, Throat (ENT) / Otolaryngology - Head and Neck Surgery New York Eye and Ear Infirmary of Mount Sinai Benjamin C. Tweel, MD Medical Director, Department of Otolaryngology – Head and Neck Surgery Mount Sinai Health System Gregory P. Tsai, MD Assistant Professor, Otolaryngology Mount Sinai Health System Joshua Zeiger, MD Assistant Professor, Department of Otolaryngology-Head and Neck Surgery Mount Sinai Health System Zachary G. Schwam, MD Assistant Professor, Department of Otolaryngology-Head and Neck Surgery Division of Otology-Neurotology, Lateral Skull Base Surgery Mount Sinai Health System The Mount Sinai Otolaryngology Surgical video series presents adenoidectomy. This procedure is commonly performed by our pediatric, as well as adult general otolaryngologists. This video was edited by Zachary Swam. Here we have a pediatric patient with sleep apnea who will be undergoing tonsillectomy and adenoidectomy. Only. The adenoidectomy is shown here. A retractor is placed in the tongue and endotracheal tube are kept in the midline upon zooming. In one can see the relevant anatomy which is labeled here. The anodes cannot be seen as they are in the back of the nose or the nasopharynx. In order to see the anodes, the soft palate must be retracted. A red rubber catheter is placed in the nose until it is seen in the oropharynx. It is then grabbed with a clamp and pulled tat A four by four gauze protects the face. Once the soft palate and uvula have been retracted, the adenoid bed can be seen around the corner while our faculty use everything from a cob blader to microdebrider to suction. Cotter only suction Cotter is shown in this video. It is important to cauterize in the midline and not to extend two laterally. So as not to damage the station two bora which will be shown later, the soft tissue of the aid bed is slowly cauterized with a suction Bovi staying in the midline partial resection is shown here. The eta tub orifice can be seen laterally and is somewhat polypoid. In this case, the adenoid is not cauterized inferiorly over pavan ridge to minimize the chance of Vilonia insufficiency or reflux of materials from the oropharynx to the nasopharynx. the Kenna or back of the nose can also be seen. The remainder of the adenoid bed is cauterized. The Kenna inferior turbinates and bilateral e station tubes are well visualized.