Tonsillectomy and adenoidectomy is the commonest surgical operation, and it is natural that there should be a great variety of instruments and methods available for its performance. Almost any of these are satisfactory for surgeons experienced in their use.
The head-low, or so-called "upside down," position with the Crowe-Davis mouth gag is becoming more commonly used, indicating certain inherent advantages. The merits of the method may be listed as follows: 1. The airway is maintained by holding the tongue and hyoid structures forward. 2. Blood and secretions drain away from the operative field and the larynx. 3. Excellent exposure is obtained without constant manipulation of the tongue. This encourages careful removal of lymphoid tissue and complete hemostasis. 4. No assistant is necessary.
This method has certain disadvantages when the anesthetist is required to support the handle of the tongue blade manually. It becomes heavy and fatiguing, as he is working
WALLNER LJ. AN AID TO TONSILLECTOMY AND ADENOIDECTOMY IN THE HEAD-LOW POSITION. AMA Arch Otolaryngol. 1956;63(3):299–300. doi:10.1001/archotol.1956.03830090071019