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Comparison of transnasal and transoral routes of microdebrider combined curettage adenoidectomy and assessment of endoscopy for residue: a randomized prospective study

  • Head and Neck
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Abstract

Purpose

The aim of this study is to investigate the frequency and locations of residual adenoid tissue in conventional curettage adenoidectomy (CA) via transnasal endoscopic examination at the end of the operation and to determine the most appropriate technique for residual adenoid tissue removal by transoral or transnasal microdebrider usage.

Methods

Sixty-three patients aged 4–12 years who were scheduled for CA were included in this randomized prospective study in a tertiary reference center. Patients who underwent CA had the endoscopic residual tissue exploration at the end of surgery. The amount and locations of residual tissue were recorded. Patients with > 20% residual tissue were divided into two groups according to randomization list for removing the residual tissue, depending on the use of transoral microdebrider (TOMD) and transnasal microdebrider (TNMD). Two procedures were compared in terms of duration, bleeding, pain, post-anesthesia care unit (PACU) transfer time, and complications.

Results

Residual tissue was detected in 38 patients (60.2%). The most common location of residual tissue was peritubal area (41.3%). The TOMD group had lower surgical duration, blood loss, pain scores and shorter PACU transfer time (p = 0.001, p = 0.002, p˂0.001, and p = 0.006, respectively).

Conclusion

Endoscopic exploration at the end of CA should be considered to avoid residual tissue retention. Furthermore, if residual tissue is present, the use of TOMD is easier, faster, and associated with lower morbidity than the use of TNMD

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Funding

This study did not receive funding.

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Authors and Affiliations

  1. Departments of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Balikesir University Health Practice and Research Hospital, 10440, Cagis, Balikesir, Turkey

    Kamil Gokce Tulaci, Erhan Arslan, Tugba Tulaci, Aziz Dinek & Hasmet Yazici

Authors
  1. Kamil Gokce Tulaci
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  2. Erhan Arslan
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  3. Tugba Tulaci
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  4. Aziz Dinek
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  5. Hasmet Yazici
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by KGT, EA, TT, AD and HY. The first draft of the manuscript was written by KGT and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kamil Gokce Tulaci.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Balikesir University Faculty of Medicine Ethics Committee (Ethical committee approval number: 2019/108) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants’ parents included in the study.

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Patients’ parents signed informed consent regarding publishing their data and photographs.

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Tulaci, K.G., Arslan, E., Tulaci, T. et al. Comparison of transnasal and transoral routes of microdebrider combined curettage adenoidectomy and assessment of endoscopy for residue: a randomized prospective study. Eur Arch Otorhinolaryngol 278, 797–805 (2021). https://doi.org/10.1007/s00405-020-06385-x

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  • DOI: https://doi.org/10.1007/s00405-020-06385-x

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