RESUMO
In this study, 49 adult patients with adenoid, proved endoscopically, were recorded. Clinical evaluation was done to detect any associated otorhinologic 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 and 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, a transnasal approach with a straight Blakesley forceps or diode laser was adopted. 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 entopic adenoid tissue in the choanae. Associated nasal pathology [e.g. septal deviation, hypertrophy mucosa on the turbinated] was present in cases with nasopharyngeal and choanal adenoid, while the associated aural complication 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. The combined method of a transoral and transnasal 0 or 30 and 70 endoscopic 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 of choanae. This method has the potential to become the procedure of choice for adenoidectomy