Conventional Adenoidectomy Research Articles

A comparative study of endoscopic assisted curettage adenoidectomy with conventional adenoidectomy

<p class="abstract"><strong>Background:</strong> In ENT adenoidectomy is a commonly performed surgery. It is conventionally done using the curettage method. This present study aims to evaluate endoscopic assisted curettage<strong> </strong>adenoidectomy as an alternative.</p><p class="abstract"><strong>Methods:</strong> The present study consisted of forty cases requiring adenoidectomy were divided into two groups of twenty each. In Group A adenoidectomy was done by conventional curettage method and in Group B by endoscopic assisted micro-debrider adenoidectomy. The parameters studied between two groups were intra-operative time, intra-operative bleeding and completeness of resection .The study period was from June 2015 to December 2016. </p><p class="abstract"><strong>Results:</strong> The average time taken in Group A (conventional surgery) was 5.30 minutes and in Group B (powered endoscopic surgery) was 12.30 minute. The average blood loss in Group A was 35 ml (range 10–50) as compared to 30 ml in Group B. Nearly 25 % of the patients who underwent endoscopic assisted adenoidectomy had grade II adenoids. About 30% of the patients who underwent conventional adenoidectomy had Grade III adenoids. A total of 10% of the patients developed primary haemorrhage which was more in conventional adenoidectomy (15%) as compared to endoscopic adenoidectomy (5%).</p><strong>Conclusions:</strong>Endoscopic assisted microdebrider adenoidectomy was found to be a safe and effective tool for adenoidectomy. Endoscopic adenoidectomy better for completeness of resection, accurate resection under vision. On the other hand, in conventional adenoidectomy operative time and intra-operative bleeding was less.<p> </p>

A comparative study between coblation adenoidectomy and conventional adenoidectomy

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the advantages and results between coblation adenoidectomy and conventional adenoidectomy by curettage.</p><p class="abstract"><strong>Methods:</strong> The study was<strong> </strong>conducted in Stanley medical college, Chennai (a tertiary care centre) from June 2013 to June 2016. Fifty patients were studied who underwent adenoidectomy. Twenty five patients underwent conventional adenoidectomy by curettage and rest by nasal endoscopy assisted coblation adenoidectomy. Following outcomes were evaluated: pain score on first day, days reporting pain, analgesic days, school absenteeism, endoscopic adenoid grading and intraoperative bleeding. </p><p class="abstract"><strong>Results:</strong> Patients who underwent coblation adenoidectomy showed better results during follow up with lesser complications.</p><p class="abstract"><strong>Conclusions:</strong> Coblation adenoidectomy is a better technique when compared to conventional technique of curettage.</p>

A comparative study of adenoidectomy by microdebrider vs conventional method

<p class="abstract"><strong>Background:</strong> Adenoidectomy is a commonly performed ENT surgery. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative for conventional curettage method.</p><p class="abstract"><strong>Methods:</strong> Sixty consecutive cases requiring adenoidectomy were randomized into two groups of thirty each. Group A underwent endoscopic assisted micro-debrider adenoidectomy and Group B underwent conventional adenoidectomy using the curettage method in study period from November 2015 to May 2017. </p><p class="abstract"><strong>Results:</strong> The average time taken in Group A was 34.10 minutes and in Group B was 22.83 minutes (p<0.001). The average blood loss in Group A was 29.57 ml as compared to 16.67 ml in Group B (p<0.001). The resection was invariably complete in Group A whereas five (16.7%) cases had more than 50% residual adenoid tissue in Group B. Four cases in group B had collateral damage whereas in Group A, there were no added injuries. Post operative pain was studied only in cases undergoing adenoidectomy alone. Group A (n=8) demonstrated a pain score of 3.50 – 3.09 whereas Group B (n=11) demonstrated a pain score of 2.75-2.55. In group A, the mean recovery period was 2.80 days and 8.23 days in Group B (p<0.001).</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic powered adenoidectomy was found to be a safe and effective tool for adenoidectomy. The study parameters where endoscopic powered adenoidectomy fared better were completeness of resection, accurate resection under vision, lesser collateral damage and faster recovery time. On the other hand, conventional adenoidectomy scored in matter of lesser operative time and intra-operative bleeding.</p>

