Curettage Adenoidectomy Research Articles

Comparative outcomes of microdebrider adenoidectomy, curettage adenoidectomy through oral cavity under 70 endoscope, and endoscopic transoral low-temperature ablation for adenoid hypertrophy

AimWe aimed to compare the effects of microdebrider adenoidectomy, curettage adenoidectomy through oral cavity under 70°endoscope, and endoscopic transoral low-temperature ablation on adenoid hypertrophy. MethodsA total of 180 children suffering from adenoid hypertrophy hospitalized during November 2019 and November 2023 were allocated to group A (microdebrider adenoidectomy, n = 65), group B (curettage adenoidectomy through oral cavity under 70° nasal endoscope, n = 54), and group C (nasal endoscopic transoral low-temperature adenoid ablation, n = 61). The operation data (operation time and bleeding amount), pain score, postoperative recovery, and complications were compared. ResultsThe operation time of group A was significantly shorter than those of other two groups, while group C had a significantly smaller bleeding amount than those of other two groups (P < 0.05). An incidence rate of secondary bleeding at 6.15 % was detected in group A, without other complications. Group B had an adenoid residual rate of 35.19 % and a recurrence rate of 14.81 %, significantly exceeding those of other two groups (P < 0.05). The soft palate injury rate was 24.59 % in group C, which was raised significantly compared with those of other two groups (P < 0.05). In comparison to other two groups, significant increases in postoperative pain score and pain duration were detected in Group C (P < 0.05). ConclusionThere is no significant difference in the effective rate among the three methods. Nasal endoscopic transoral low-temperature adenoid ablation is recommended as the first choice because of small bleeding amount, few postoperative residuals, and low recurrence rate, but it poses high requirements on the operation of doctors.

A Comparative Study on Conventional Adenoidectomy and Endoscopic Powered Adenoidectomy

Introduction: Adenoids are a type of nasopharyngeal lymphoid tissue that is a component of Waldeyer’s ring. They are typically present from birth, reach their maximum size between the ages of 7 and 10 years, and then gradually decrease in size to become atrophied in adulthood. The objective of the current study is to compare conventional adenoidectomy using curette with power-assisted adenoidectomy. Materials and Methods: This randomized clinical trial was conducted at Teerthanker Mahaveer Medical College and Research Center from March 2023 to August 2023. A total of 40 patients were planned for adenoidectomy and randomly allocated under two groups. The conventional curettage adenoidectomy method was done on patients in Group A and patients in Group B who underwent power-assisted adenoidectomy using microdebrider. Both the groups were further compared in terms of surgical clearance of adenoids, operative time taken in procedure, injury to surrounding structures, and symptom score improvement on follow-up. Results: Surgical clearance was excellent in Group B with no adenoid tags left in all 20 (100%) patients, whereas few tags were left in 18 (90%) patients in Group A (P &lt; 0.0001). The mean operative time (in minutes) for Group A was 22.4 ± 1.67, whereas Group B was 18.1 ± 1.76 (P = 0.001). Postoperative pain score in Group A was 3.7 ± 1.63, whereas for Group B was 2.8 ± 1.01 (P &lt; 0.043). Recovery time in terms of number of days to return to normal diet and activities in Group A was 3.1 ± 0.3 days, whereas Group B was less 2.1 ± 0.2 days (P &lt; 001). Postoperative nasal symptom score at 6 weeks in Group A was 1 in 1 patient and 2 in 4 patients with mean of 0.45 ± 83, whereas in Group B was 0 (P = 0.043). Conclusion: It was concluded from the study that power-assisted adenoidectomy was a better surgical procedure than conventional adenoidectomy. There was better improvement in nasal symptom score and surgical clearance by power-assisted adenoidectomy. Postoperative pain score and time taken for recovery after surgery were also less in power-assisted adenoidectomy.

Endoscopic Evaluation after Conventional Adenoid Curettage.

Introduction Adenoidectomy is one of the most common procedures performed by otolaryngologists. Traditional adenoid curettage is performed blindly, which can result in inadequate removal of the adenoid and injury to the surrounding structures. Objective To perform transnasal endoscopic examinations to assess the nasopharynx after conventional curettage adenoidectomy. Methods The present prospective study included 100 children with a mean age of 4.2 ± 3.07 years. It is composed of two steps: conventional curettage adenoidectomy by a resident trainee; and endoscopic evaluation of the nasopharynx through a 0° telescope to assess adenoidal remnants, injury to the surgical field or adjacent structures, and bleeding points. Results Adenoid remnants were observed in 42% of the cases after conventional adenoid curettage in multiple locations, such as the roof of the nasopharynx over the choana (24%), the tubal tonsil (12%), the posterior pharyngeal wall (4%), and the posterior end of the nasal septum (2%). Injury to the surgical field and adjacent structures was observed in 46% of the cases (posterior pharyngeal wall: 23%; lateral pharyngeal wall: 11%; Passavant ridge: 10%; and the Eustachian tube orifice: 2%). Endoscopic bleeding was observed in 29% of the cases; 13% of the cases were from adenoid remnants, 10%, from the mucosa, and 6%, from the pharyngeal muscles. Bleeding was mild in 19% of the cases, moderate in 9%, and severe in 1%. Conclusion Endoscopic evaluation of the nasopharynx following conventional adenoid curettage provides important data regarding adenoid remnants, injury to the surgical field or nearby structures, and bleeding points, which aids in the provision of optimal care and in the achievement of a better outcome.

Assessment of middle ear function after conventional or endoscopic microdebrider assisted adenoidectomy.

To compare pre- and post-operative pure tone audiometric and impedance audiometric analysis following conventional and endoscopic microdebrider assisted adenoidectomy and compare the outcomes. Patients diagnosed with chronic adenoiditis were divided in groups of 25 each. Patients in the first group underwent conventional curettage adenoidectomy, while those in second group underwent endoscopic microdebrider assisted adenoidectomy. Pre- and post-operative pure tone and impedance audiometry were performed for all patients and outcomes were compared. The endoscopic microdebrider assisted method resulted in significantly better outcomes compared to conventional curettage. Criteria such as hearing threshold (p value 0.004 at second follow-up), peak pressure (p value 0.045 at first follow-up) and tympanogram (p value 0.016) showed that the endoscopic method was better, while peak compliance (p value 0.340 at first follow-up) did not show any significant difference between groups. The endoscopic microdebrider assisted method for adenoidectomy has a definite advantage of better visualisation resulting in better clearance of tissue, leading to enhanced middle ear function compared to conventional curettage.

Endoscopic coblation adenoidectomy and conventional adenoidectomy: a comparative study

Background: Adenoidectomy is most common paediatric surgical procedures. Commonly used methods for adenoidectomy are conventional curettage adenoidectomy and endoscopic coblator assisted adenoidectomy. The technique of coblation adenoidectomy has considerable influence on the duration of surgery, the blood lost intra operatively, pain on the first postoperative period. Methods: Sample selected for study were children of age group 3 to 11 years attending ENT OPD with clinical signs of adenoid hypertrophy, who underwent adenoidectomy during the time period from October 2019 to June 2021. We compared the efficacy of ECA with CCA based on the intra-operative (operative time and bleeding) and post-operative parameters (pain on the first post operative day). Results: Our study revealed that intra operative bleeding was more in CCA compared to ECA (p&lt;0.001). ECA took more operative time than CCA group (p&lt;0.001). Pain on the first post-operative day was more in CCA than ECA. Conclusions: Primary objective was comparison of intra operative bleeding among both groups and the outcome was blood loss in ECA was less than CCA. Secondary objective was comparison of operative duration and pain on the first post-operative day and the outcome was, operative duration was less in CCA and pain in the first post-operative day was more in CCA. Our conclusion is that ECA was efficient on the basis of intra operative blood loss and post- operative pain in the first day. CCA was effective in operative duration.

