Abstract
Introduction
Adenoidectomy is most commonly performed in children to alleviate the symptoms pertaining to adenoid hypertrophy. The conventional cold steel method utilizing adenoid curette is the most commonly performed method in the world even after the invention of endoscopes & powered instruments like coblator & microdebrider due to the cost & time factors. The conventional method being a blind procedure, carries higher rate of recurrence due to remnant tissues. The visualization of the adenoid tissue in nasopharynx through the nasal endoscope helps in better engagement of adenoids into the curette & adequate tissue clearance with reduced recurrence of symptoms.
Aim
To study the effect of visualization of adenoid tissue for better tissue clearance in conventional adenoidectomy.
Objectives
To compare the duration of surgery, blood loss & recurrence rate following conventional cold steel adenoidectomy (CSA) & endoscope assisted cold steel adenoidectomy (EACSA).
Method
50 patients who underwent adenoidectomy with various indications were grouped into two groups with 25 patients each. Group A underwent (CSA)with or without tonsillectomy & Group B underwent (EACSA) with or without tonsillectomy were followed up for the duration of 3 months. The patients were evaluated for duration of surgery & post operatively for the recurrence at 3rd month of follow up.
Results
In our study, it was found that the tissue clearance in Group A was significantly low. The recurrence rate of 48% was observed in CSA group compared to 0% in group B with EACSA. The duration of surgery in both the procedures were comparable.
Conclusion
EACSA is an effective modification to CSA. It adds the benefits of endoscopic visualization of adenoid for the conventional curettage. The high recurrence rates of CA can be effectively reduced with no significant variation in duration of surgery.
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References
Hellings P, Jorissen M, Ceuppens JL (2000) The Waldeyer’s ring. Acta Otorhinolaryngol Belg 54(3):237–241 PMID: 11082757
Rout MR, Mohanty D, Vijaylaxmi Y, Bobba K, Metta C (2013) Jul;65(3):269 – 74 Adenoid Hypertrophy in Adults: A case Series. Indian J Otolaryngol Head Neck Surg. doi: 10.1007/s12070-012-0549-y. Epub 2012 Mar 29. PMID: 24427580; PMCID: PMC3696153
Schupper AJ, Nation J, Pransky S (2018) Adenoidectomy in children: what is the evidence and what is its role? Curr Otorhinolaryngol Rep 6(1):64–73. https://doi.org/10.1007/s40136-018-0190-8Epub 2018 Mar 2. PMID: 32226659; PMCID: PMC7100808
El-Tahan A-R, Elzayat S, Hegazy H (2016) Adenoidectomy: comparison between the conventional curettage technique and the coblation technique in pediatric patients. Egypt J Otolaryngol 32. https://doi.org/10.4103/1012-5574.186528
Kamel R, Fattah A (2013) Choanal adenoid after conventional curettage adenoidectomy. PAJR 3:5–8
Fujioka M, Young LW (1979) Girdany. “Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio. Am J Roentgenol 133(3):401–404
Clemens J, McMurray JS, Willging JP (1998) Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol. Mar 1;43(2):115 – 22. https://doi.org/10.1016/s0165-5876(97)00159-6. PMID: 9578120
Meyer W On adenoid vegetations in the Naso-pharyngeal cavity: their Pathology, diagnosis, and treatment. Med Chir Trans 1870;53:191-216.1. https://doi.org/10.1177/095952877005300110. PMID: 20896354; PMCID: PMC2150457.
Pagella F, Matti E, Colombo A, Giourgos G, Mira E How we do it: a combined method of traditional curette and power-assisted endoscopic adenoidectomy. Acta Otolaryngol. 2009 May;129(5):556-9. https://doi.org/10.1080/00016480802294377. PMID: 18720070
Monroy A, Behar P, Brodsky L (2008) Revision adenoidectomy—A retrospective study. Int J Pediatr Otorhinolaryngol 72(5):565–570. https://doi.org/10.1016/j.ijporl.2008.01.008
Saxby AJ, Chappel CA (2009) Nov;79(11):809 – 11 Residual adenoid tissue post-curettage: role of nasopharyngoscopy in adenoidectomy. ANZ J Surg. https://doi.org/10.1111/j.1445-2197.2009.05106.x. PMID: 20078531
Somani SS, Naik CS, Bangad SV (2010 Oct) Endoscopic adenoidectomy with microdebrider. Indian J Otolaryngol Head Neck Surg 62(4):427–431. https://doi.org/10.1007/s12070-011-0118-9Epub 2011 Jan 11. PMID: 22319707; PMCID: PMC3266095
Yanagisawa E, Weaver EM (1997) Feb;76(2):72 Endoscopic adenoidectomy with the microdebrider. Ear Nose Throat J. 74. PMID: 9046692
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Biradar, K., Deepthi, S., Kumar, S. et al. Endoscopic Assisted Cold Steel adenoidectomy – A Cost Effective Modification for Better Outcome. Indian J Otolaryngol Head Neck Surg 75, 3211–3215 (2023). https://doi.org/10.1007/s12070-023-03979-9
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DOI: https://doi.org/10.1007/s12070-023-03979-9