Comparison of microdebrider assisted adenoidectomy and adenoid curette adenoidectomy

<p class="abstract"><strong>Background:</strong> Adenoidectomy is the surgical procedure to remove the adenoids. It is conventionally performed using the curettage method. The aim is to compare between adenoid curette adenoidectomy and microdebrider assisted adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> From April 2016 to March 2017, 50 patients (34 males and 16 females), requiring adenoidectomy were randomized into two groups each of twenty five. Group A underwent microdebrider assisted adenoidectomy. Group B underwent conventional adenoidectomy using the curettage method. The parameters studied were intra-operative time, blood loss, residual tissue, associated trauma, and post-operative symptomatic relief and complications. </p><p class="abstract"><strong>Results:</strong> Microdebrider assisted adenoidectomy was significantly better in terms of residual tissue left behind as compared to adenoid curette adenoidectomy (p<0.001), similar operative blood loss and operative time with no difference in complications.</p><p class="abstract"><strong>Conclusions:</strong> Microdebrider-assisted adenoidectomy is a safe and effective alternative to curettage method as it allows complete removal of adenoid tissue under direct vision.</p>

Comparative study between radiofrequency coblation and traditional adenoidectomy

Background Adenoid hypertrophy is known to be the most common cause of nasal obstruction in children; thus, adenoidectomy with or without tonsillectomy is one of the most commonly performed surgical procedures in the pediatric population. The widely used conventional curette adenoidectomy was first described. Dissatisfaction with this technique led to the use of other methods, including powered-shaver adenoidectomy, bipolar electrocautery, coblation, and LASER. Aim This study aimed to compare the endoscopic-assisted coblation adenoidectomy to conventional adenoidectomy (by cold instruments) in terms of safety, efficacy, results, and complications. Patients and methods Eighty patients were diagnosed depending on history, clinical examination, and radiology. The patients were operated on by either conventional or coblation adenoidectomy and divided into two groups: the patients in group A underwent conventional adenoidectomy, whereas the patients in group B underwent coblation adenoidectomy. The intraoperative parameters studied were operative time, intraoperative bleeding, and completeness of removal of adenoid. Postoperative parameters included assessment of postoperative pain, resolution time, and complications. Results It was found that although coblation has a longer operative time, it is a safe and effective alternative to curette adenoidectomy, it is more complete and accurate, there is less intraoperative blood loss, less postoperative pain, and fast resolution time, and fewer complications. Conclusion Coblation adenoidectomy proved to be safe and effective; however, reducing the cost is mandatory before considering it as the modality of choice for adenoidectomy.

Comparison of three different adenoidectomy techniques in children - has the conventional technique been surpassed?

IntroductionPharyngeal tonsil hyperplasia is the most frequent cause of nasal obstruction and chronic mouth breathing during childhood. Adenoidectomy is the procedure of choice for the resolution of these symptoms. It is not yet known, however, whether the conventional technique (“blind curettage”) has been surpassed by more modern adenoidectomy techniques (video-assisted, with the aid of instruments). This study aimed to compare the conventional adenoidectomy technique with two other emerging techniques, performed in a reference otorhinolaryngology center. MethodsThis is a prospective and observational study of 33 children submitted to adenoidectomy using 3 different techniques that were followed up for a period of 3 months after surgery. The patients were divided into 3 different groups, according to the adenoidectomy technique: Group A (conventional technique - "blind curettage”); Group B (video-assisted adenoidectomy with microdebrider); Group C (video-assisted adenoidectomy with radiofrequency – Coblation®). The surgical time of each procedure was measured, being considered from the moment of insertion of the mouth gag until complete hemostasis was achieved. The questionnaire for quality of life OSA-18 was applied to all caregivers on the day of the surgery and 30–90 days after the procedure. Postoperative complications were also analyzed. ResultsFor the entire patient sample, there was an improvement in quality of life after the surgery (p < 0.05). When analyzing the evolution of OSA-18 index, all groups showed statistically significant improvement, for all assessed domains. There were no statistically significant differences between the 3 techniques assessed for quality of life improvement after the surgery (p > 0.05). Regarding the duration of the procedure, the conventional technique showed the shortest surgical time when compared to the others (p < 0.05). No postoperative complications were noted, for any patient. ConclusionsThe adenoidectomy resulted in improvement of quality of life, and there were no major postoperative complications, for all operated children, regardless of the technique used. The conventional technique was faster when compared to the more modern adenoidectomy techniques.

