Skip to main content
The Egyptian Journal of Otolaryngology
Download PDF

Removal of adenoid remnants after curettage adenoidectomy: Do we need powered instruments?

The Egyptian Journal of Otolaryngology volume 30, pages 102–105 (2014)Cite this article

En

Abstract

Aim

To compare powered to cold instruments for removing adenoid remnants after conventional curettage adenoidectomy.

Methods

110 patients (4 to 12 years old) scheduled for adenoidectomy with or without other surgeries (tonsillectomy, myringotomy and ventilation tube insertion) were enrolled in this prospective controlled study. We included patients with endoscopically detected adenoid remnants after curettage adenoidectomy including revision cases. Adenoidectomy was done using the adenoid curette, adenoid remnants detected endoscopically were removed by blakesley forceps (Group A) or by the microdebrider (Group B). Both groups were compared in terms of operative time, operative bleeding, post operative complications and adenoid recurrence.

Results

20 patients were excluded due to absence of adenoid remnants after curettage and 10 more were lost for follow up, so we were left with 80 patients (42 in group A and 38 in group B). The mean age was 4.5 years for group A and 5 years for group B. The mean operative time was 10 minutes in group A and 9.5 minutes in group B, the difference was not statistically significant (p>0.05). Excessive intra operative bleeding was encountered in 1 patient of group B, which was controlled with suction cauetry. We didn’t encounter any postoperative bleeding in either group. Also, there were no other post operative complications like nasopharyngeal stenosis and velopharyngeal insufficiency, no adenoid recurrence was detected in both groups.

Conclusions

Both the powered instruments (microdebrider) and the traditional instruments (blakesley forceps) under endoscopic control were characterized by a high level of precision, complete resection of residual adenoid with a very low incidence of post-operative bleeding and no recurrence, but we feel that powered instruments didn’t add any advantage over the traditional ones especially if the cost of the disposable blades is taken in consideration

References

  1. Tankel JW, Cheesman AD. Symptom relief by adenoidectomy and relationship to adenoid and post-nasal airway size. J Laryngol Otol 1986; 100: 637–640.

    Article  CAS  Google Scholar 

  2. Wan YM, Wong KC, Ma KH. Endoscopic-guided adenoidectomy using a classic adenoid curette: a simple way to improve adenoidectomy. Hong Kong Med J 2005; 11: 42–44.

    PubMed  CAS  Google Scholar 

  3. Elluru RG, Johnson L, Myer III CM. Electrocautery adenoidectomy compared with curettage and power-assisted methods. Laryngoscope 2002; 112: 23–25.

    Article  Google Scholar 

  4. Stanislaw Jr P, Koltai PJ, Feustel PJ. Comparison of power-assisted adenoidectomy vs adenoid curette adenoidectomy. Arch Otolaryngol Head Neck Surg 2000; 126:845–849.

    Article  Google Scholar 

  5. Koltai PJ, Chan J, Younes A. Power-assisted adenoidectomy: total and partial resection. Laryngoscope 2002; 112: 29–31.

    Article  Google Scholar 

  6. Costantini F, Salamanca F, Amaina T, Zibordi F. Videoendoscopic adenoidectomy with microdebrider. Acta Otorhinolaryngol Ital 2008; 28: 26–29.

    PubMed  PubMed Central  CAS  Google Scholar 

  7. Havas T, Lowinger D. Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy. Arch Otolaryngol Head Neck Surg 2002; 128: 789–791.

    Article  Google Scholar 

  8. Cannon CR, Replogle WH, Schenk MP. Endoscopic-assisted adenoidectomy. Otolaryngol Head Neck Surg 1999; 121: 740–744.

    Article  CAS  Google Scholar 

  9. Clemens J, McMurray JS, Willging JP. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol 1998; 43: 115–122.

    Article  CAS  Google Scholar 

  10. 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; 129:556–559.

    Article  Google Scholar 

  11. El-Badrawy A, Abdel-Aziz M. Transoral endoscopic adenoidectomy. Int J Otolaryngol 2009; 2009:949315.

    Article  Google Scholar 

  12. Murray N, Fitzpatrick P, Guarisco JL. Powered partial adenoidectomy. Arch Otolaryngol Head Neck Surg 2002; 128:792–796.

    Article  Google Scholar 

  13. Heras HA, Koltai PJ. Safety of powered instrumentation for adenoidectomy. Int J Pediatr Otorhinolaryngol 1998; 44:149–153.

    Article  CAS  Google Scholar 

  14. Rodriguez K, Murray N, Guarisco JL. Power-assisted partial adenoidectomy. Laryngoscope 2002; 112:26–28.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Faculty of Medicine, Cairo University (affliated to Magrabi Eye and Ear Centre, Muscat, Oman, 106 Rumaila building, Nahda street, P.O. Box: 513, Postal Code 112

    Ahmed Hesham

  2. Department of Otorhinolaryngology, Faculty of Medicine, Cairo University (affliated to Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia

    Mahmoud Attia & Hatem Badran

  3. Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Ahmed Hussien

  4. Department of Otorhinolaryngology, Laser Institute of Enhanced Laser Sciences, Cairo University, Cairo, Egypt

    Sherif Safwat

Authors
  1. Ahmed Hesham
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mahmoud Attia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hatem Badran
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ahmed Hussien
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sherif Safwat
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ahmed Hesham.

Additional information

Conflicts of interest

None declared.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hesham, A., Attia, M., Badran, H. et al. Removal of adenoid remnants after curettage adenoidectomy: Do we need powered instruments?. Egypt J Otolaryngol 30, 102–105 (2014). https://doi.org/10.4103/1012-5574.133204

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1012-5574.133204

Keywords