Comparison of two different adenoidectomy techniques with special emphasize on postoperative nasal mucociliary clearance rates: Coblation technique vs. cold curettage

Abstract

ObjectiveTo compare the cold curettage and coblation techniques for pediatric adenoidectomy by means of intraoperative blood loss, operation time, and pre- and postoperative nasal mucociliary clearance rates. MethodsThe study included 60 consecutive patients undergoing adenoidectomy operation upon the diagnosis of adenoid hypertrophy ranging in age 4–8 years (mean age: 5.82±1.25 years). Two groups consist of 30 patients. The two different adenoidectomy techniques were compared by means of intraoperative blood loss, operation duration, preoperative and postoperative nasal mucociliary clearance rate (NMCR) values. The nasal mucociliary clearance was described as the velocity (mm/min) of nasal mucociliary transport of the 99mTc-MAA droplet. Rhinoscintigraphy was performed on right nasal cavity before and after the surgery in all the patients. ResultsThe average NMCR of the curettage adenoidectomy and coblation adenoidectomy groups before surgery was 1.33±0.20mm/min and 1.35±0.19mm/min, respectively. There was no statistically significant difference between the two groups before surgery (p=0.615). In the six weeks of the post-operative period, the average NMCR of the curettage adenoidectomy and coblation adenoidectomy groups were 1.80±0.21mm/min and 2.06±0.31mm/min, respectively. The NMCR differences of preoperative and postoperative periods in coblation adenoidectomy group were higher than curettage adenoidectomy group (p<0.001). Mean operative time was 20.5±5.5min for coblation adenoidectomy group (n: 30), and 13.5±5.2min for curettage adenoidectomy group (n: 30). Mean intraoperative blood loss was 5.25±3.5ml for coblation adenoidectomy group, and 21.55±8.2ml for curettage adenoidectomy group. The difference between mean intraoperative blood loss and operative time of two groups were statistically significant (p<0.05). ConclusionThe coblation technique provides a less bleeding surgical bed but a longer operation time when compared to curettage technique. Also the better NMCR values that we have found with coblation adenoidectomy may be translated to a more rapid recovery of ciliary function of the surface mucosa.