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Background and Objectives:Because of its advantage over the conventional method, power-assisted adenoidectomy has become microdebrider to achieve the most successful outcome in patients with various configuration of adenoid vegetation. Subjects and Method:One hundred ninety-one patients who underwent adenoidectomy in the department of Otolaryngology at Inje University Seoul Paik Hospital from January 2000 to February 2006 were reviewed by charts and recorded video tapes for the techniques that we applied to these patients. Results:Four diferent combinations can be created from two diferent angles of endoscope and microdebrider;transnasal 0° (TN ), transnasal 0° endoscopic guided transoral adenoidectomy using curved microdebrider (TNTO), transoral 70° endoscopic guided transnasal adenoidectomy using straight microdebrider (TOTN) and transoral 70° endoscopic guided transoral adenoidectomy using curved microdebrider (TOTO). TOTO was the most frequent combination for simple adenoid vegetation. However, it is t combined technique was TNTN, which has inherent limitation to use in small sized nares and younger age. In this situation, TOTN is a better alternative to use. Conclusion:From six years of experience, we confirmed that endoscopic guided power-asisted adenoidectomy should be performed with proper combination of endoscope and microdebrider based on the location and configuration of adenoid vegetation. The most ideal combination we consistently applied for removal of adenoid is as follows;first, TNTO, secondly, TOTO. Lastly, TOTN could be useful in selected cases. ;50 :53-8)

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