ANESTHESIA:  General

PROCEDURE IN DETAIL: 
The patient was brought to the operating room, and consent and identity were verified.  General anesthesia was induced, and the patient was intubated by the Anesthesia team.  The bed was spun 90 degrees.  FiO2 was lowered to less than 35%.  Operative time-out was performed to confirm the correct patient, procedure, and laterality.

A shoulder roll was inserted.  A folded towel was used to protect the eyes and upper face.  The Crowe-Davis mouth gag was inserted to expose the oropharynx, and the patient was suspended from the Mayo stand.  The tonsils and palate were inspected and palpated.  No submucous cleft palate was appreciated.  The right tonsil was grasped with a curved Allis clamp and removed using electrocautery in an extracapsular dissection plane.  The left tonsil was removed in a similar fashion.  In accordance with the literature, the tonsils were not sent for pathology given that there was no clinical concern for malignancy and no gross abnormality of the tonsils intraoperatively.  The tonsillar fossae were examined and hemostasis was achieved with suction Bovie.

A red rubber catheter was inserted through the right nasal cavity and used to retract the soft palate anteriorly.  A mirror was used to visualize the adenoids.  The adenoids were reduced using suction Bovie, taking care to protect the toris tubaris bilaterally and preserve a ridge of tissue inferiorly.

The red rubber catheter was removed.  The nasopharynx and oropharynx were irrigated.  The patient was let down from suspension and the tension on the mouth gag was removed for 30 seconds.  The oropharynx was then re-exposed and inspected.  Any remaining areas of bleeding were addressed with electrocautery until hemostasis was ensured.  An orogastric tube was passed into the stomach, which was suctioned of its contents.  The Crowe-Davis mouth gag was removed, and the lips, tongue, teeth, and gums were inspected and found to be free of any injuries.  The shoulder roll was removed.  The patient was turned over to Anesthesia, awakened, extubated, and taken to the recovery room in good condition.

COMPLICATIONS:  None.

SPECIMENS:  None.

BLOOD LOSS:  Minimal.

DISPOSITION:  PACU and home.