Adenoids in adult clinical and serological study, and endoscopic management

الملخص EN

Abstract: In this study 49 adult patients with adenoid, proved endoscopically, were recorded.

Clinical evaluation was done to detect any associated oto-rhinologic pathology.

Serological tests for HIV, Epstein-Barr virus and cytomegalovirus was studied in the serum of these patients before surgery.

Also, serial CT scan on the paranasal sinuses, tympanometry and acoustic nasometric analysis were done to all patients.

A safe and more effective technique was proposed to be performed using endoscopic direct visualization during adenoidectomy in adults using 4:0 mm 0, 30 &70 endoscopes.

The adenoid curette was applied transorally to the nasopharynx to remove the main bulk of the adenoids.

To remove the peritubal residual adenoid tissue or any residual adenoid tissue obstructing the choanae, we adopted a transnasal approachwith a straight Blakesley forceps or diode laser.

This study showed that in our locality, adenoid in adults is not uncommon problem especially in females .

Endoscopically, the adenoid was seen to be located on the posterior wall of the nasopharynx or as an ectopic adenoid tissue in the choanae Associated nasal pathology (e.g.

septal deviation , hypertrophic mucosa on the turbinates) was present in cases with both nasopharyngeal and choanal adenoid while the associated aural complications did not recorded with choanal adenoid.

Serological findings revealed that most cases showed positive cytomegalovirus IgG (86.8%) indicating old infection .

HIV and Infectious mononucleosis spot test were negative in all cases (100%).

The combined method of a transoral and transnasal 0 or 30 &70endoscopic approach offered a clear operative field.

The surgical procedures were all performed under direct visualization.

None of the 49 patients had complications, such as postoperative nasopharyngeal hemorrhage or injury to the eustachian tube or choanae.

This method has the potential to become the procedure of choice for adenoidectomy