Evolution of Adenoid Surgery

Abstract

Adenoid, also known as the Luschka’s or nasopharyngeal tonsil, is a mass of lymphoid tissue located in the roof of nasopharynx. The term ‘adenoid’ was coined by Meyer. Earliest records of adenoid surgery date back to 1842, when Yearsley reported removal of mucus membrane from behind the uvula to improve ear function. Other techniques for adenoidectomy included bare fingernails or finger ring knife, which are considered obsolete now. From mid-1930s to early 1960s, radiation therapy of the adenoid was used extensively. Transoral adenoid curetting and electrical dissection techniques followed and became mainstay of treatment for a long time. Infact, these are still in use in many centres across the world. Like any other surgery, introduction of nasal endoscopes and powered instruments revolutionised adenoid surgery by greatly increasing the precision and minimising collateral damage. Plasma-mediated ablation (Coblation) promises ‘blood-less’ surgery. Presently, the trend is focussed towards using powered instruments (Microdebrider and/or Coblation) under endoscopic visualisation for complete adenoidectomy.