Audiological Outcome of Classical Adenoidectomy versus Endoscopically-Assisted Adenoidectomy using a Microdebrider

Document Type: Original

Authors

1 Department of Otorhinolaryngology, Sri Guru Ram Das Institute of Medical Sciences & Research, Amritsar, Punjab, India.

2 Department of Otorhinolaryngology, Christian Medical College, Ludhiana, Punjab, India.

Abstract

Introduction:
The aim of this study was to evaluate audiological outcomes following adenoidectomy by the classical method and by endoscopically-assisted adenoidectomy using a powered instrument (microdebrider).
 
Materials and Methods:
This study was conducted in a tertiary care center. It included 40 patients divided into two equal groups of 20 each. Group-A patients underwent classical adenoidectomy, while Group-B patients were subjected to endoscopically-assisted adenoidectomy using a microdebrider. Hearing outcome was measured by post-operative pure-tone audiometry and tympanometry.
 
Results:
The post-operative average air-bone gap (ABG) was reduced from 19.6 dB to 11.8 dB in Group A and from 17.6 dB to 8.7 dB in Group B (P=0.010). There was reversal of tympanometric curves from type-B and type-C to type-A in 55% of the patients in Group A, while type-A curve was seen in 90% cases in Group B in the post-operative period.
 
Conclusion: 
Audiological outcomes of endoscopically-assisted adenoidectomy using a microdebrider were superior compared with classical adenoidectomy.

Keywords

Main Subjects


1.Caylan R, Bektas D, Atalay C, Korkmaz O. Prevalence and risk factors of otitis media with effusion in Trabzon, a city in northeastern Turkey, with an emphasis on the recommendation of OME screening. Eur Arch Otorhinolaryngol. 2006; 263 (5):404–8.

2. Sarafoleanu C, Enache R, Sarafoleanu D. Eustachian Tube Dysfunction of Adenoid Origin. Therapeutics, Pharmacology and Clinical Toxicology. 2010;14(1):36–40.

3. Bluestone CD, Doyle WJ. Anatomy and physiology of Eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol. 1988; 81: 997-1003.

4. Bross Soriano D, Schimelmitz-Idi J, Arrieta-Gomez JR. Endoscopic adenoidectomy; use or abuse of the technology? Cir. 2004;72(1):15–9.

5. Gelder LV. Open nasal speech following adenoidectomy and tonsillectomy. J Comm Dis.
1974;7(3):263–7.

6. Canon CR, Relogle WH, Schenk MP. Endoscopic assisted adenoidectomy. Otolaryngology Head and Neck Surgery. 1999;121(6):740–4.

7. Becker SP, Roberts N, Coglianese D. Endoscopic adenoidectomy for the relief of serous otitis media. Laryngoscope.1992;102:1379–84.

8. Rodriguez K, Murray N, Guarisco JL. Power assisted partial adenoidectomy. Laryngoscope. 2002; 112:26–8.

9. Fujioka M, Young LW, Girdang BR. Radiographic evaluation of adenoidal size in children: Adenoidal-nasopharyngeal ratio. Am J Radiol.1979;133:401.

10. Clemens J, McMurray JS, Willging JP. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol.1998;43(2):115–22.

 

11. Grewal N, Godhane AV. Lateral cephalometry: A simple and economical clinical guide for assessment of nasopharyngeal free airway space in mouth breathers. Contemp Clin Dent. 2010;1(2):66–9.

 

12. Mlynarek A, Tewfik MA, Hagr A, Manoukian JJ, Schloss MD, Tewfik TL et al. Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size. J Otolaryngol. 2004; 33(6):360–5.

 

13. Datta R, Singh VP, Deshpal. Conventional versus Endoscopic powered adenoidectomy: A Comparative Study. MJAFI. 2009;65:308–12.

 

14. Caylan R, Bektas D, Atalay C, Korkmaz O. Prevalence and risk factors of otitis media with effusion in Trabzon, a city in northeastern Turkey, with an emphasis on the recommendation of OME screening. Eur Arch Otorhinolaryngol. 2006; 263 (5):404–8.

 

15. Parsons DS. Rhinologic uses of powered instrumentation in children beyond sinus surgery. Otolaryngol Clin North Am.1996;29:105-14.

