Is Transnasal Endoscopic Examination Necessary Before and After Adenoidectomy?

Abstract

The present study aimed to investigate the amount of residual adenoid tissue following the conventional adenoidectomy as compared with preoperative values. A total of 32 girls and 44 boys (range, 3-15 years) in whom adenoidectomy procedure was planned were included in the study. Adenoid tissue sizes before adenoidectomy and residual tissue sizes after conventional curettage adenoidectomy were measured by transnasal endoscopic examination and were recorded. Adenoid tissue size before and after adenoidectomy was compared. The mean age of the patients was 7.7 years (range, 3-15 years). Before adenoidectomy grade 4 adenoid tissue was noted in 43.4% (n = 33), grade 3 was noted in 28.9% (n = 22), grade 2 was noted in 25% (n = 19), and grade 1 was noted in 2.6% (n = 2) of the patients. Following adenoidectomy, no significant difference was noted with respect to residual adenoid tissue sizes of grade 4 and grade 3 patients (P = 0.75, P = 0.76). Transnasal endoscopic examination is suggested to be the most appropriate method to assess the amount of residual adenoid tissue after conventional curettage adenoidectomy. The residual adenoid tissue with the help of a microdebrider in case of a large residual adenoid tissue located in the choana are necessary for complete adenoidectomy.

Effectiveness of Evaluation of Adenoid Hypertrophy in Children by Flexible Nasopharyngoscopy Examination (FNE), Proposed Schema of Frequency of Examination: Cohort Study

“…In 5 out of 10 operated children, the authors reported no complete removal of the tonsil in the radiological examination. This is much more than that described by other authors assessing the surgical effects of adenoidectomy (e.g., with endoscopic examination) [ 22 ]. Moreover, it has also been proven that evaluation of adenoid size by cephalometric radiography is much less effective than CT, and what was mentioned above overestimated the adenoid size [ 19 , 23 ].…”

“…[ 34 , 35 ]. It is also dependent on the surgeon’s experience and surgical technique [ 22 , 34 ]. Yildirim shows that blind curettage adenoidectomy may have left in 18% large residual adenoid.…”

“…Yildirim shows that blind curettage adenoidectomy may have left in 18% large residual adenoid. For precise resection of the adenoid, we controlled the nasopharynx with a mirror [ 22 ]. In our study, one patient (fewer than 1%) needed revision surgery because of adenoid regrowth (A/C ratio 70%) and concomitance hypoacusis caused by middle-ear effusion.…”

Comparison of Transoral/Transnasal Endoscopic-Guided Adenoidectomy with Endoscopic Nasopharyngeal Inspection at the End of Curettage Adenoidectomy

“…Several adenoidectomy techniques have been described in the literature. The most common and classical adenoidectomy method is blindly transoral removal of the adenoid tissue with an adenoid curette or adenotome [1,3,4]. After conventional curettage adenoidectomy, residual adenoid tissue may remain.…”

“…After conventional curettage adenoidectomy, residual adenoid tissue may remain. Therefore, alternative surgical methods have been described [3,4].…”