CPT® Code 42830

1. Indications

The adenoidectomy procedure is indicated for various conditions related to the adenoids, particularly in pediatric patients. The following are the explicitly provided indications for performing an adenoidectomy:

• Recurrent Infections Patients who experience frequent episodes of otitis media (middle ear infections) or sinusitis may require adenoidectomy to alleviate these recurrent infections.
• Obstructive Sleep Apnea Children suffering from obstructive sleep apnea due to enlarged adenoids may benefit from this procedure to improve airflow and reduce sleep disturbances.
• Chronic Nasal Obstruction Persistent nasal obstruction caused by enlarged adenoids can lead to difficulty breathing through the nose, prompting the need for surgical intervention.

2. Procedure

The adenoidectomy procedure involves several key steps to ensure the effective removal of the adenoids. The following procedural steps are outlined:

• Step 1: Anesthesia and Preparation The patient is placed under general anesthesia to ensure comfort and immobility during the procedure. A mouth prop is then utilized to keep the mouth open, providing the surgeon with adequate access to the surgical site.
• Step 2: Resection of Adenoids The surgeon begins by retracting the soft palate to expose the adenoids. An appropriately sized adenoid curette is selected and positioned at the posterior edge of the vomer bone. The curette is then carefully pushed along the vault of the nasopharynx and over the odontoid process to effectively remove the adenoid tissue.
• Step 3: Inspection and Removal of Remnants After the initial resection, the surgical site is thoroughly inspected for any remaining adenoid tissue. If any remnants are identified, they are removed using a small curette or electrocautery to ensure complete excision and minimize the risk of regrowth.
• Step 4: Hemostasis To control any bleeding that may occur during the procedure, the surgeon employs cautery techniques and may use gauze sponges soaked in epinephrine to achieve hemostasis effectively.

3. Post-Procedure

Following the adenoidectomy, patients are typically monitored in a recovery area until they are stable. Post-procedure care may include pain management, hydration, and instructions for dietary modifications to ensure comfort during the recovery phase. Patients are advised to avoid strenuous activities and to follow up with their healthcare provider to monitor healing and address any concerns. It is important to educate caregivers about potential signs of complications, such as excessive bleeding or difficulty breathing, that may require immediate medical attention.