Whether or not an endotracheal tube is utilized for tonsillectomy and adenoidectomy (T & A) is frequently referable to the type of mouth gag employed and the patient's position on the operating table.
Patients operated in a head-up or partial sitting position are, of necessity, more frequently intubated than those operated in a head-down position.
Many anesthesiologists prefer to employ an endotracheal tube when administering anesthesia for T & A regardless of the patient's position or the type of gag used.
However, many otolaryngologists object to intubation, claiming that the orally placed tube restricts and interferes with operative maneuverability and the nasally placed tube interferes with efficient performance of adenoidectomy. This is especially so in young children, they claim, since the control of bleeding is made more difficult. A further objection to the routine endotracheal tube for T & A surgery involves the possibility of edema with possible tracheal obstruction
SHANE SM, TOWLEN IW, LAZARO BM, ASHMAN H. A Method of General Anesthesia for Tonsillectomy Without Ether or Endotracheal Tube. Arch Otolaryngol. 1960;72(2):178–182. doi:10.1001/archotol.1960.00740010183004
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