Comparison between Endoscopic and Curettage Adenoidectomy

Introduction: Adenoidectomy is a procedure to remove the adenoid tissue in the post nasal space, commonly done using curettage (conventional method) which is blind surgery.
Aim: To show the differences between curettage and endoscopic adenoidectomy regarding long term results, safety, and accuracy.
Patients and Methods: From October 2017 to October 2019 eighty (80) patients (32 males and 48 females) underwent adenoidectomy. They were divided into two groups, each group of forty patients. Group A underwent adenoidectomy by conventional curettage while group B underwent endoscopic adenoidectomy trans nasally assisted by debrider.
The parameters studied are, Intra operative time, complete excision, trauma during surgery, vello- pharyngeal insufficiency, adenoid remnant and lastly symptoms relief.
Results: Surgery time in group A is from 10-35 minutes(mean time is 23 minutes)while in group B is from 21-91 minutes (mean time is 42 minutes). Adenoidectomy is nearly complete in group B while 8 patients in group A had remnant adenoid tissue (20%). Group A has associated trauma in 6 patients (15%). (including minor trauma to uvula or posterior pharyngeal wall) while in group B 10 cases (25%) have septal mucosal injury for which 4 patients need anterior nasal packing. Vello pharyngeal insufficiency occurred in 4 cases in group A while 6 patients affected in group B. All are mild and resolved within days. Infection occurred in 2 patients in both groups. Retained swab had occurred in 2 patients in group A while nil in group B.
Conclusion: Adenoidectomy by assisted endoscopy is accurate and safe because it fulfills complete excision of adenoid under direct visualization