Curettage adenoidectomy versus endoscopic microdebrider adenoidectomy in children: A randomized controlled trial

Abstract

Introduction: Adenoidectomy is one of the most frequently performed surgical procedures with different techniques and technologies. Although curettage adenoidectomy (CA) has been practiced conventionally for many years, endoscopic microdebrider adenoidectomy (EMA) has emerged as an innovative surgical method. Comparing physiological effects, efficacy and safety of the endoscopic microdebrider adenoidectomy (EMA) and curettage adenoidectomy (CA) in pediatric population is aimed with this prospective, single-blind, randomized, controlled trial.

Methods: Sixty pediatric patients with type-A tympanogram according to Jerger classification in both ears before surgery were randomly assigned to receive the CA (n = 30) and the EMA (n = 30). Tympanometry evaluation for each ear was performed the day before surgery firstly and was repeated on days 1, 7 and 14 after surgery. Intraoperative time, complications during and after the operation were recorded. Postoperative pain was also evaluated for 10 days postoperatively.

Results: Tympanometric evaluation revealed significantly reduced middle ear peak pressure levels with the EMA than with the CA for each ear on day 1 after surgery and for only left ear on day 7 after surgery (P < 0.05). In addition, statistically significant reduced pain scores in postoperative first 3 days were related to the EMA (P < 0.05). There was no significant difference between the methods in terms of duration of surgery and complications.

Conclusion: According to findings from this study, the EMA procedure may be as safe and rapid as the CA. Furthermore, the EMA may be more controlled and less invasive to the surrounding tissues. Further studies are advised to support these data.

Keywords: Curettage; Endoscopic adenoidectomy; Microdebrider; Tympanometry.