16. Murray N, Flitzpatrick P, Guarisco JL. Powered Partial Adenoidectomy. Arch Otolaryngol Head and Neck Surg. 2002;128(7):792-6.

17. Costantini F, Salamanca F, Amaina T, Zibordi F, Videoendoscopic adenoidectomy with microdebrider. Acta Otolaryngologica Italica. 2008, 28(1):26–9.

18. Somani SS, Naik CS, Bangad SV. Endoscopic adenoidectomy with microdebrider. Indian J Otolaryngol Head Neck Surg. 2010;64(4):427-31

19. Benito Orejas JI, Alonso Mesonero M, Almaraz Gomez A, Morais Perez D, Santos Perez J. Trend changes in adenotonsillar surgery. An Otorhinolaryngol Ibero Am. 2006;33(6):537-81.

20. Mori H, Kitahara K, Kita M, Takahashi H, Nakai Y. Analysis of tympanograms in relation to the treatment of adenoid vegetation. Nippon Jibiinkoka Gakkai Kaiho.1980;83(4):415-23.

1.Caylan R, Bektas D, Atalay C, Korkmaz O. Prevalence and risk factors of otitis media with effusion in Trabzon, a city in northeastern Turkey, with an emphasis on the recommendation of OME screening. Eur Arch Otorhinolaryngol. 2006; 263 (5):404–8.

2. Sarafoleanu C, Enache R, Sarafoleanu D. Eustachian Tube Dysfunction of Adenoid Origin. Therapeutics, Pharmacology and Clinical Toxicology. 2010;14(1):36–40.

3. Bluestone CD, Doyle WJ. Anatomy and physiology of Eustachian tube and middle ear related to otitis media. J Allergy Clin Immunol. 1988; 81: 997-1003.

4. Bross Soriano D, Schimelmitz-Idi J, Arrieta-Gomez JR. Endoscopic adenoidectomy; use or abuse of the technology? Cir. 2004;72(1):15–9.

5. Gelder LV. Open nasal speech following adenoidectomy and tonsillectomy. J Comm Dis. 1974;7(3):263–7.

6. Canon CR, Relogle WH, Schenk MP. Endoscopic assisted adenoidectomy. Otolaryngology Head and Neck Surgery. 1999;121(6):740–4.

7. Becker SP, Roberts N, Coglianese D. Endoscopic adenoidectomy for the relief of serous otitis media. Laryngoscope.1992;102:1379–84.

8. Rodriguez K, Murray N, Guarisco JL. Power assisted partial adenoidectomy. Laryngoscope. 2002; 112:26–8.

9. Fujioka M, Young LW, Girdang BR. Radiographic evaluation of adenoidal size in children: Adenoidal-nasopharyngeal ratio. Am J Radiol.1979;133:401.

10. Clemens J, McMurray JS, Willging JP. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol.1998;43(2):115–22.

11. Grewal N, Godhane AV. Lateral cephalometry: A simple and economical clinical guide for assessment of nasopharyngeal free airway space in mouth breathers. Contemp Clin Dent. 2010;1(2):66–9.

12. Mlynarek A, Tewfik MA, Hagr A, Manoukian JJ, Schloss MD, Tewfik TL et al. Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size. J Otolaryngol. 2004; 33(6):360–5.

13. Datta R, Singh VP, Deshpal. Conventional versus Endoscopic powered adenoidectomy: A Comparative Study. MJAFI. 2009;65:308–12.

14. Caylan R, Bektas D, Atalay C, Korkmaz O. Prevalence and risk factors of otitis media with effusion in Trabzon, a city in northeastern Turkey, with an emphasis on the recommendation of OME screening. Eur Arch Otorhinolaryngol. 2006;263 (5):404–8.

15. Parsons DS. Rhinologic uses of powered instrumentation in children beyond sinus surgery. Otolaryngol Clin North Am.1996;29:105-14.

16. Murray N, Flitzpatrick P, Guarisco JL. Powered Partial Adenoidectomy. Arch Otolaryngol Head and Neck Surg. 2002;128(7):792-6.

17. Costantini F, Salamanca F, Amaina T, Zibordi F, Videoendoscopic adenoidectomy with microdebrider. Acta Otolaryngologica Italica. 2008, 28(1):26–9.

18. Somani SS, Naik CS, