Surgical treatment of adenoids in adults with the use of laser technology
Kunelskaya N.L.^1,2, Tsarapkin G.Y.^1, Kucherov A.G.^1, Tovmasyan A.S.^1, Arzamazov S.G.^1, Panasov S.A.<sup>1

1</sup> Scientific Research Clinical Institute of Otorhinolaryngology named after L.I. Sverzhevsky, Moscow
² Russian National Research Medical University named after N.I. Pirogov, Moscow 

Adenoid vegetations are among the most common pathology of the upper respiratory tract in children. According to some authors, adenoids can occur in the adult population, causing a number of clinically significant symptoms. Considering the presence of more pronounced intraoperative bleeding in adenotomy in the adult contingent of patients, the development and improvement of sparing methods of surgical treatment of pharyngeal tonsil hypertrophy is extremely urgent.
Purpose of the study: improvement of methods of surgical treatment for adenoids in adults, taking into account morpho-functional features of adenoid tissue.
Patients and methods: we examined and treated 69 patients diagnosed with adenoid vegetations of grade II-III. Patients were divided into two groups (the main group,  n = 33 and control group, n = 36). Patients of the main group underwent laser adenotomy. In the control group of patients classical adenotomy of Becken's adenotome was performed, the removed adenoid tissue was sent for histological examination. In the postoperative period, the volume of intraoperative bleeding, the severity of the pain syndrome, the presence of scar deformation of the nasopharynx, the presence of delayed bleeding in patients of both groups was assessed.
Results: By histological examination of the removed adenoid tissue of the patients of the main group, we revealed the characteristic morphological features of the adenoid tissue, which explained the more pronounced intraoperative bleeding. When analyzing the results of laser adenotomy in comparison with the "cold method," we obtained objective data, which made it possible to consider this technique as a justified and effective method for removing adenoids.
Conclusions: expressed intraoperative bleeding in adenotomy in adults is due to morpho-functional features of adenoid tissue in this contingent of patients. The use of a holmium laser in adenotomy is a valid, safe method of surgical treatment of adenoids.

Key words: adenoids, surgical treatment of pharyngeal tonsil hypertrophy, holmium laser, morphological features of adenoid tissue, adenoids in adults, prevention of bleeding in adenotomy.
For citation: Kunelskaya N.L., Tsarapkin G.Y., Tovmasyan A.S. et al. Surgical treatment of adenoids in adults with the use of laser technology // RMJ. 2017. № 6. P. 396–399.