Role of Endoscopy in Adenoidectomy (Comparative Study)

Adenoidectomy is a commonly performed procedure. The advent of endoscopic sinus surgery has popularized the use of endoscopes. So, endoscopic-assisted adenoidectomy (EAA) is a natural progression of this technology to allow a more complete adenoidectomy. It was found that the incidence of adenoid remnants, after traditional curette adenoidectomy, was probably rather common in most series. The aim of this study is to determine the role of endoscopy in evaluating traditional adenoidectomy (TA) and to compare between TA and the endoscopic-assisted transnasal adenoidectomy (EATA). This work was based on studying two groups of patients; the first group included 40 children who have underwent traditional adenoidectomy (TA). The second group included another 40 selected patients who have underwent endoscopic-assisted transnasal adenoidectomy (EATA). All patients were examined endoscopically preoperatively and immediately postoperatively to evaluate the presence of adenoid remnants in the form of adenoid/choana ratio (A/C%). Comparison between the postoperative results of both two groups showed that there was a high significant difference between the two groups p=0.001 indicating the significance of the EATA method (group II) than the other TA (group I). The present study recommended the use of endoscope in adenoidectomy whenever possible but its use is strongly indicated in certain situations such as very large adenoid, revision adenoidectomy, serous otitis media with possibility of tubal tonsil hypertrophy, cleft palate, choanal adenoid, ectopic nasal adenoid, neck instability, and when another endoscopic sinonasal procedure is planned.