gms | German Medical Science

Introduction: The recent study was performed in order to compare the differences between the two techniques (curettage adenoidectomy versus endoscopic-assisted coblation adenoidectomy) on quality of removal of the adenoid tissue, blood loss, duration of the procedure and postoperative pain.

Methods: 70 patients (58 children, 12 adults) participated in this study. In 25 patients the preferred technique was curettage adenoidectomy (using Beckmann’s and St. Clair-Thompson’s curettes) and in 25 patients coblation adenoidectomy. In the remaining 20 cases we used combined method- after the curettage adenoidectomy, we performed endoscopic evaluation of the immediate post operative result and after that we used the Coblator for hemostasis and removal of residual tissue if present. For visualization during the coblation adenoidectomy we used 45° rigid endoscope introduced trans orally.

Results: The conventional adenoidectomy is characterized by increased blood loss and decreased precision compared to the endoscopic removal of the adenoid tissue. In more than a half of the cases the curettage adenoidectomy was unable to remove completely the lymphoid tissues in certain areas (the choanae and the areas near the ostium of the Eustachian tubes), especially in patients with high grade adenoid hyperplasia. The use of coblation along with direct visualization lacked the fore-mentioned issues with the only major disadvantage of increased intraoperative time. In terms of post operative pain the three methods didn’t show significant differencies between each other.

Conclusions: The use of endoscopic-assisted coblation adenoidectomy appeared to have superior results in terms of reduction of the adenoid size, precision and intra-operative blood loss.