European Archives of Oto-Rhino-Laryngology

, Volume 269, Issue 3, pp 1037–1040 | Cite as

Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy



Adenoid hypertrophy (AH) is a common cause of airway obstruction in children and its recurrence after conventional curettage adenoidectomy is not rare. The purpose of this study is to assess the efficacy of endoscopic nasopharyngeal exploration at the end of curettage adenoidectomy on decreasing the incidence of adenoid re-hypertrophy. Three hundred and fifty children diagnosed as having AH, underwent conventional curettage adenoidectomy by a single surgeon. The cases were randomly divided into two equal groups A and B, group B were further subjected to nasopharyngeal exploration by the nasal endoscope after removal of their adenoids with cauterization of any visible residuals, while group A were not subjected to this endoscopic maneuver. Follow-up was carried out for at least 2 years; flexible nasopharyngoscopy was used for detection of recurrent AH. Cases that were not subjected to endoscopic nasopharyngeal exploration (group A) showed a high recurrence rate (6.6%), while explored cases (group B) showed a low incidence of recurrence (1.18%). Most recurrence of group A (6%) was detected within the first year of the follow-up period which may indicate re-growth of residual adenoidal tissues that were missed during conventional curettage adenoidectomy. Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy is a useful method in decreasing the incidence of recurrent AH.


Adenoid Adenoidectomy Nasal endoscopy Nasal obstruction 


Conflict of interest



  1. 1.
    Rutkow IM (1986) Ear, nose, and throat operations in the United States, 1979 to 1984. Arch Otolaryngol Head Neck Surg 112:873–876PubMedCrossRefGoogle Scholar
  2. 2.
    Wright AL, Holberg CJ, Martinez FD, Halonen M, Morgan W, Taussig LM (1994) Epidemiology of physician-diagnosed allergic rhinitis in childhood. Pediatrics 94:895–901PubMedGoogle Scholar
  3. 3.
    Emerick KS, Cunningham MJ (2006) Tubal tonsil hypertrophy: a cause of recurrent symptoms after adenoidectomy. Arch Otolaryngol Head Neck Surg 132:153–156PubMedCrossRefGoogle Scholar
  4. 4.
    Becker SP, Roberts N, Colianese D (1992) Endoscopic adenoidectomy for relief of serous otitis media. Laryngoscope 102:1379–1384PubMedCrossRefGoogle Scholar
  5. 5.
    Dhanasekar G, Liapi A, Turner N (2010) Adenoidectomy techniques: UK survey. J Laryngol Otol 124(2):199–203PubMedCrossRefGoogle Scholar
  6. 6.
    Elluru RG, Johnson L, Myer CM 3rd (2002) Electrocautery adenoidectomy compared with curettage and power-assisted methods. Laryngoscope 112:23–25PubMedCrossRefGoogle Scholar
  7. 7.
    Stanislaw P Jr, Koltai PJ, Feustel PJ (2000) Comparison of power-assisted adenoidectomy vs adenoid curette adenoidectomy. Arch Otolaryngol Head Neck Surg 126:845–849PubMedGoogle Scholar
  8. 8.
    Koltai PJ, Chan J, Younes A (2002) Power-assisted adenoidectomy: total and partial resection. Laryngoscope 112:29–31PubMedCrossRefGoogle Scholar
  9. 9.
    Wan YM, Wong KC, Ma KH (2005) Endoscopic-guided adenoidectomy using a classic adenoid curette: a simple way to improve adenoidectomy. Hong Kong Med J 11:42–44PubMedGoogle Scholar
  10. 10.
    Koltai PJ, Kalathia AS, Staislaw P et al (1997) Power-assisted adenoidectomy. Arch Otolaryngol Head Neck Surg 123:685–688PubMedCrossRefGoogle Scholar
  11. 11.
    Yanagisawa E, Weaver EM (1997) Endoscopic adenoidectomy with the microdebrider. Ear Nose Throat J 76:72–74PubMedGoogle Scholar
  12. 12.
    El-Badrawy A, Abdel-Aziz M (2009) Transoral endoscopic adenoidectomy. Int J Otolaryngol. doi:  10.1155/2009/949315
  13. 13.
    Cassano P, Gelardi M, Cassano M, Fiorella ML, Fiorella R (2003) Adenoid tissue rhinopharyngeal obstruction grading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatr Otorhinolaryngol 67(12):1303–1309PubMedCrossRefGoogle Scholar
  14. 14.
    Saxby AJ, Chappel CA (2009) Residual adenoid tissue post-curettage: role of nasopharyngoscopy in adenoidectomy. ANZ J Surg 79(11):809–811PubMedCrossRefGoogle Scholar
  15. 15.
    Regmi D, Mathur NN, Bhattarai M (2011) Rigid endoscopic evaluation of conventional curettage adenoidectomy. J Laryngol Otol 125(1):53–58PubMedCrossRefGoogle Scholar
  16. 16.
    Songu M, Altay C, Adibelli ZH, Adibelli H (2010) Endoscopic-assisted versus curettage adenoidectomy: a prospective, randomized, double-blind study with objective outcome measures. Laryngoscope 120(9):1895–1899PubMedCrossRefGoogle Scholar
  17. 17.
    Ezzat WF (2010) Role of endoscopic nasal examination in reduction of nasopharyngeal adenoid recurrence rates. Int J Pediatr Otorhinolaryngol 74(4):404–406PubMedCrossRefGoogle Scholar
  18. 18.
    Rasmussen N (1987) Complications of tonsillectomy and adenoidectomy. Otolaryngol Clin North Am 20:383–390PubMedGoogle Scholar
  19. 19.
    Cannon CR, Replogle WH, Schenk MP (1999) Endoscopic-assisted adenoidectomy. Otolaryngol Head Neck Surg 121:740–744PubMedCrossRefGoogle Scholar
  20. 20.
    Buchinsky FJ, Lowry MA, Isaacson G (2000) Do adenoids regrow after excision? Otolaryngol Head Neck Surg 123:576–581PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Department of Otolaryngology, Faculty of MedicineCairo UniversityCairoEgypt

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