Conventional curettage adenoidectomy vs endoscopic microdebrider adenoidectomy - A comparative study.

Abstract

Background: Adenoidectomy is a frequently done ENT procedure. The purpose of the current article is to assess endoscopic powered adenoidectomy as a potential replacement for the traditional curettage approach.

Methods: Two hundred forty consecutive adenoidectomy cases were randomly divided into two groups of one hundred twenty each. Between August 2020 to February 2023 after getting ethical clearance from Institutional Ethical Committee, Group I underwent Conventional Curettage Adenoidectomy (CA), while Group II underwent Endoscopic Micro-debrider Adenoidectomy (EMA).

Results: Average operative time in CA Group was 31.4 min and in EMA group was 55.7 min. In CA group, mean intraoperative blood loss was 64.4 mL, however, in EMA group, mean blood loss was 86.7 mL (p 0.001). In EMA Group, the resection was consistently complete, with 112 out of 120 cases having an adenoid grade of less than I in post-op. However in the CA group, in 44 (36.7%) of the patients, there was more than 25% remaining adenoid tissue postoperatively and more than 50% remnant adenoid tissue was found in 12 cases (10%) post-op. Post-operative pain was studied with the CA Group demonstrating an average 7 days' postoperative pain score of 3.90 whereas EMA Group demonstrating an average 7 days' postoperative pain score of 0.9.

Conclusions: It was observed that EMA was a secure and reliable tool for adenoidectomy. Endoscopic powered adenoidectomy performed better in the completion of resection, accuracy of resection under vision, collateral damage, and post-operative pain. Contrarily, conventional Curettage adenoidectomy scored higher in terms of shorter surgery times and less intraoperative hemorrhage.