Outcomes of endoscopic guided adenoidectomy versus conventional adenoidectomy

: Adenoidectomy is one of the most common surgical procedures performed on children. Conventional curettage adenoidectomy is a low-cost procedure that is still widely practised, particularly in developing nations. To compare conventional curettage adenoidectomy and endoscopic-assisted powered adenoidectomy using a microdebrider. Consecutive cases for Conventional Adenoidectomy (Group I) and Endoscopic Assisted Adenoidectomy (Group II) were taken from cases undergoing adenoidectomy, with each group consisting of 20 patients. The operating time and postoperative pain score were measured and compared between the two groups. Patients were evaluated at the first and sixth weeks to measure subjective improvement of symptoms , DNE was performed to evaluate remaining adenoid tissue and scarring of adjacent structures. The total operating time in groups I and II was 13 minutes (range: 10-15 minutes) and 21 minutes (range: 15-25 minutes), respectively. In 12 cases, remnent adenoid tissue ranged from 25 to 50%. Ten of them received conventional adenoidectomy. Group I experienced significantly higher postoperative pain than group II. Endoscopic adenoidectomy is a safe and effective alternative to conventional curettage. It favours consistent restoration of nasopharyngeal patency, improved haemostasis, and reduced postoperative pain.

A comparative study of two adenoidectomy technics for efficacy and safety: Conventional curettage adenoidectomy versus endoscopic microdebrider adenoidectomy

PurposeConventional cold curettage adenoidectomy (CCA) is the most used method for Adenoidectomy. With the advances in surgical instruments, endoscopy assisted less invasive techniques are coming into use. Herein we compared CCA with endoscopic microdebrider adenoidectomy (EMA) in terms of safety and recurrence. MethodsPatients who underwent adenoidectomy in our clinic between 2016 and 2021 years were included into the study. Study performed retrospectively. Patients operated with CCA accepted as GroupA and EMA as GroupB. Two groups compared for the recurrence rate and post-operative complications. ResultsWe studied 833 children aged between 3 and 12 years (mean 4,2 years old), had adenoidectomy, including 482 male(57.86 %) and 351 female (42.14 %). There were 473 patients in GroupA, and 360 patients in GroupB. Seventeen patients (%3.59) in GroupA had reoperation for the recurrence of adenoid tissue. There was no recurrence in GroupB. Residual tissue, recurrent hypertrophy, and postoperative otitis media rates were higher in GroupA, and this was statistically significant (p < 0.05). Whereas ventilation tube insertion rates didn't differ significantly (p > 0.05). Although hypernasality rate at second week was slightly higher in GroupB, this was not statistically significant (p > 0.05), and in further period it resolved in all patients. No major complications were reported. ConclusionOur study indicates that EMA is a safer technique than CCA, and prominent postoperative complications like residual adenoid tissue, recurrent adenoid hypertrophy, and postoperative otitis media with effusion rates are lower.

Coblation Assisted Adenoidectomy vs. Conventional Curettage Adenoidectomy: A Comparative Study

Background: Adenoid is a patch of tissue that is situated high up in the throat and just behind the nose in the nasopharynx. Adenoid along with the tonsils, is a part of the lymphatic system that clears away infection and keeps body fluids in balance.Whenever, adenoid become enlarged, seriously infected or causes certain complications, adenoidectomy becomes essential. It can be performed with many ways includingcoblation assisted adenoidectomy and conventional curettage adenoidectomy.&#x0D; Aim of the study: The aim ofthis study was to assessthe advantages of coblation assisted adenoidectomy over conventional curettage adenoidectomy.&#x0D; Methods: This comparative observational study was conducted in the Department of ENT, Bangladesh Medical College Hospital and Popular Medical College Hospital, Bangladesh during the period from July 2019 to June 2022. A total of 100 admitted patients for adenoidectomy were included as the study. All the participants were divided in two groups. In Conventional group, there were 50 participants selected for conventional curettage adenoidectomy.On the other hand, in coblation group, other 50 participants selected for coblation assisted adenoidectomy. For comparison of both the method all necessary data along with demographic and clinical status were collected in a predesigned questioner. All data were processed and analyzed and disseminated by using MS Office and SPSS version 23 programs as per need.&#x0D; Results: In this study, as the superiority of coblation assisted adenoidectomy over conventional curettage adenoidectomy we found significantly lower ‘intra operative blood loss in ml (7.58±3.28 ml)’, ‘post-operative bleeding (0%)’, presence of residual lymphoid tissue (8%)’, ‘days with analgesics (10.42±3.60 days), ‘post operative adenoid grading (0.0±0.0)’, ‘rate of recurrence (20%)’ and ‘needed days for recovery (4.68±2.17 days)’ among coblation group patients than that among conventional group patients.&#x0D; Conclusion: Coblation assisted adenoidectomy ensures more easier and specific treatment for the patient. As per the findings of this study we can conclude that, considering the attractive features like lower intra operative and post-operative blood loss, presence of residual lymphoid tissue, days with analgesics, post operative adenoid grading, rate of recurrence and needed days for recovery coblation assisted adenoidectomy may be considered as the method of choice for such treatment.&#x0D; Bangladesh J Otorhinolaryngol 2022; 28(2): 128-134

