Friday, 20 April 2012

Thursday, 19 April 2012

ENDOSCOPIC LASER ASSISTED ADENOIDECTOMY


WHO NEEDS LASER ASSISTED ADENOIDECTOMY?

• CHILDREN
• SOME ADULTS

WHY DO WE DO ADENOIDECTOMY?

• RECURRENT ADENOID INFECTION
• ENLARGED ADENOID CAUSING SNORING AND SLEEP APNOEA
• ENLARGED ADENOID CAUSING RECURRRENT MIDDLE EAR INFECTION
• RECURRENT UPPER RESPIRATORY INFECTION  DUE TO BLOCKAGE OF MUCOSAL DRAINAGE LEADING TO POST NASAL DRIP FROM NOSE TO THROAT
• PEOPLE WHO DEVELOP FREQUENT BAROTRAUMA DURING FLIGHT OR DEEP SEA DIVING
• CHILDREN WHO MOUTH BREATH AND HAS NOISY BREATHING (STERTOR)
- PART OF SLEEP APNOEA SURGERY TO CREATE PATENT AIRWAY

WHAT BENEFIT DOES LASER ASSISTED ADENOIDECTOMY HAVE?

• LESS PAIN
- PRECISE PROCEDURE WITH DIRECT VISION USING ENDOSCOPE AND CAMERA
• FASTER RECOVERY
• SAFER
• WELL DEFINED REMOVAL OF ADENOID WITHOUT ACCIDENTAL INJURY TO THE CERVICAL VERTEBRAE OR SURROUNDING VITAL STRUCTURES
• PARTIAL REMOVAL OF ADENOID FOR RECURRENT EUSTACHIAN TUBE OBSTRUCTION
• LESS BLEEDING
• LESS INCIDENCE OF PHARYNGEAL STENOSIS
- LESS INCIDENCE OF EUSTACHUAN TUBE INJURY

WHAT ARE THE RISKS INVOLVED?

• MINIMAL RISK
• LESSER THAN THE CONVENTIONAL (OLDER) METHOD OF REMOVIG ADENOID

WHAT IS A GOOD AGE?

• NO SPECIFIC AGE

PROCEDURE

• DISCUSS WITH THE DOCTOR
• DAY CARE PROCEDURE / ADMIT OVER NIGHT
• SURGERY DONE UNDER GENERAL ANAESTHESIA
• PATEINT IS INTUBATED DURING SURGERY (AIR WAY TUBE PLACED FOR BREATHING)
• LASER PRECAUTION TAKEN DURING ALL LASER PROCEDURES
• TIME TAKEN IS ABOUT 15 MINUTES
• POST SURGERY – ONCE THE PATIENT IS CONSCIOUS, PATIENT IS ABLE TO EAT NORMAL DIET
• FOLLOW UP IS AFTER 5 DAYS TO 1 WEEK AFTER SURGERY
• BACK TO NORMAL DUTY ( SCHOOL OR WORK ) IN 1 OR 2 DAYS

WHAT TYPE OF LASER IS USED?

CO2 LASER

FUTURE PLANS

TO START LASER ADENOIDECTOMY AS A LOCAL ANAESTHESIA PROCEDURE


Surgical pictures

1) Pre operative picture: large adenoid obstructing the left eustachian tube and causing airway obstruction







Post endoscopic laser adenoidectomy: the eustachian tube are open and no airway obstruction

5 days post operation : note the left eustachian tube is open



1 month  post laser