The Institute of Plastic reconstructive surgery «Virtus» is equipped with a unique set of diagnostic equipment (endoscopic diagnosis with video fixation). Narrow Band Imaging (NBI), a powerful optical image enhancement technology, is based on the narrow band of blue and green light to illuminate the area under study, which falls in the hemoglobin absorption band. NBI (early diagnosis of malignant tumors) allows to identify problems objectively and choose the necessary method of treatment (surgical or therapeutic). Narrow band imaging is not worse than chromoendoscopy in identifying foci of precancer and early cancer.
Technique of Adenoidectomy
Removal of adenoids by laser.
Modern laser devices show unsurpassed results in various fields of surgery. A Department of Laser Technologies of the clinic «Virtus» is equipped with the latest models of laser devices made in Germany and Italy.
The technology is classified into two types of manipulations:
- Coagulation – using a focused laser beam, the surgeon removes the adenoid growths of all sizes (more frequently in large adenoids)
- Valorisation – the lymphoid tissue is evaporated in layers
The technique is ideally suited for the removal of small size adenoids. The doctor can choose the best type of the apparatus for a particular operation. For example, small adenoid vaporization is carried out by means of carbon dioxide laser.
Advantages of the laser are:
- Small trauma
- High accuracy
- Pronounced analgesic, anti-inflammatory, anti-bacterial properties of the laser beam
- Minor bleedings or their absence
- Minimum recovery period after surgery
- High efficacy at relatively low cost
To perform endoscopy a special thin probe – endoscope equipped with optical systems is used. A surgeon makes the examination of the area, and a computerized system displays a large-scale image, which shows the details that cannot be seen during the routine examination.
Advantages of the endoscopic examination are:
- Painlessness of the procedure
- An excellent alternative to X-ray of the nasopharynx and absence of dangerous radiation
- Detection of abnormalities invisible during routine ENT examination
- The possibility of visual assessment of the real extent of inflammation
The procedure for removing the adenoids using endoscopy is carried out in several ways:
- Using the so-called electrocoagulation «Loop», heated up to a temperature required for prevention the possibility of bleeding when removing the adenoids
- Shaver adenotomy is performed using a special microdebrider (shaver), having a fixed element with a sharp blade inside at the end. The cut off tissue is ground by the blade and removed by suction
Advantages of shaver adenotomy are:
- Sparing approach
- Accurate removal of the lymphoid tissue from the nasopharynx
- Coblation (is a modern method of removing the soft tissue, using cold plasma electrosurgical devices with a low temperature of the beam – no more than 60°C)
Advantages of coblation are:
- Prevention of the healthy tissue damage due to the minimum thickness of the plasma beam
- Reduction of bleeding due to the effects of coagulation
- Minimization of pain (during surgery and rehabilitation period) due to the complete absence of the thermal effect on the tissue
- Easy-to-use design of plasma electrodes, allowing to treat the inflamed tissue in the most remote places
- Reduced hospital-stay
Endoscopic adenotomy may be supplemented by a laser/radiowave treatment for more careful treatment of the operated area and reduced risk of relapse. The price of adenoidectomy will vary depending on the method chosen. The surgery usually takes about an hour.
The quality of the operation is of importance. If the adenoid tissue is not removed completely, there is a risk of recurrence. Besides, whatever operation technique is chosen, in some cases it is important to go through special procedures for normalization of nasal breathing and hearing restoration. This approach minimizes the risk of complications and relapses.