Comparison of the efficacy and safety of conventional curettage adenoidectomy with those of other adenoidectomy surgical techniques: a systematic review and network meta-analysis

ObjectivesThere is a lack of robust evidence in regards to whether the intra and post-operative safety and efficacy of conventional curettage adenoidectomy is better than those of other available surgical techniques. Therefore, this study was conducted as a systematic review and network meta-analysis of published randomized controlled trials (RCTs) with the aim of comparing the safety and efficacy of conventional curettage adenoidectomy with all other available adenoidectomy techniques.Materials and methodsA systematic search of published articles was performed in 2021 using databases such as PubMed/Medline, EMBASE, EBSCO, and the Cochrane Library. All RCTs that compared conventional curettage adenoidectomy with other surgical techniques and were published in English between 1965 and 2021 were included. The quality of the included RCTs have been assessed using Cochrane Collaboration Risk of Bias Tool.ResultsAfter screening 1494 articles, 17 were identified for comparing several adenoidectomy techniques and were eligible for quantitative analysis. Of those, 9 RCTs were analyzed for intraoperative blood loss, and 6 articles were included for post-operative bleeding. Furthermore; 14, 10, and 7 studies were included for surgical time, residual adenoid tissue, and postoperative complications respectively. Endoscopic-assisted microdebrider adenoidectomy yielded a statistically significantly greater estimate of intraoperative blood loss compared with conventional curettage adenoidectomy (mean difference [MD], 92.7; 95% confidence interval [CI] 28.3–157.1), suction diathermy (MD, 117.1; 95% CI 37.2–197.1). Suction diathermy had the highest cumulative probability of being the preferred technique because it was estimated to result in the least intraoperative blood loss. Electronic molecular resonance adenoidectomy was estimated to be more likely to result in the shortest surgical time (mean rank, 2.2). Participants in the intervention group were 97% less likely to have residual adenoid tissue than children in the conventional curettage group (odds ratio 0.03; 95% CI 0.01–0.15); therefore, conventional curettage was not considered an appropriate technique for complete removal of adenoid tissue.ConclusionThere is no single technique that can be considered best for all possible outcomes. Therefore, otolaryngologists should make an appropriate choice after critically reviewing the clinical characteristics of children requiring adenoidectomy. Findings of this systematic review and meta-analysis may guide otolaryngologists when making evidence-based decisions regarding the treatment of enlarged and symptomatic adenoids in children.

