[Solved]: LOCATION: Outpatient, Hospital PATIENT: Heidi…

LOCATION: Outpatient, Hospital PATIENT: Heidi Marker SURGEON: Jeff King, M.D. PREOPERATIVE DIAGNOSIS: Chronic adenotonsillitis. POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Tonsillectomy and adenoidectomy. OPERATIVE NOTE: Heidi is an 18-year-old who was seen in the office and diagnosed with the above condition. The decision was made in consultation with the patient after explanation of the risks and benefits to undergo the above-named procedure. The patient was admitted through the Same Day Surgery program and taken to the Operating Room where she was administered a general anesthetic via intravenous injection. She was then intubated endotracheally. A Jennings gag was placed in the mouth and expanded. This was secured to the Mayo stand. Two red rubber catheters were placed through the nose and brought out through the mouth. These were secured with snaps. This was done to elevate the palpate. A laryngeal mirror was placed in the nasopharynx. The adenoid tissue was visualized. Using suction cautery, the adenoid tissue was removed in a systematic fashion. Once this was completed, the red rubbers were released and brought out through the nose. The right tonsil was then grasped with Allis forceps and retracted medially. Using electrocautery, the capsule was identified laterally. The tonsil was removed from its fossa in an inferior to superior fashion. Once this was completed, the bed was inspected and no bleeding was noted. The left tonsil was then grasped with Allis forceps and retracted medially. Again, electrocautery was used to identify the capsule laterally. The tonsil was removed from its fossa in an inferior to superior fashion. Once this was completed, the bed was inspected and no bleeding was noted. Three tonsillar sponges soaked in 0.5% Marcaine with epinephrine were then placed in the nasopharynx and one in each tonsil bed. These were left in position for five minutes. At the end, they were serially removed. The beds were inspected and no further bleeding was noted. The gag was then released and removed from the mouth. The TM joint was checked. The patient was then allowed to recover from the anesthetic and taken to the Post Anesthesia Care Unit in stable condition. There were no complications during this procedure. Pathology Report Later Indicated: Upon submission of tonsils and adenoids, examination confirms chronic inflammatory tissue.