![]() The otolaryngologist uses monopolar cautery to successfully perform an extracapsular tonsillectomy and adenoidectomy. On the day of surgery, an anesthesiologist assesses his airway and he is placed under general anesthesia, intubated with an oral right angle endotracheal (RAE) tube. The remainder of his physical exam is normal.ĭue to his history of recurrent pharyngitis and description consistent with sleep-disordered breathing (SDB), his pediatrician refers him to an otolaryngologist and the decision is made to perform a tonsillectomy and adenoidectomy. There is no exudate, erythema, or tenderness over the sinuses, or bleeding inside his mouth. HEENT shows enlarged tonsils with pink and moist oral mucosa. He currently has no fever, sore throat, or cough.Įxam: VS T 37.1, P 80, RR 14, BP 118/74, oxygen saturation 99% in room air. There is no history of headaches in the morning, vomiting, or diarrhea. He has received multiple courses of antibiotics for recurrent episodes of pharyngitis. His schoolteacher has also complained to his parents about moments of aggressive behavior with his peers. He complains of tiredness during the day and has had declining performance in his 6th grade class. At night his parents have noticed that he sleeps with an open mouth and has episodes of restlessness. ![]() Tonsillectomy and AdenoidectomyĪn 11-year-old boy presents to the office with a chief complaint of difficulty breathing through the nose for the past 7 years.
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