Endoscopic-Assisted Powered Adenoidectomy versus Conventional Adenoidectomy: A Randomized Study

Saroo Singh, B. Vageesh Padiyar, Nishi Sharma
2019 Dubai Medical Journal  
Adenoidectomy is one of the most common surgical procedures performed in children. Conventional curettage adenoidectomy has the advantage of being cost-effective and continues to be a commonly used method, especially in developing countries. Objective: To compare conventional curettage adenoidectomy and endoscopic-assisted powered adenoidectomy using a microdebrider. Methods: A total of 60 patients were randomly divided into two groups. Group I underwent conventional curettage adenoidectomy
more » ... e group II underwent endoscopic-assisted powered adenoidectomy. Duration of surgery, amount of intraoperative bleeding, adequateness of removal, and damage to adjacent structures were assessed and compared between the two groups. All patients were followed for 24 months. Results: In our study, we observed approximately three times more mean blood loss and total operating time in the endoscopic-assisted powered procedure compared to the conventional technique (150 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 to 48 h with a mean of 33.6 h for group I and 36 h for group II; 23 patients (77%) in group II presented with residual disease in the 3-month follow-up period. Conclusion: The endoscopic-assisted powered adenoidectomy technique is very efficient in complete removal of adenoid tissue, thus preventing patients from undergoing a second surgery and its possible associated risks. The precision of the microdebrider prevents damage to adjacent vital structures. However, on the other hand, conventional adenoidectomy scored better in terms of shorter duration of surgery and less intraoperative bleeding.
doi:10.1159/000500746 fatcat:p3ryuzvc2jby3lvzlbc32z5u7a