DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20202603

Revisiting conventional adenoidectomy using technology

Kiran Gangadhar S., Sonee Thingujam, Jayita Poduval

Abstract


Background: Adenoidectomy is one of the most frequently applied surgical procedures in the paediatric population, either alone or in conjunction with tonsillectomy and/or insertion of ventilation tubes. The main purpose of the adenoidectomy is to eliminate the nasopharyngeal respiratory pathogens and to remove nasal airway obstruction. Aim of the study was to compare the outcomes of conventional and endoscopic assisted curettage adenoidectomy.

Methods: In this comparative study, 50 patients were divided into 2 groups. Group 1 (25 patients) underwent endoscopic curettage adenoidectomy and group 2 (25 patients) underwent conventional curettage adenoidectomy. Intraoperative time, complications and postoperative pain were recorded.  

Results: 72% in group 1 and 64% in group 2 had grade 2 adenoid hypertrophy. 68% in group 1 and 64% in group 2 had a moderate degree of obstruction in lateral view of soft tissue X-ray nasopharynx. The mean time taken for surgery in group 1 was 13.29±3.28 minutes, and in group 2,6.28±2.31 minutes. Minimal loss of blood was recorded in group 1 with less than 20 ml, whereas in group 2, the blood loss was high; 30% of patients had blood loss more than 30 ml. In group 1, the mean VAS was 3.25 and 2.55 in group 2 2.55. In group 1, 4% of patients had primary haemorrhage and in group 2, 8% of patients had primary haemorrhage. No patient had velopharyngeal dysfunction in either group.

Conclusions: More operative time but less blood loss were noted in endoscopic adenoidectomy. Intraoperative visualisation of the nasopharynx in endoscopic procedures showed no significant advantage over conventional adenoidectomy.


Keywords


Adenoidectomy, Conventional method, Endoscopic method, Curettage

Full Text:

PDF

References


Thornval A. Wilhelm Meyer and the adenoids. Arch Otolaryngol. 1969;90(3):383-6.

Gerhardsson H, Stalfors J, Odhagen E, Sunnergren O. Pediatric adenoid surgery in Sweden 2004-2013: incidence, indications and concomitant surgical procedures. Int J Pediatr Otorhinolaryngol. 2016;87:61-6.

Babakurban ST, Aydın E. Adenoidectomy: Current approaches and review of the literature. Kulak Burun Bogaz Ihtis Derg. 2016;26(3):181-90.

Anand V, Sarin V, Singh B. Changing trends in adenoidectomy, Indian J Otolaryngol Head Neck Surg. 2014;66(4):375-80.

Randall DA, Hoffer ME. Complications of tonsillectomy and adenoidectomy. Otolaryngol Head Neck Surg. 1998;118(1):61-8.

Datta Lt Col R, Singh Col VP. Deshpal Col. Conventional versus Endoscopic powered adenoidectomy: a Comparative Study. MJAFI. 2009;65:308-12.

Clemens J, McMurry JS, Willging JP. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otolaryngol. 1998; 43:115-22.

Bitar MA, RahiA,Khalifeh M, Madanat LM A suggested clinical score to predict the severity of adenoid obstruction in children. Eur Arch Otorhinolaryngol. 2006;263:924-8.

Nikanne E, Kokki H, Tuovinen K. Postoperative pain after adenoidectomy in children. Br J Anaesthesia. 1999;82(6):886-9.

Bispo NH, Whitaker ME, Aferri HC, Neves JD, Dutka Jde C, Pegoraro-Krook MI. Speech therapy for compensatory articulations and velopharyngeal function: a case report. J Appl Oral Sci. 2011;19(6):679-84.

Yearsley J. On Deafness from Morbid Conditions of the Mucous Membrane of the Stomach, Throat, and Ear. The Effect of Cold, Dyspepsia, Scarlatina, Measles, etc. London, England: Nisbet & Co; 1842.

Cannon CR, Replogle WH, Schenk MP. Endoscopic-assisted adenoidectomy. Otolaryngol Head Neck Surg. 1999;121:740-4.

Parsons, DS. Rhinologic uses of powered instrumentation in children beyond surgery. Otolaryngol Clin North Am. 1996;29:105-14.

Somani SS, Naik CS, Bangad SV. Endoscopic adenoidectomy with microdebrider. Indian J Otolaryngol Head Neck Surg. 2010;62(4):427-31.

Prakash NS, Mallikarjunappa AM, Samuel HT. Endoscopic assisted adenoidectomy versus conventional curettage adenoidectomy- A comparative study. National J Otorhinolaryngol Head & Neck Surg. 2013;1(10):10-2.

Koltai PJ, Kalathia AS, Stanislaw P, Heras HA. Power-assisted adenoidectomy. Arch Otolaryngol Head Neck Surg. 1997;123:685-8.

Stanislaw P, Koltai PJ, Feustel PJ. Comparison of powerassisted adenoidectomy vs adenoid curette adenoidectomy. Arch Otolaryngol Head Neck Surg. 2000;126:845-9.

Feng Y, Yin S. Comparison of the powered-assisted adenoidectomy with adenoid curette adenoidectomy. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2006;20:54-7.

Murray N, Fitzpatrick P, Guarisco JL. Powered partial adenoidectomy. Arch Otolaryngol Head Neck Surg. 2002;128:792-6.

Ravishakar C, Killera S. Comparing endoscopic microdebrider assisted adenoidectomy with curettage procedure. Int J Otorhinolaryngol Head Neck Surg. 2018;4:559-64.

Muniraju M, Saifulla M. A comparative study of adenoidectomy by microdebrider vs conventional method. Int J Otorhinolaryngol Head Neck Surg. 2018;4:808-14.

Yang L, Shan Y, Wang S, Cai C, Zhang H. Endoscopic assisted adenoidectomy versus conventional curettage adenoidectomy: a meta-analysis of randomised controlled trials. Springerplus. 2016;5:426.

Vokurka J. Shaver (micro debridor) in otorhinolaryngology. Int Congr Ser. 2003;1240:1411-5.

Al-Mazrou KA, Al-Qahtani A, Al-Fayez AI. Effectiveness of transnasal endoscopic powered adenoidectomy in patients with choanal adenoids. Int J Pediatr Otorhinolaryngol. 2009;73(12):1650-2.