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Year : 2014  |  Volume : 30  |  Issue : 2  |  Page : 102-105

Removal of adenoid remnants after curettage adenoidectomy: Do we need powered instruments?

1 Department of Otorhinolaryngology, Faculty of Medicine, Cairo University (affliated to Magrabi Eye and Ear Centre, Muscat, Oman)
2 Department of Otorhinolaryngology, Faculty of Medicine, Cairo University (affliated to Saudi German Hospital, Jeddah, Kingdom of Saudi Arabia)
3 Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
4 Department of Otorhinolaryngology, Laser Institute of Enhanced Laser Sciences, Cairo University, Egypt

Correspondence Address:
Ahmed Hesham
(Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, affliated to Magrabi Eye and Ear Centre, Muscat, Oman), 106 Rumaila building, Nahda street, P.O. Box: 513, Postal Code 112

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1012-5574.133204

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Aim To compare powered to cold instruments for removing adenoid remnants after conventional curettage adenoidectomy. Methods 110 patients (4 to 12 years old) scheduled for adenoidectomy with or without other surgeries (tonsillectomy, myringotomy and ventilation tube insertion) were enrolled in this prospective controlled study. We included patients with endoscopically detected adenoid remnants after curettage adenoidectomy including revision cases. Adenoidectomy was done using the adenoid curette, adenoid remnants detected endoscopically were removed by blakesley forceps (Group A) or by the microdebrider (Group B). Both groups were compared in terms of operative time, operative bleeding, post operative complications and adenoid recurrence. Results 20 patients were excluded due to absence of adenoid remnants after curettage and 10 more were lost for follow up, so we were left with 80 patients (42 in group A and 38 in group B). The mean age was 4.5 years for group A and 5 years for group B. The mean operative time was 10 minutes in group A and 9.5 minutes in group B, the difference was not statistically significant (p>0.05). Excessive intra operative bleeding was encountered in 1 patient of group B, which was controlled with suction cauetry. We didn't encounter any postoperative bleeding in either group. Also, there were no other post operative complications like nasopharyngeal stenosis and velopharyngeal insufficiency, no adenoid recurrence was detected in both groups. Conclusions Both the powered instruments (microdebrider) and the traditional instruments (blakesley forceps) under endoscopic control were characterized by a high level of precision, complete resection of residual adenoid with a very low incidence of post-operative bleeding and no recurrence, but we feel that powered instruments didn't add any advantage over the traditional ones especially if the cost of the disposable blades is taken in consideration

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