Our Summary

This research paper is about a common surgery in children, called adenoidectomy (removal of the adenoids), which is often done along with tonsillectomy (removal of the tonsils). The surgery is quick and usually done in a day. However, managing a child’s airway during the surgery can be a bit tricky since both the surgeon and the anesthesiologist need access to it. Traditionally, a tube placed into the windpipe (endotracheal tube or ETT) is used, but recently a device called a laryngeal mask airway (LMA) is being used more frequently. The researchers looked back at data from 210 surgeries over a 4-year period to compare the use of LMA versus ETT. They found that LMA was used more often and had fewer breathing complications than ETT. Also, fewer muscle relaxants were needed when the LMA was used. The amount of pain medication needed during surgery was about the same for both groups. The study suggests that LMA is a good alternative to ETT for this type of surgery.

FAQs

  1. What is an adenoidectomy and how is it usually performed?
  2. What are the differences between using an endotracheal tube (ETT) and a laryngeal mask airway (LMA) during adenoidectomy?
  3. Based on the research, what benefits does the use of a laryngeal mask airway (LMA) provide over the traditional endotracheal tube (ETT) in adenoidectomy?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about adenoidectomy is to follow post-operative care instructions carefully, including avoiding strenuous activities and eating soft foods to help with healing. It is also important to stay hydrated and get plenty of rest to aid in recovery. If any unusual symptoms or complications arise, such as difficulty breathing or excessive bleeding, it is important to contact your healthcare provider immediately.

Suitable For

Patients who are typically recommended adenoidectomy include:

  1. Children with recurrent or chronic ear infections: Enlarged adenoids can block the Eustachian tube, leading to fluid buildup in the middle ear and recurrent infections.

  2. Children with sleep-disordered breathing or obstructive sleep apnea: Enlarged adenoids can obstruct the airway during sleep, leading to breathing difficulties and disrupted sleep patterns.

  3. Children with chronic nasal congestion or sinus infections: Enlarged adenoids can block the nasal passages, leading to chronic congestion and recurrent sinus infections.

  4. Children with speech or swallowing difficulties: Enlarged adenoids can obstruct the back of the throat, leading to speech or swallowing difficulties.

  5. Children with frequent sore throats or tonsillitis: Enlarged adenoids can contribute to chronic throat infections, leading to frequent episodes of sore throat or tonsillitis.

Overall, adenoidectomy may be recommended for children who have persistent symptoms related to enlarged adenoids that do not improve with conservative treatment options.

Timeline

Before the adenoidectomy:

  1. Patient is evaluated by a physician and diagnosed with adenoid hypertrophy.
  2. Surgery is scheduled and pre-operative instructions are given to the patient and their family.
  3. Patient undergoes pre-operative testing and clearance.
  4. Patient arrives at the hospital or surgical center on the day of surgery.
  5. Anesthesia is administered to the patient before the surgery begins.

After the adenoidectomy:

  1. Adenoids are removed using surgical instruments.
  2. Patient is monitored in the recovery room post-surgery.
  3. Patient may experience some pain and discomfort in the throat.
  4. Patient is discharged home with post-operative care instructions.
  5. Patient may experience sore throat, difficulty swallowing, and mild bleeding for a few days after surgery.
  6. Patient follows up with their physician for a post-operative evaluation.
  7. Patient gradually resumes normal activities as they recover from the surgery.

What to Ask Your Doctor

  1. What are the benefits of using a laryngeal mask airway (LMA) compared to an endotracheal tube (ETT) during adenoidectomy surgery?
  2. Are there any potential risks or complications associated with using an LMA instead of an ETT for this type of surgery?
  3. How does the use of an LMA versus an ETT impact the recovery process for the child after adenoidectomy surgery?
  4. Will the choice between an LMA and an ETT affect the length of time the child will need to stay in the hospital or recovery room after surgery?
  5. How experienced is the surgical team with using an LMA for adenoidectomy surgery, and what is their success rate with this method?
  6. Will the choice between an LMA and an ETT impact the child’s ability to breathe or swallow normally after surgery?
  7. Are there any specific factors about my child’s health or medical history that may make one airway management technique more suitable than the other for their adenoidectomy surgery?
  8. How will pain management during and after surgery be affected by the use of an LMA versus an ETT?
  9. Are there any alternative airway management techniques that could be considered for my child’s adenoidectomy surgery, and what are the pros and cons of each option?
  10. What follow-up care and monitoring will be necessary after the surgery, particularly in relation to the choice between an LMA and an ETT for airway management?

Reference

Authors: Matanović EP, Pašalić T, Botica I, Curić-Radivojević R. Journal: Acta Clin Croat. 2023 Apr;62(Suppl1):29-34. doi: 10.20471/acc.2023.62.s1.03. PMID: 38746611