Endoscopic Adenoidectomy with Microdebrider Versus Conventional Adenoidectomy

Background: Adenoidectomy is one of the most common surgical procedures performed in children in Bangladesh. Though conventional curettage is highly popular as it has the advantage of being cost effective and continues to be a commonly used method especially in developing countries but Microdebrider has opened the new horizon in this arena. To compare conventional curettage adenoidectomy and endoscopic-assisted powered adenoidectomy using a microdebrider.&#x0D; Materials and methods: This is randomized single blinded comparative study, which was performed in the Medical Center Hospital, Chattogram from August 2019 to July 2020. A total of 60 patients were randomly divided into two groups. Group I underwent conventional curettage adenoidectomy while Group II underwent endoscopic- assisted powered adenoidectomy. Duration of surgery, amount of intra-operative bleeding, adequateness of removal and damage to the adjacent structures were assessed and compared between two groups. All patients were followed for 12 months. Statistical analysis was done using statistical software package SPSS v 22.0. Data were represented as mean ± SD. Continuous variables were compared using the were using the t test while nonparametric data were compared using Mann-Whitney U test. The c2 test was used to compare the nominal data. A p value &lt;0.05 was considered statistically significant. Ethical directives from the Managing Body of Medical Centre Hospital, Chattogram for this study was obtained.&#x0D; Results: in our study, we observed approximately almost three times more mean blood loss and total operating time in the endoscopic-assisted powered procedure compared to the conventional technique (149 and 56 ml, respectively, 63 and 27 min, respectively). Nine (30%) cases in group I had more than 50% residual adenoid tissue while 20 – 50% of residual adenoid tissue was documented among 7 patients (23%). Postoperative pain was found to be significantly higher in group I compared to group II. In both groups, recovery time ranged from 24-48 hour with a mean of 33.6 hour in group I and 36 hour for group II. 23 patients (77%) in group I presented with residual disease in the 3 months follow up period, where number of patients with the exact instance in group II was 0.&#x0D; Conclusion: Endoscopic assisted adenoidectomy may appear more handy over conventional curettage. But precise peri-operative care and awareness are required to attain the successful outcomes.&#x0D; JCMCTA 2022 ; 33 (1) : 88-92

Endoscopic Adenoidectomy Replacing the Outdated Curette Adenoidectomy: Comparison of the Two Methods at a Tertiary Care Centre.

To compare intraoperative and postoperative parameters of the two techniques of adenoidectomy, endoscopeand microdebrider powered adenoidectomy and conventional adenoidectomy. Study Design Prospective study. Setting: Academic tertiary referral centre. In our study, cases of adenoid hypertrophy were randomly selected from the outpatient department of department of ORL & HNS. Out of these patients, 30 underwent Endoscopic adenoidectomy (EA) (Group A) and 30 underwent Conventional adenoidectomy (CA) (Group B). All of the patients were assessed pre-operatively, intra-operatively and post-operatively to compare the various parameters. The most common complaint in both the groups was mouth breathing with snoring. Intra-operative bleeding was 29.15ml in group EA and 15.2ml in group CA. Operative time for CA was shorter at 21.8min as compared to 32.1min for group EA. Residual adenoids and injury to adjacent structures were more common in group CA. Hospital stay was 3.2days for EA patients and 3.43days for CA patients. Resolution of symptoms was near comparable in both groups. Operative time and intra-operative bleeding are both significantly reduced with the CA as opposed to EA. However, injury to adjacent structures and residual adenoids occur significantly less in group EA. After weighing the risks and benefits, we can conclude that EA is comparatively better than CA.

Comparison Between Different Approaches Applied in Pediatric Adenoidectomy: A Network Meta-Analysis.

Adenoidectomy is a surgical procedure most frequently performed by otolaryngologists. However, there are no universally accepted guidelines for the choice of the surgical approach in specific circumstances. Therefore, a network meta-analysis (NMA) is needed to summarize existing studies and provide more evidence-based medical guidelines. A systematic search of the literature was conducted in the Cochrane Central Register of Controlled Trials, PubMed, and EMBASE databases from inception to 31 July 2021. A network meta-analysis of operating time, intraoperative blood loss, postoperative pain score, and incidence of postoperative residual tissue was performed. A total of 20 studies with 2329 patients were included. Four common surgical approaches, including powered vacuum shaver adenoidectomy (PVSA), plasma field ablation adenoidectomy (PFAA), curettage adenoidectomy (CUA), and suction diathermy adenoidectomy (SDA), were compared for operative time, intraoperative blood loss, postoperative pain score, and incidence of postoperative residual tissue. There were no significant differences between the surgical techniques for the 3 endpoints, operative time, intraoperative blood loss, and incidence of postoperative residual tissue. The data showed lower postoperative pain scores for PFAA than for CUA (MD = -3.45, 95% CI [-6.01, -0.95]). There were no significant differences in other surgical approaches for postoperative pain scores. There were no significant differences between PVSA, PFAA, CUA, and SDA for operative time, intraoperative blood loss, and incidence of postoperative residual tissue. PFAA had advantages over CUA for postoperative pain scores.

