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Effectiveness of transnasal endoscopic powered adenoidectomy in patients with choanal adenoids
Khalid A Al-Mazrou1, Abdulaziz Al-Qahtani, Abdulrhman I Al-Fayez
1Pediatric Otolaryngology, Department of Otolaryngology-Head & Neck Surgery, King Saud University & University Hospitals, Riyadh, Saudi Arabia. kalmazrou@gmail.com
Insights
Transnasal endoscopic powered adenoidectomy (TEPA) is a safe and effective technique for removing choanal adenoids in children. This method significantly reduces operative time and blood loss compared to traditional curettage adenoidectomy.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Endoscopic Surgery
Background:
- Adenoid hypertrophy is a common cause of upper airway obstruction in children.
- Choanal adenoids, specifically, can lead to significant respiratory and sleep disturbances.
- Traditional adenoidectomy techniques may have limitations in terms of efficacy and safety.
Purpose of the Study:
- To evaluate the technique and efficacy of transnasal endoscopic powered adenoidectomy (TEPA).
- To compare TEPA with curettage adenoidectomy (CA) in pediatric patients.
Main Methods:
- A randomized study involving 40 children (ages 3-17) with symptoms of snoring or obstructive sleep apnea.
- Patients were divided into two groups: Group A (TEPA) and Group B (CA).
- Pre- and postoperative nasal endoscopy were performed; outcomes included operative time, blood loss, morbidity, and symptom resolution.
Main Results:
- TEPA demonstrated significantly less blood loss (8.2 ml vs. 22.1 ml) and shorter operative time (6.1 min vs. 12.3 min) compared to CA (p<0.05).
- No operative or postoperative complications were observed in either group.
- Postoperative follow-up confirmed no recurrence of symptoms or adenoid tissue.
Conclusions:
- Transnasal endoscopic powered adenoidectomy is an adequate and safe surgical option for choanal adenoid removal.
- TEPA offers advantages in reduced blood loss and operative time.
- This technique should be considered by pediatric otolaryngologists for treating adenoid hypertrophy.
Objectives:
To demonstrate the technique and efficacy of powered assisted adenoidectomy using nasal endoscopy.
Patients And Methods:
Between 2002 and 2003, forty children (age ranged from 3 to 17 years) with symptoms and signs suggestive of snoring and/or obstructive sleep apnea and choanal adenoids were randomly selected and distributed in two groups. Group A underwent transnasal endoscopic powered adenoidectomy (TEPA) and group B underwent curettage adenoidectomy (CA). Both groups underwent pre- and postoperative nasal endoscopy. Direct comparisons between the two groups were made with regards to operative time, amount of blood loss, postoperative morbidity, complications, and resolution of symptoms.
Results:
Male to female distribution was equal 1:1. The mean age of both groups was 8 years. In group A, the mean blood loss was 8.2 ml compared to 22.1 ml in group B (p<0.05). The operative time in group A was 6.1 min vs 12.3 min in group B (p<0.05). There were no operative or postoperative complications in both groups. Postoperative follow up and nasal endoscopy showed no recurrence of symptoms or adenoid remnants.
Conclusion:
Using TEPA for removing choanal adenoids is an adequate and safe method. The TEPA technique can be added to the armamentarium of techniques used by pediatric otolaryngologists.
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