Adenoidectomy in adults: conventional curretageversusendoscopicmicrodebrider

Abstract

Adenoid hypertrophy in adults is a common entity nowadays because of chronic infection and allergy. Although, adenoidectomy is conventionally done by curettage method, a new technique of endoscopic adenoidectomy with microdebrider is gaining popularity. This study was conducted in ENT department of Sree Balaji Medical College and hospital, Chennai, India. A prospective randomized study was done.  48 patients more than 16 years of age requiring adenoidectomy for various causes with/ without tonsillectomy were included in the study and divided into 2 groups. Group A underwent adenoidectomy with curette and group B underwent endoscopic adenoidectomy with microdebrider. Parameters assessed were Operative time, intraoperative bleeding, damage to surrounding structures, residual adenoids at the end of the procedure and after 3 months. The study shows that after surgery, in group A, 11 patients (45.8%) had residual adenoids as compared to none in group B. The difference was found to be significant (p=0.0002). After 3 months, in group A, 14 patients (58.3%) had residual /recurrent adenoids whereas in group B, 2 patients (8.3%) had recurrent adenoids. The difference was found to be significant (p=0.0002). The injuries to surrounding structures were more in group A. The mean operative time and bleeding were more in group B (p<0.05). It is concluded that endoscopic adenoidectomy with microdebrider results in complete and accurate removal of adenoid tissue and is an effective alternative to curettage especially in adults.