Numerous techniques have been described both for exposing the nasopharynx to direct view and for dealing with the diseased adenoid visualized. A historical resumé of these was presented in two previous publications.* The purpose of the present paper is to discuss these methods in a comparative way. This will be done under several headings.
Shortcomings of Blind Adenoidectomy
Although nowhere explicitly stated as such, a "decompressive" concept of adenoidectomy seems to have been implicit in much of the thinking about adenoid surgery before the introduction of the direct technique by Andrew Love3 and L. K. Guggenheim.† While even a poorly done adenoidectomy will usually relieve postnasal obstruction due to a large central adenoid mass, such incomplete surgery will frequently fail to prevent recurring bouts of otitis media or to alleviate conduction hearing impairment due to obstruction of the Eustachian orifices. We know that many children whose nasopharynges are literally
GUGGENHEIM P. Direct Adenoidectomy: II. Technical Aspects. AMA Arch Otolaryngol. 1956;64(5):361–372. doi:10.1001/archotol.1956.03830170011002
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