Comparison of effects of nasal endoscopic adenoid body excision and conventional adenoid body shaving in the treatment of adenoid hypertrophy

Objective To compare the effect of adenoidectomy with adenoidectomy under nasal endoscope in the treatment of adenoid hypertrophy. Methods 120 cases with adenoid hypertrophy were selected as the research subjects.The patients were randomly divided into two groups by random number table, and the control group(n=60) was treated with routine adenoidectomy.The surgical treatment of the observation group(n=60) was performed under nasal endoscope.Surgical treatment, surgery related indicators(operative time, the average amount of bleeding, hospitalization time and the incidence of postoperative complications) were compared between the two groups.Before and after operation, acoustic rhinometry examination of nasopharynx was used to detect the smallest cross-sectional area and compared. Results In the observation group, the operation time, the average amount of bleeding, hospitalization time and incidence rate of postoperative complication were (5.32±2.05)min, (51.05±8.26)mL, (8.50±2.50)d, 15.00%, respectively, which in the control group were (8.56±2.68)min, (78.45±10.15)mL, (12.00±3.50)d, 36.67%, respectively, there were significant differences between the two groups(t=7.44, 15.98, 6.30, χ2=7.35, all P<0.05).12 months after surgery, the nasal minimal cross-sectional area of nasal pharynx in the observation group was (1.99±0.51)cm2, which of the control group was (1.81±0.48)cm2, there was significant difference between the two groups(t=3.99, P<0.05). Conclusion Compared with conventional adenoidectomy, endoscopic adenoidectomy in the treatment of adenoid hypertrophy has good clinical curative effect, less bleeding, shorter operative time and less postoperative complications and other advantages, it is worthy of promotion. Key words: Adenoidal hypertrophy; Adenoidectomy; Endoscopy; Child

The value of endoscopic examination at the end of conventional adenoidectomy

AimThe aim of this study was to evaluate the value of the use of endoscopes after a conventional curettage adenoidectomy for detecting any residual adenoid tissue and to determine whether removing any residual, if present, affects the recurrence or not.Patients and methodsFifty patients were divided randomly into two equal groups. Group A underwent a conventional curettage adenoidectomy, followed by an endoscopic examination of the nasopharynx to detect and remove any residual adenoid tissue. Group B underwent a conventional curettage adenoidectomy only. Both groups were followed up for recurrence of symptomatic adenoid at fixed follow-up intervals at 10 days, 1, 3, and 6 months postoperatively.ResultsThere was a significant difference in the rate of adenoid recurrence between both groups 6 months postoperatively. Two (8%) patients in group A and nine (36%) patients in group B developed recurrence. The P value was statistically significant at 0.04.ConclusionEndoscopic examination after a conventional adenoidectomy is a safe and essential step for complete removal of the adenoid, thus reducing the recurrence rate.

Combined Conventional and Endoscopic Microdebrider-Assisted Adenoidectomy: A Tertiary Centre Experience.

Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy. To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure. This is a prospective study of 60 child patients who underwent combined conventional and endoscopic microdebrider-assisted adenoidectomy. The study was conducted from September 2013 to September 2015. Only child patients with grade 3 and grade 4 Adenoid Hypertrophy (AH) was included in the study. At the end of conventional adenoidectomy and after combined procedure, the AH was graded again. Post-operative complications like neck pain, hypernasality and swallowing problems were noted. Their symptom score was reviewed before surgery and after one month and one year of surgery. The duration of surgery and amount of blood loss was recorded. By this technique, complete clearance of adenoid tissue was obtained in all 60 (100%) cases. The mean pre-operative symptom score for AH was 3.7, which improved to 0 after one month of combined conventional and endoscopic microdebrider-assisted adenoidectomy. All child patients were symptom-free at the end of one month and one year. The duration of conventional adenoidectomy was 5 minutes 12 seconds while total duration of the combined conventional and endoscopic microdebrider-assisted adenoidectomy was 14 minutes 45 seconds. There was no significant blood loss (15±3 ml approximately). There were no major complications in this study. The combined approach of conventional curette along with endoscopic microdebrider-assisted adenoidectomy is a safe and effective method for complete and accurate removal of large adenoids.

A Review and Outcome of Adenoidectomy Performed in Resource Limited Settings.

Adenoidectomy remains invaluable in alleviating the obstructive symptoms of adenoid enlargement in children. The aim of this study is to review the conventional method of adenoidectomy with a view to establish its role and success in resource limited setting. A 5-year retrospective review of pediatric patients that had adenoidectomy operations done at two tertiary healthcare facilities was conducted. The clinic, ward, theatre registers and the patients' case files were the sources of information. Patients that had adenoidectomy with other otolaryngological procedures were excluded from the study. Data generated were descriptively analyzed using SPSS version 14.0. A total of 71 patients had adenoidectomy done. Of this, 65 cases were reviewed. There were a total of 45 males and 20 females with age range 11months-10years. The main indication for surgery was obstructive nasal symptoms. Conventional adenoidectomy was performed with standard adenoid curette. Intra-operative blood loss was less than 60ml and none of the patients had blood transfusion. The average duration of admission post-operatively was 1.1day. Fifty-eight (89%) of the patients were relieved of their obstructive symptoms postoperatively. Conventional curettage adenoidectomy still have a role to play especially in resource limited setting where newer techniques may be nothing but a luxury. Adequate preoperative work-up, good anesthetic and surgical techniques are sine-qua-none to successful surgical outcome. There is also a need for early referral to otolaryngologists as this will not only ensure optimal intervention but also minimal postoperative complications.

Changing Trends in Adenoidectomy.

Adenoid hypertrophy treatment is must to alleviate chronic nasal obstruction, mouth breathing, rhinosinusitis and eustachian tube dysfunction. For proper management of this clinical entity a thorough clinical examination along with radiological and endoscopic evaluation is mandatory. Although, few children having adenoid hypertrophy respond to medical treatment, surgery remains the mainstay. An adenoidectomy can be performed by variety of techniques. Conventional adenoidectomy is by the curettage method, still practiced in many institutions, though, a recent technique of endoscopic assisted adenoidectomy by microdebrider is also getting popularized. Both the techniques have their own merits and demerits. However, which of the two surgical techniques is better, is still a matter of preference and experience of the surgeon with the technique. In the present study we will compare the conventional curettage adenoidectomy with endoscopically assisted adenoidectomy done with microdebrider in 40 pediatric patients of adenoid hypertrophy.

Is Transnasal Endoscopic Examination Necessary Before and After Adenoidectomy?

