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.  Operative time-out was performed to confirm the correct patient, procedure, and laterality.

The operative microscope was used to clean the left ear canal of cerumen.  A radial myringotomy was made in the anterior-inferior quadrant of the tympanic membrane.  The middle ear was suctioned with the findings listed above.  An Armstrong grommet style tube was placed, and ciprofloxacin drops were instilled.  A cotton ball was placed in the conchal bowl.

Attention was turned to the right ear.  The operative microscope was used to clean the canal of cerumen.  A radial myringotomy was made in the anterior-inferior quadrant of the tympanic membrane.  The middle ear was suctioned with the findings listed above.  An Armstrong grommet style tube was placed, and ciprofloxacin drops were instilled.  A cotton ball was placed in the conchal bowl.  

The bed was spun 90 degrees.  FiO2 was lowered to less than 35%.  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.  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 and suctioned.  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.