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| Main Authors: | , , , , , |
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| Formato: | Recurso digital |
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Zenodo
2026
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| Acesso em linha: | https://doi.org/10.5281/zenodo.19277257 |
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Sumário:
- <p><span>Pediatric tonsillectomy and adenoidectomy remain among the most frequently performed surgical procedures in children, primarily indicated for recurrent tonsillitis and obstructive sleep apnea. A comprehensive understanding of surgical anatomy is essential to optimize outcomes, as the palatine tonsils are closely related to the superior constrictor muscle and possess a rich vascular supply that influences intraoperative bleeding and postoperative hemorrhage risk. Similarly, the anatomical position of the adenoids within the nasopharynx explains their role in airway obstruction and middle ear dysfunction. Despite their immunological function within Waldeyer’s ring, current evidence supports the long-term safety of surgical removal without significant impairment of immune competence.</span><span> </span><span>Indications for surgery are guided by established clinical criteria and validated symptom assessment tools. Adenotonsillectomy has demonstrated substantial reductions in apnea–hypopnea index values and meaningful improvements in quality of life, behavior, neurocognitive performance, and growth in children with obstructive sleep apnea. However, persistent disease may occur in selected populations, requiring individualized follow-up and management.</span><span> </span><span>Advances in surgical techniques have improved perioperative safety and recovery. Cold steel dissection, electrocautery, coblation, harmonic scalpel, and intracapsular tonsillotomy each present distinct operative profiles. Intracapsular and energy-based approaches are generally associated with reduced postoperative pain, lower hemorrhage rates, and faster return to normal activities. In adenoidectomy, techniques incorporating direct visualization decrease residual tissue and revision risk compared to blind curettage.</span></p>