Efficacy and Safety of Endoscopic Assisted Adenoidectomy in Children

Abstract

One of the most frequent surgical procedures performed on children is an adenoidectomy. In last decades, there has been a shift away from cold treatments and toward electrosurgical treatments. The aim of this study was complete removal of adenoids and reducing complications of conventional curettage adenoidectomy by using endoscopic-assisted adenoidectomy. Patients and methods: This was a randomized prospective clinical trial. This study included 54 patients with hypertrophied adenoiditis who were scheduled for adenoidectomy in otolaryngology Head and Neck Surgery department at Zagazig University Hospitals. Group I 27 patients underwent adenoidectomy through endoscopic-assisted microdebrider (group 1) and 27 patients underwent adenoidectomy through endoscopic-assisted coblation (group 2). A detailed history was obtained during the time of admission, and a complete ear, nose and throat examination was done in all patients. An X-ray nasopharynx lateral view soft tissue exposure or diagnostic nasal endoscopy was done to confirm the diagnosis. The details were obtained from the out-patient and in-patient medical records. Results: The mean operation time in all endoscopic adenoidectomy was 27.22 min ±8.61. Post-operative complications was postoperative bleeding in 3 (5.6%) cases, local infection in 3 (5.6%)  cases, AOM in 3 (5.6%) cases, postop voice change in 6 (11.1%) cases, Ear pain in 4 (7.4%) cases, neck pain in 3 (5.6%) cases, halitosis in5 (9.3%) cases, torticollis in 5 (9.3%)cases and fever in 4 (7.4%) cases.There was no statistically significant difference between both groups regarding post-operative complications. Conclusion: Both coblation and microdebrider adenoidectomy provide distinct advantages over traditional methods. One obvious benefit of coblation over microdebrider is the need for only one instrument, rather than necessitating a microdebrider and an electro-cautery device for hemostasis. However, the reduction of intraoperative time achieved by microdebrider is associated with less complications and cost