Rhinologic uses of powered instrumentation in children beyond sinus surgery

Powered instrumentation is now available for a variety of sinonasal procedures in children. Microdebriders with continuous suction at the operative site allow increased precision for complex procedures that often were difficult in small, fragile, pediatric noses. These instruments can be used for functional endoscopic sinus surgery in children and for such procedures as benign and malignant sinonasal or base of skull tumors, choanal atresia, complicated adenoidectomies, dacrocytorinostomies, septal spurs, and recurrent respiratory papillomatosis. These instruments can remove mucosa, neoplastic tissue, cartilage, thin bony septations, nasal debris, and blood under continuous endoscopic visualization. Edematous mucosa is not stripped, but trimmed and preserved, allowing much more rapid postoperative healing because exposed bone is avoided.