The present study aimed to investigate the amount of residual adenoid tissue following the conventional adenoidectomy as compared with preoperative values. A total of 32 girls and 44 boys (range, 3-15years) in whom adenoidectomy procedure was planned were included in the study. Adenoid tissue sizes before adenoidectomy and residual tissue sizes after conventional curettage adenoidectomy were measured by transnasal endoscopic examination and were recorded. Adenoid tissue size before and after adenoidectomy was compared. The mean age of the patients was 7.7years (range, 3-15years). Before adenoidectomy grade 4 adenoid tissue was noted in 43.4% (n=33), grade 3 was noted in 28.9% (n=22), grade 2 was noted in 25% (n=19), and grade 1 was noted in 2.6% (n=2) of the patients. Following adenoidectomy, no significant difference was noted with respect to residual adenoid tissue sizes of grade 4 and grade 3 patients (P=0.75, P=0.76). Transnasal endoscopic examination is suggested to be the most appropriate method to assess the amount of residual adenoid tissue after conventional curettage adenoidectomy. The residual adenoid tissue with the help of a microdebrider in case of a large residual adenoid tissue located in the choana are necessary for complete adenoidectomy.

Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy

Adenoid hypertrophy (AH) is a common cause of airway obstruction in children and its recurrence after conventional curettage adenoidectomy is not rare. The purpose of this study is to assess the efficacy of endoscopic nasopharyngeal exploration at the end of curettage adenoidectomy on decreasing the incidence of adenoid re-hypertrophy. Three hundred and fifty children diagnosed as having AH, underwent conventional curettage adenoidectomy by a single surgeon. The cases were randomly divided into two equal groups A and B, group B were further subjected to nasopharyngeal exploration by the nasal endoscope after removal of their adenoids with cauterization of any visible residuals, while group A were not subjected to this endoscopic maneuver. Follow-up was carried out for at least 2 years; flexible nasopharyngoscopy was used for detection of recurrent AH. Cases that were not subjected to endoscopic nasopharyngeal exploration (group A) showed a high recurrence rate (6.6%), while explored cases (group B) showed a low incidence of recurrence (1.18%). Most recurrence of group A (6%) was detected within the first year of the follow-up period which may indicate re-growth of residual adenoidal tissues that were missed during conventional curettage adenoidectomy. Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy is a useful method in decreasing the incidence of recurrent AH.

Comparison of Endoscopic-Assisted Adenoidectomy with Conventional Method

ABSTRACT Objective To evaluate and compare the efficacy of endoscopic-assisted (EA) adenoidectomy with the conventional adenoidectomy (CA) with an aim to reduce rates of residual adenoid tissue after adenoidectomy. Methods A prospective randomized study involving 32 patients in which 16 underwent EA and 16 underwent CA. The outcomes compared were residual adenoid tissue after 3 months of surgery, operative blood loss, operative time and complications. Setting A tertiary care teaching hospital. Results EA was significantly better in terms of residual tissue left behind as compared to CA (p &lt; 0.05), similar operative blood loss and operative time with no difference in complications. Conclusion EA makes for a safe and efficacious way to do an adenoidectomy which has a significant advantage over CA.

Konvansiyonel Adenoidektominin Etkinliği ve Endoskopik Tamamlayıcı Adenoidektominin Gerekliliği

Objective: This study was performed to evaluate efficacy of the conventional adenoidectomy (CA) and necessity of the endoscopic complementary adenoidectomy (ECA). Material and Methods: Eighty-one children were prospectively evaluated under general anesthesia, with 2.7 or 4.0 mm 0 degree rigid endoscopes prior to adenoidectomy. The endoscopic findings were recorded. After CA, nasopharynx was examined with mirror and rigid endoscope for any residual adenoid tissue (RAT) and its localization. RAT was removed under endoscopic visualization with forceps. Blood loss and operative time for CA and ECA were recorded. Results: RAT was seen in 60.5% of the patients with mirror and 85.2% with endoscope after CA. The difference was statistically significant between methods (p<0.01). The mean blood loss for CA was 27.06 ± 11.41 ml and for 39.78 ± 15.69 ml ECA The mean time required to complete the adenoidectomy was 10.47 ± 4.31 minutes while for ECA it was 18.84 ± 7.61 minutes. No postoperative complications were seen in this study. Conclusion: CA was effective in 14.8% of patients. This findings show the need for an endoscopic complementary adenoidectomy. This technique did not increase the medical costs and provided a direct view to remove RAT. Under direct visualization, bleeding may be stopped effectively and unnecessary trauma may be avoided without any complication.

