Pediatric endoscopic transnasal adenoid ablation.

We describe a technique in which suction diathermy is used for adenoid ablation through a solely endoscopic transnasal approach in the older pediatric population. This procedure has proved to be both effective and convenient during other transnasal endoscopic procedures, as it provides excellent visualization of both the superior and inferior parts of the nasopharynx and results in minimal to no bleeding in the adenoid bed. In all cases to date, there has been complete resolution of preoperative problems of infection, pain, and bleeding. All patients had good control of postoperative pain. There has been no evidence of postoperative nasopharyngeal stenosis and no velopharyngeal insufficiency. Although transnasal adenoid ablation is not appropriate for the entire pediatric population, this procedure has multiple benefits when another endoscopic sinonasal procedure is planned, when there is neck instability, or when enhanced visualization of the nasopharynx is desired.