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Published on: December 6, 2016
Objective assessment of endoscopy assisted adenoidectomy
Ismail Elnashar1, Mohammad Waheed El-Anwar1, Waleed Mohamed Basha1
1Otorhinolaryngology-Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Egypt.
Objectives:
To objectively assess the effectiveness of endoscopy assisted adenoidectomy utilizing adenoid tissue volume measurement and to set some parameters for which patients are more legible to this procedure.
Methods:
Forty three patients for whom adenoidectomy was conventionally done using adenoid curettes. Surgeon's satisfaction for adenoid removal after curettage and digital palpation was reported. The volume of removed adenoidal tissue was measured. The remaining adenoid tissue, if any, was removed transnasally guided by endoscope. Residual adenoid volume was also was measured. The data was tabulated and statistically analyzed.
Results:
The volume of adenoid removed by curettage ranged from 1 to 3.6 ml with a mean of 2.45 ml. The volume of residual adenoid removed by endoscopy after curettage ranged from 0 to 2.9 ml (mean: 0.67 ± 0.58 ml). The volume of residual adenoid after blind curettage was found to have statistically significant relation to older age of patients, preoperative larger adenoid by X-ray and Surgeon's dissatisfaction about the completeness of removal after curettage.
Conclusion:
Conventional curettage adenoidectomy misses a substantial volume of adenoid tissue. Endoscopy-assisted adenoidectomy is significantly recommended in children age >10 years, dissatisfied surgeon after curettage and palpation, and grade 3 adenoid enlargement on X-ray.
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