A preliminary study of the secondary postoperative haemorrhage in pediatric coblation adenotonsillectomy

To compare secondary postoperative haemorrhage rate of coblation with the conventional pediatric adenotonsillectomy. And to analyze possible reasons which cause the secondary bleeding after coblation adenotonsillectomy. A retrospective study was applied to compare the secondary postoperative haemorrhage rate and the bleeding moment between two groups in which 1-14 years old children from April 2005 to September 2009 in Guangzhou Children's Hospital were included. Group A was pediatric patients who had conventional adenoidectomy and/or tonsillectomy (dissection, without heat damage to the tissue) from April 2005 to July 2006 in Department of Otorhinolaryngology. Group B was pediatric patients who had coblation adenoidectomy and/or tonsillectomy from April 2008 to September 2009 in Department of Otorhinolaryngology. Two of 484 cases in group A had secondary postoperative bleeding, the rate was 0.4%. One happened 2 days after operation, another after 3 days. Eleven of 502 cases in group B had secondary postoperative bleeding, the rate was 2.2%. Secondary bleeding happened 2 to 12 days after surgery, median 6.0 days. The secondary postoperative haemorrhage rate of operating by the freshman was 2.6%(10/385), and it was 0.9%(1/117) by the senior. The rate of secondary bleeding was higher in group B than group A (chi(2) = 5.987, P < 0.05). There was no significant difference of secondary bleeding time in both groups (Mann-Whitney U score was 2.500, P > 0.05). Six of 13 cases who had secondary bleeding suffered wound or upper respiratory tract infection. Three of 13 ate inappropriately after the operation. Pediatric coblation adenotonsillectomy is a new method. The most possible reasons of secondary bleeding are poor surgery skills and ill experience. And, infection, inappropriate eating after the operation may be the other reasons of secondary bleeding.

Adenoidectomy: Conventional or Endoscopic Assisted?

ABSTRACT Objectives Adenoid hypertrophy is known as the most common cause of nasal obstruction in children; thus, adenoidectomy is one of the most commonly performed surgical procedures in the pediatric population. We performed both conventional and endoscopic-assisted adenoidectomies in 54 patients. Our objectives were to compare the efficacy of both methods in terms of subjective and objective relief of symptoms, safety, recurrence, and postoperative morbidity. Materials and methods Fifty-four patients were studied and were diagnosed depending upon clinical examination and radiological investigation. The patients were operated by either conventional or endoscopic-assisted adenoidectomy (EAA). Intraoperative and postoperative complications were looked for. After discharge from the hospital, the patients were called for follow-up on 1st week, 3rd week, 2nd and 4th month, and patients were asked for relief of symptoms and examined for nasal disease and for recurrence. Results Adenoid hypertrophy was seen commonly in children and the most common presenting complaints were nasal obstruction, mouth breathing, and snoring. The patients were diagnosed to have chronic adenoiditis, chronic adenotonsillitis, with or without chronic suppurative otitis media. More number of patients became symptom free with EAA as compared with conventional adenoidectomy. Conclusion Conventional adenoidectomy and EAA both have comparable success rates. Endoscopic-assisted adenoidectomy allows complete removal of adenoid tissue, thereby reducing the chances of developing recurrent adenoid obstructive symptoms and reducing the bacterial reservoir in the nasopharynx. How to cite this article Goel AK. Adenoidectomy: Conventional or Endoscopic Assisted? Clin Rhinol An Int J 2017;10(2):74-77.

