Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy

Abstract

Adenoid hypertrophy (AH) is a common cause of airway obstruction in children and its recurrence after conventional curettage adenoidectomy is not rare. The purpose of this study is to assess the efficacy of endoscopic nasopharyngeal exploration at the end of curettage adenoidectomy on decreasing the incidence of adenoid re-hypertrophy. Three hundred and fifty children diagnosed as having AH, underwent conventional curettage adenoidectomy by a single surgeon. The cases were randomly divided into two equal groups A and B, group B were further subjected to nasopharyngeal exploration by the nasal endoscope after removal of their adenoids with cauterization of any visible residuals, while group A were not subjected to this endoscopic maneuver. Follow-up was carried out for at least 2 years; flexible nasopharyngoscopy was used for detection of recurrent AH. Cases that were not subjected to endoscopic nasopharyngeal exploration (group A) showed a high recurrence rate (6.6%), while explored cases (group B) showed a low incidence of recurrence (1.18%). Most recurrence of group A (6%) was detected within the first year of the follow-up period which may indicate re-growth of residual adenoidal tissues that were missed during conventional curettage adenoidectomy. Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy is a useful method in decreasing the incidence of recurrent AH.

Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction

“… 19 Abdel-Aziz identified residual adenoid tissue in 20.5% of the cases. 20 Residual adenoid tissue, particularly around the torus tubarius, causes Eustachian tube dysfunction. Additionally, endoscopy is performed under visual control and we, therefore, think that leaving the surgical site cleaner and more efficiently removing blood clots will also be helpful for the microdebrider adenoidectomy technique.…”

Video Nasoendoscopic-Assisted Transoral Adenoidectomy with the PEAK PlasmaBlade: A Preliminary Report of a Case Series

“…With the evolution of endoscopic sinus surgery [2, 4, 5, 16, 17], the introduction of endoscopic vision during curettage adenoidectomy seems rational and optimal compared to use of the mirror for indirect vision. Several manipulations have been adopted to improve the adenoidectomy technique by introducing different surgical instruments from different routes under endoscopic vision, for example, transoral adenoidectomy guided by transoral or transnasal endoscope and transnasal adenoidectomy guided by transnasal or transoral endoscope [1].…”

Hot nasal packing with hot saline irrigation for hemostasis after adenoidectomy: A prospective randomized controlled study

“…Since Meyer first described adenoidectomy in 1868, it has been among the frequently performed surgical procedures in children by otorhinolaryngologists [1][2][3]. Even though many new high technology techniques have been developed over the years, the conventional adenoidectomy technique is still the most widely used one worldwide [4].…”