Title: A Comparative Study on Surgical Outcome of Conventional Adenoidectomy and Endoscopic Adenoidectomy in Children with Adenoid Hypertrophy
Authors: Parveen Baabi M A, Santhosh G S, Satheesh S, Susan James
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.46
Abstract
Background and Objective: Advances in endoscopy and powered instruments have revolutionized the field of otorhinolaryngology . With the advent of endoscopes we could remove adenoids under vision. Aim of the study was to compare the surgical outcome of endoscopic adenoidectomy and conventional adenoidectomy.
Methods: A descriptive longitudinal study which spanned a period of 18 months. Consecutive cases were posted for Endoscopic Assisted Adenoidectomy (Group I) and Conventional Adenoidectomy (Group II), each group comprising 32 patients. Postoperative pain score was assessed and compared between two groups undergoing adenoidectomy alone. Patients were called for follow up at 12th week to assess subjective improvement of symptoms, DNE done to assess remnant adenoid tissue and scarring of surrounding structures, and tympanogram done to assess middle ear compliance and finally surgical outcome was compared between both groups.
Results: Mouth breathing and snoring were common presenting complaints. Preoperative endoscopic assessment showed Grade III adenoid hypertrophy in majority of patients (78.1% in group I and 81.3% in group II). Postoperative pain was less in endoscopic assisted adenoidectomy group and the difference was statistically significant (p value<0.01).Postoperatively in Group I , only6.2% patients had remnant adenoid tissue (20-50%) whereas in Group II, 51.3% had remnant adenoids between 20-50% and 6.3% patients had more than 50% remnant adenoids. Postoperatively none of the patients in Group I had bilateral type C curves whereas in Group II, 21.9% patients had bilateral type C curve. The difference was statistically significant (p value<0.01). 81.3% patients in Group I had good surgical outcome whereas in group II it was only 31.3% and the difference was statistically significant (p value <0.01).
Conclusion: Endoscopic assisted adenoidectomy is a safe and effective alternative to conventional curettage method. It ensures reliable restoration of nasopharyngeal patency, better achievement of haemostasis, less postoperative pain, faster recovery.
Keywords: Curettage adenoidectomy; Endoscopic adenoidectomy; Microdebrider; Surgical outcome.
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