Conventional versus endoscopic powered adenoidectomy: A comparative study

Background: Adenoidectomy is a commonly performed ENT surgery. It is conventionally performed using the curettage method. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative. Methods:Sixty consecutive cases requiring adenoidectomy were randomized into two groups of thirty each.Group A underwent conventional adenoidectomy using the curettage method and Group B underwent endoscopic assisted micro-debrider adenoidectomy. The parameters studied were intra-operative time, intra-operative bleeding and completeness of resection, collateral damage, post operative pain and recovery time. Result: Sixty cases of adenoidectomy were done using conventional surgery and powered endoscopic adenoidectomy in the study period from Aug 04 to Dec 05. The time taken in Group A (conventional surgery) varied from 22–39 minutes (95% Confidence Interval (CI) −27.7 – 30.9)and in Group B (powered endoscopic surgery) from 27–55 minutes(95% CI 36.6 – 41.9 ) (p<0.05). The average blood loss in Group A was 21 ml (range 10–50) as compared to 31.67 ml (range 10-60) in Group B (p<0.05). The resection was invariably complete in Group B whereas seven(23%) cases had more than 50% residual adenoid tissue in Group A. Three cases in group A had collateral damage whereas in Group B, there were no added injuries. Post operative pain was studied only in cases undergoing adenoidectomy alone. Group A (n=8) demonstrated a pain score of 1.64–2.63–3.63 (95% CI) whereas Group B (n=11) demonstrated a pain score of 1.19–2.13–3.06 (95% CI). This difference was not statistically significant. In group A, the mean recovery period was 3.5 days and 2.93 days in Group B(p<0.05). Conclusion: Endoscopic powered adenoidectomy was found to be a safe and effective tool for adenoidectomy. The study parameters where endoscopic powered adenoidectomy fared better were completeness of resection, accurate resection under vision, lesser collateral damage and faster recovery time. On the other hand, conventional adenoidectomy scored in matter of lesser operative time and intra-operative bleeding.

흡입식 절삭기를 이용한 비내시경하 경비강 아데노이드 절제술

Background and Objectives: The conventional adenoidectomy with adenoid currette, adenotome, and adenoid punch result in various complication such as bleeding and damage to the mucosa of posterior nasopharyngeal wall or orifice of Eustachian tube. This procedure may be left relatively much remnant adenoid tissue. The purpose of this paper is to compare conventional adenoidectomy with transnasal microdebrider-assisted adenoi- dectomy under endoscopy based on postoperative outcome and intraoperative effectiveness. Subjects and Methods: We performed a prospective study comparing sixty seven cases of conventional adenoidectomy with sixty two cases of transnasal microdebrider-assisted adenoidectomy under endoscopy. We evaluated postoperative change of symptoms, endoscopic grade, lateral skull radiographs, operation time and complication. Results: There was no statistical difference in the subjective symptoms and operation time. However, it was found that patients, who had been performed transnasal microdebrider assisted adenoidectomy under endoscopy, had better outcomes in the postoperative endoscopic grade and improvement in lateral skull radiographs. Conclusion: Compared to the conventional method, transnasal microdebrider assisted adenoidectomy under endoscopy removed adenoid tissue precisely and safety. So we suggest that this procedure is an attractive surgical method in removal of severe vegetated adenoid. (J Clinical Otolaryngol 2007;18:41–46)

Suction diathermy for adenoidectomy: Complications and risk of recurrence

When introduced, suction coagulation was initially utilised for haemorrhage control following curettage of the adenoid pad. More recently the whole procedure has been performed using the technique. This study aims to report post-operative haemorrhage rates and risk of recurrence in adenoidectomy performed solely by suction diathermy in children. A retrospective study of 1411 consecutive paediatric patients. Surgery was performed using suction diathermy. No patients were excluded. All patients were followed up. There were no cases of post-operative haemorrhage. 1.7% of patients remained symptomatic and underwent revision adenoidectomy. None required a third procedure. Re-growth of adenoid tissue may occur despite visualisation of the nasopharynx at the time of surgery. The incidence of re-growth is similar to that reported in patients undergoing conventional adenoidectomy by curettage. Post-operative haemorrhage was not encountered in children having adenoidectomy by suction diathermy. The authors suggest suction diathermy as the most appropriate method for adenoidectomy in children.