Evaluation of endoscopic assisted suction coagulation adenoidectomy versus traditional curettage technique

BackgroundAdenoidal hypertrophy is a common condition in children and can cause symptoms such as mouth breathing, nasal discharge, snoring, sleep apnea, and hyponasal speech. The curettage adenoidectomy has some disadvantages, especially the intranasal extension of the adenoid tissue that makes this technique inadequate. This study is conducted to evaluate and compare between assisted suction coagulation adenoidectomy and traditional curettage techniques.ResultsOne hundred twenty-two patients with symptomatic adenoid hypertrophy such as nasal obstruction, snoring, and mouth breathing were included in our study. Patients underwent adenoidectomy either traditional curettage adenoidectomy (60 patients as group A) or endoscopic assisted suction coagulation adenoidectomy (62 patients as group B). Patients were scheduled for follow-up visits with respect to operative time, operative and postoperative complications. The mean age of groups A and B were 6.57+2.8 and 7+2.8 ranging from 3 to12 years. There was a statistically significant difference between groups as regard intraoperative blood loss, trauma, postoperative complications as neck stiffness and bad odor plus postoperative endoscopic and radiological grading after the operation.ConclusionsSuction coagulation diathermy adenoidectomy is alternative to cold adenoidectomy with significantly fewer intraoperative complications such as blood loss and trauma of prevertebral muscle plus post-operative complications such as primary or secondary bleeding and rhinolalia aperta.

English

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

Endoscopic Coblation versus Cold Curettage Adenoidectomy

Abstract Background Adenoidectomy remains one of the surgical procedures most frequently performed by otolaryngologist. Adenoid hypertrophy causes nasal obstruction and airway problems such as snoring, obstructive sleep apnea, recurrent sinusitis, and/or Eustachian tube dysfunction. There is also reduced ability to smell and taste, hyponasal speech and craniofacial abnormalities. These complications frequently lead to a need for adenoidectomy. Aim of the Work Compare between endoscopic coblation versus cold curettage adenoidectomy as regard operative time, blood loss, post-operative pain and complications. Materials and Methods We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results We performed a comperehensive search of five electronic databases to comperehensively include all eligible studies. In addition, the risk of bias was low among the included studies. However, we acknowledge that the present study has some limitations. Some included studies were observational studies with inherent limitations of possible misclassification and ascertainment bias. In addition, most of the studies were a single-center experience and therefore the results cannot be generalized to the general population. Conclusion Endoscopic coblation technique is superior to cold curettage adenoidectomy in pediatric population. The present systematic review and meta-analysis showed that endoscopic coblation technique had better outcomes in terms of intraoperative blood loss and postoperative pain. However, special attention should be paid for operation time with endoscopic coblation. Nevertheless, further studies are still needed to confirm our findings and to identify patient factors that significantly increase the rate of recurrence in both techniques.

Endoscopic coblation versus cold curettage adenoidectomy

Objective To compare between endoscopic coblation versus cold curettage adenoidectomy regarding operative time, blood loss, postoperative pain, and complications. Patients and methods This systematic review was performed in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. An electronic search was conducted from 1998 till 2019 using the different keywords (curettage–coblation techniques of adenoidectomy) through the MEDLINE databases. Results The search retrieved 163 unique records. We then retained 49 potentially eligible records for screening. Finally, 14 studies were included in the present work. Concerning the operative time, the overall effect estimates favored curettage over coblation [95% confidence interval (CI) −11.1 to −4.41; P = 0.001). A smaller amount of blood loss was noted in coblation group (95% CI −14.29 to −15.76; P = 0.23). The postoperative pain was less with coblation (95% CI −0.07 to −4.75; P = 0.04). One study directly compared the recurrence rate in the two groups. It favored coblation over curettage for reduction of recurrence rate. Conclusion Endoscopic coblation is superior to curettage adenoidectomy regarding the intraoperative blood loss and postoperative pain. However, special attention should be paid for operation time with endoscopic coblation. Nevertheless, further studies are still needed to confirm our findings.

