title: Powered instrumentation for transnasal endoscopic partial adenoidectomy in children with submucosal cleft palate.
abstract: OBJECTIVE
  Partial adenoidectomy is the selective removal of the obstructing part of adenoid tissue, thus relieves obstruction symptoms and preserves the velopharyngeal valve action. Patients with palatal dysfunction are candidates for the technique. This study describes the use of microdebrider, transnasally (guided by the nasal endoscope) to perform partial adenoidectomy in patients with submucosal cleft palate, who presented with adenoidal hypertrophy and also it discusses its effects on nasal obstruction and speech.
  
  
  METHODS
  This prospective study was carried out on twenty-three submucosal cleft palate patients who were referred to the ORL-HN department; Zagazig University Hospitals complaining of respiratory obstruction and sleep disturbances due to adenoids hypertrophy. After preoperative nasoendoscopic and speech evaluation, transnasal endoscopic, power-assisted partial adenoidectomy was done for all patients. All patients were followed up at regular visits including nasoendoscopy and speech evaluation.
  
  
  RESULTS
  The procedure insured fast, safe, reliable, under vision and well controlled steps. Intraoperatively no major complications were recorded. During follow up, nasal obstruction and respiratory obstruction symptoms were improved. Speech outcome results were reported.
  
  
  CONCLUSIONS
  The study demonstrates the feasibility of using the microdebrider for performing transnasal partial adenoidectomy (under endoscopic guidance). The procedure is precise, rapid, safe and well-tolerated with the advantage of direct visualization of a traditionally difficult-to-expose area. The study reported improvement of respiratory obstruction symptoms with good speech results.
authors.affiliation: ORL-HN Surgery Department, Faculty of Medicine, Zagazig University, Zagazig City, Sharkia Governorate, Egypt. Electronic address: askr_sh@yahoo.com.
authors.forename: Sherif M
authors.initials: SM
authors.lastname: Askar
authors.affiliation: Phoniatrics Unit, ORL-HN Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
authors.forename: Amal S
authors.initials: AS
authors.lastname: Quriba
mesh_terms: D000233:Adenoidectomy / Q000295:instrumentation*; D000234:Adenoids / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D002972:Cleft Palate / Q000601:surgery*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D009297:Nasal Mucosa / Q000601:surgery*; D015508:Nasal Obstruction / Q000601:surgery*; D011446:Prospective Studies
keywords: Partial adenoidectomy; Powered instrumentation; Submucosal cleft palate