Complications of microdebrider assisted endoscopic adenoidectomy.

Abstract

Background: The adenoid is part of lymphoid tissue called Waldeyer’s ring. Pathological effects include rhinitis, rhino sinusitis, otitis media and otitis media with effusion. Failure of medical therapy in these conditions may need surgical intervention. Adenoidectomy is one of the most common surgical procedures in children, but many complications can occur as bleeding, velopharyngeal incompetence, and re growth of the adenoid. Aim of the study: To assess the complications of microdebrider assisted endoscopic adenoidectomy. Methods: This study is a prospective in natureconsisted of 100 patients. They were 55 males and 45 females. They had been assessed at the Al-Diwaniah Teaching Hospital, Al-Diwaniah city, Iraq, during the period of March 2017 to January 2020, the age ranges from 5-15 years. An inclusion criterion is adenoid hypertrophy causing one or more of the following: nasal obstruction, recurrent upper respiratory tract infections, recurrent acute otitis media, otitis media with effusion, or sleep apnea, not responding to adequate conservative therapy. Exclusion criteria are: small asymptomatic adenoid, bleeding tendency, patient required tonsillectomy and patient with craniofacial anomalies as cleft palate. All the patients had microdebrider assisted endoscopic adenoidectomy. Results: The post-operative pain was mild, reactionary haemorrhage recorded in 3 patients while secondary haemorrhage was not recorded. 2 patients developed adenoid recurrence. 1 patient developed nasopharyngeal blood clot. Infection occurred in 2 patients. Velopharyngeal incompetence occurred in 3 patients. Eustachian tube injury occurred in only 1 patient. Conclusion: Microdebrider Assisted Endoscopic Adenoidectomy (MAEA) provides direct visualization and controlled surgery so it is safe and decrease the rate of complications, and can be carried as day case surgery.