Comparison between Endoscopic and Curettage Adenoidectomy

Comparison between Endoscopic and Curettage Adenoidectomy

A comparative study of conventional curettage adenoidectomy versus endoscopic microdebrider-assisted adenoidectomy in children

Introduction: Adenoid hypertrophy or chronic adenoiditis may cause significant problems requiring adenoidectomy. Patients with chronic adenoid hypertrophy causing craniofacial morphology problems, excessive snoring, or possibly quality of life issues are candidates for adenoidectomy. The aim of this study is to compare the advantages of endoscopic-assisted microdebrider adenoidectomy in comparison with conventional curettage adenoidectomy. Materials and Methods:A prospective study of patients undergoing adenoidectomy was performed in the Department of ENT, Head and Neck Surgery at Tertiary center from January 2018 to October 2019. Results: Fifty patients of adenoid hypertrophy underwent adenoidectomy (25 patients in Group I and 25 patients in Group II). The groups were almost similar in age and sex. The mean operative time was 15 min 60 s in Group I and 12 min 56 s in Group II. The average blood loss was 31 ml in Group I and 28.60 ml in Group II. The residual adenoid tissue and complications were present in eight and three patients in Group I, respectively. Conclusion: The endoscopic-assisted adenoidectomy is minimally invasive. Intraoperative bleeding, duration of surgery, and complication were less in endoscopic-assisted adenoidectomy as comparison to conventional curettage method.

Comparison between endoscope assisted powered and conventional adenoidectomy

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Adenoidectomy is one of the commonest operations done on children. It is conventionally performed using the curettage method. This present study was done to compare the results of endoscopic powered adenoidectomy and conventional adenoidectomy.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The present prospective randomized study was conducted among 50 patients between 4-16 years of age requiring adenoidectomy with or without tonsillectomy in department of ENT in Government Medical College and Rajindra Hospital, Patiala. All the 50 patients were divided into two groups (group A and group B) by systematic random sampling. Group A consisted of 25 patients who underwent conventional curettage adenoidectomy and group B consisted of 25 patients who underwent Microdebrider-Assisted Adenoidectomy. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; In group A and B, mean±SD intraoperative blood loss (in ml) was 20.60±7.96 and 30.60±7.96 respectively. Mean±SD operative time (in minutes) was 28.60±4.71 in group A, while in group B it was 39.60±4.71 with statistically significant difference. Complete adenoid removal was found in 52% of the subjects in group A while it was found in 96% of the subjects in group B with statistically significant difference. In group A, mean±SD recovery time (in hrs) observed was 33.52±10.58 while in group B, recovery time (in hours) observed was 36.22±11.31.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Based on the results of this study, it can be concluded that the new method of microdebrider assisted powered adenoidectomy was found to be safer and more useful tool for adenoidectomy than conventional method.&lt;/p&gt;

Trans-oral endoscopic assisted radio-frequency for adenoid ablation; A randomized prospective comparative clinical study

ObjectiveThis study compared the efficacy and safety of conventional adenoidectomy using a curette and the Radio-frequency (RF) adenoid ablation using endoscope via the trans-oral technique. MethodsA randomized prospective comparative study was conducted in a tertiary care hospital. The study included 80 patients with a diagnosis of adenoid hypertrophy, which was confirmed by X-ray of a lateral view of the skull. The patients were submitted into two groups 40 for each: curettage group and Radiofrequency group. Patients with bleeding diathesis, congenital anomalies, previous adenoidectomy, and morbid illness were excluded from the study. We evaluated the time consumption, the adenoid tissue remnant by the endoscope, blood loss, and clinical correlations like pain by Visual Analog Scale, halitosis, and secondary bleeding in both study groups. ResultsIntra-operative blood loss was 20–40 ml in the Radio-frequency (RF) group, but in the curettage group was 36 – 55 ml. Post-operative pain in the (RF) group was lower than the curettage group. Secondary bleeding was reported mostly in the curettage group (15%). The duration of the operation in (RF) group was relatively long. Halitosis decreased mainly after curettage adenoidectomy. ConclusionThe endoscopic radio-frequency adenoid ablation surpassed the conventional method. We encourage using Radio-frequency in adenoid surgery as a replacement for the traditional method.