Rigid endoscopic evaluation of conventional curettage adenoidectomy

Regmi, Deepak; Mathur, N. N.; Bhattarai, Manoj

doi:10.1017/s0022215110002100

Cited by 35 publications

(29 citation statements)

References 11 publications

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“…Nonvisualized curette technique with digital palpation to confirm completeness of adenoid removal reported residual adenoid tissue in 80% of cases 12. Endoscopic evaluation immediately after curettage has shown residual adenoid tissue in >60% of patients 13. Other groups have advocated the use of transnasal endoscopy and microdebrider to remove residual adenoid tissue remaining after curette adenoidectomy 14…”

Section: Discussionmentioning

confidence: 99%

Incidence of revision adenoidectomy in children

Grindle¹,

Murray²,

Chennupati³

et al. 2011

The Laryngoscope

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Section: Discussionmentioning

confidence: 99%

Incidence of revision adenoidectomy in children

Grindle¹,

Murray²,

Chennupati³

et al. 2011

The Laryngoscope

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“…With the evolution of endoscopic sinus surgery [2, 4, 5, 16, 17], the introduction of endoscopic vision during curettage adenoidectomy seems rational and optimal compared to use of the mirror for indirect vision. Several manipulations have been adopted to improve the adenoidectomy technique by introducing different surgical instruments from different routes under endoscopic vision, for example, transoral adenoidectomy guided by transoral or transnasal endoscope and transnasal adenoidectomy guided by transnasal or transoral endoscope [1].…”

Section: Discussionmentioning

confidence: 99%

Video Nasoendoscopic-Assisted Transoral Adenoidectomy with the PEAK PlasmaBlade: A Preliminary Report of a Case Series

Kuo

Lin

Chen

et al. 2017

BioMed Research International

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Objectives. The primary objective for this study is to evaluate the advantages, disadvantages, surgical applicability, and outcome of the pulsed electron avalanche knife (PEAK) PlasmaBlade in transoral adenoidectomy under direct visualization using video nasoendoscopy. Patients and Methods. In this series, six cases of adenoid hypertrophy showing varying clinical presentations in relation to its clinical course were surgically treated using a PEAK PlasmaBlade. Before and after surgery, all patients underwent nasal endoscopy to define the grading of hypertrophic adenoids and postoperative outcome. Pure tone audiometry and tympanometry tests were carried out to investigate the change in middle and inner ear functions. Results. The mean follow-up period was 23.8 months. Postoperatively, symptoms of otitis media with effusion were all relieved with closure of the air-bone gap (6/6). Other relevant ear complaints like tinnitus were resolved (1/1) and aural fullness disappeared in 87.5% of ears (7/8). Nasal obstruction (2/2) and postnasal drip (2/2) were improved after surgery. Conclusions. Based on this preliminary report of a case series in a limited sample size, we suggest that using the transoral PEAK PlasmaBlade for adenoidectomy guided by video nasoendoscopy is a safe and feasible surgical technique, allowing remarkable outcomes by providing precise tissue removal, effective hemostasis, and painless postoperative recovery.

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“…Saxby and Chappel [14] found some residual adenoidal tissues evident on nasopharyngoscopy in 68%, of which 24% had significant obstruction. Also, Regmi et al [15] reported that conventional curettage adenoidectomy usually misses a substantial amount of adenoid tissue in more than 60%. By the end of a 2-year follow-up, recurrent obstructive adenoid was detected in 6.6% of cases that were not subjected to nasopharyngeal endoscopic exploration, while it was detected in 1.18% of cases that were explored with cauterization of any residual adenoidal tissues.…”

Section: Discussionmentioning

confidence: 99%

“…Ezzat [17] studied 312 adenoidectomy patients; with endoscopic examination of 122 patients, he found residual obstructive adenoidal tissues that were missed after conventional adenoidectomy in 14.5%, however, adenoidectomies were not done by a single surgeon with different experience and surgical talent between otolaryngologists, telephone questionnaire was used in the follow-up of patients and it showed recurrence in 5.6% in the non-endoscopically examined group while it was 0.85% in the endoscopically examined group. As recurrence of nasal obstructive symptoms after conventional adenoidectomy is not rare, many authors recommended endoscopic assisted technique for more complete removal and consequently to decrease the recurrence rate [15,[17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy

Abdel‐Aziz

2011

Eur Arch Otorhinolaryngol

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Adenoid hypertrophy (AH) is a common cause of airway obstruction in children and its recurrence after conventional curettage adenoidectomy is not rare. The purpose of this study is to assess the efficacy of endoscopic nasopharyngeal exploration at the end of curettage adenoidectomy on decreasing the incidence of adenoid re-hypertrophy. Three hundred and fifty children diagnosed as having AH, underwent conventional curettage adenoidectomy by a single surgeon. The cases were randomly divided into two equal groups A and B, group B were further subjected to nasopharyngeal exploration by the nasal endoscope after removal of their adenoids with cauterization of any visible residuals, while group A were not subjected to this endoscopic maneuver. Follow-up was carried out for at least 2 years; flexible nasopharyngoscopy was used for detection of recurrent AH. Cases that were not subjected to endoscopic nasopharyngeal exploration (group A) showed a high recurrence rate (6.6%), while explored cases (group B) showed a low incidence of recurrence (1.18%). Most recurrence of group A (6%) was detected within the first year of the follow-up period which may indicate re-growth of residual adenoidal tissues that were missed during conventional curettage adenoidectomy. Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy is a useful method in decreasing the incidence of recurrent AH.

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Rigid endoscopic evaluation of conventional curettage adenoidectomy

Abstract: Conventional curettage adenoidectomy misses a substantial amount of adenoid tissue. Rigid endoscopy-assisted adenoidectomy improves this result by enabling localisation of any residual adenoid tissue.

Cited by 35 publications

References 11 publications

Incidence of revision adenoidectomy in children

Incidence of revision adenoidectomy in children

Video Nasoendoscopic-Assisted Transoral Adenoidectomy with the PEAK PlasmaBlade: A Preliminary Report of a Case Series

Endoscopic nasopharyngeal exploration at the end of conventional curettage adenoidectomy

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