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

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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

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Correspondence to Ahmed Hesham.

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None declared.

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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

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Keywords

  • adenoidectomy
  • curette
  • powered
  • remnants
  • traditional