Endoscopic evaluation of completeness of conventional curettage adenoidectomy: a single-blinded observational study

Abstract

Background Conventional curettage adenoidectomy is a blind procedure, which performed in a confined postnasal space produces surgical challenges. The aim was to examine the completeness of conventional adenoidectomy and compare it with surgeon satisfaction and to identify the need to objectively assess the residual tissue at the end of procedure. Aim The primary aim was to objectively assess the residual adenoid mass after curettage adenoidectomy and compare it with surgeon satisfaction using digital palpation. Settings and design A prospective single-blinded observational study was conducted at a tertiary care hospital between February 2015 and September 2015. Patients and methods A total of 45 cases that underwent conventional curettage adenoidectomy were included in the study. Intraoperative images of the postnasal space were recorded and compared with surgeon satisfaction score by a single-blinded observer. Statistical analysis Statistical analysis of interobserver correlation was performed using Cohen’s κ statistics using Graphpad Prism, version-6.07 (trial). Results The 45 cases had a mean±SD age of 8.45±2.47 years, and female to male ratio was 1.4 : 1. The kappa analysis of surgeon satisfaction in relation to the presence of residual adenoid tissue showed that the strength of agreement was worse than that expected by chance (κ=−0.383, SE=0.129). Conclusion The study showed that surgeon satisfaction via digital palpation alone fails to assess residual adenoid tissue, and we recommend endoscopic visualization of the nasopharynx to assess completeness of adenoidectomy.