DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20181876

A comparative study of adenoidectomy by microdebrider vs conventional method

M. Muniraju, Mohammed Saifulla

Abstract


Background: Adenoidectomy is a commonly performed ENT surgery. This present article aims to evaluate endoscopic powered adenoidectomy as an alternative for conventional curettage method.

Methods: 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.  

Results: 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).

Conclusions: 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.


Keywords


Adenoidectomy, Conventional, Microdebrider

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References


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

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

Koltai PJ, Chan J, Younes A. Power-assisted adenoidectomy: total and partial resection. Laryngoscope. 2002;112:29-31.

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

Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988;14:9-17.

Baker S. Fighting for life. The Macmillan Company. New York, NY; 1939: 140-141.

Huang Q, Wu H, Chen X, Xiang M, Cao R, Meng G. Clinical analysis of 68 patients with obstructive sleep-disordered breathing in children. Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2005;19:971-3.

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.

Havas T, Lowinger D. Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy. Arch Otolaryngol Head Neck Surg. 2002;128:789-91.

Bosenberg A, et al. Validation of a six-graded faces scale for evaluation of postoperative pain in children. Paediatr Anaesth. 2003;13:708-13.

Stern Y, Segal K, Yaniv E. Endoscopic adenoidectomy in children with submucosal cleft palate. Int J of Paediatric Otorhinolaryngology 2006;70:1871-4.

Parikh SR, Coronel M, Lee JJ Brown SM. Validation of a new grading system forendoscopic examination of adenoid hypertrophy. Otolaryngology-Head and Neck Surg. 2006;135(5):684-7.