Transoral Endoscopic-Assisted Adenoidectomy: A Prospective Study.

Abstract

Introduction: Adenoidectomy, with or without tonsillectomy, is a common pediatric surgical procedure. It has been noted that blind curettage has many drawbacks. First of all, it cannot completely remove the adenoid tissue from the posterior choana or the margins of the Eustachian tube orifices, which leads to incomplete removal. Secondly, applying curettage blindly may damage the Eustachian tube opening.

Objective: To illustrate our surgical technique for a successful and safe adenoidectomy using a transoral 70° endoscope.

Methods: The present was a prospective study carried out from December 2022 to September 2024. All patients had adenoid hypertrophy either alone or with tonsillar hypertrophy. There were 46 female and 50 male patients, all of whom underwent transoral endoscopic adenoidectomy using a 70° scope.

Results: There were 96 patients included in this study. The mean age was 5 years and 8 months. Of that total, 35 cases were revisions. The primary procedure was done 12 to 26 months prior (mean: 19). All patients were compliant for the scheduled fiberoptic scope 1 year after surgery. We found that 4 patients (4.16%) had small adenoid regrowth, primarily near the Eustachian tube orifices, without causing any symptoms or airway compromise.

Conclusion: Transoral endoscopic adenoidectomy is a technically viable procedure that is better than the traditional curettage method. There was reduced likelihood of incomplete adenoid removal, and it is nearly impossible to damage adjacent structures, making it safer than blind curettage.