Evolution of Technology

Coblation

Coblation stands for controlled ablation. The technology uses radiofrequency in combination with low temperatures to “ablate” tissues, commonly using a saline rinse to wash away ablated tissues. The temperature of coblation instruments ranges from 60 to 70 degrees Celsius, whereas electrocautery instruments may exceed 400 degrees Celsius. It has been proposed that this method causes less bleeding and postoperative pain than cold steel excision, and electrocautery, respectively. Coblation is also commonly used as a method for tonsillectomy.

Evolution of Procedure

Adenoidectomy

The surgical removal of the adenoids has typically been performed through a various number of methods. Using a laryngeal mirror, the adenoids are visualized through the mouth, and an instrument is used to remove or shrink the adenoid tissue. Traditionally, this is performed by methods such as cauterization, ablation, cold steel excision with a knife, and microdebridement. It is common for children undergoing tonsillectomy to have adenoidectomy performed at the same time. In addition, older children and those with multiple sets of ear tubes that are still having ear infections will typically consider adenoidectomy.

Evolution of Diagnosis

Adenoid Hypertrophy

Adenoid hypertrophy is unusual growth of the lymphatic tissue in the oropharynx known as the adenoid pad. Enlargement can cause obstruction of the nasal airways, leading to mouth breathing and snoring. It can also contribute to Eustachian tube dysfunction, leading to middle ear effusions and otitis media, commonly in pediatric patients. Enlarged adenoids for long periods during facial development can affect dentofacial growth, leading to an appearance classically referred to as “adenoid facies”, which means long face syndrome.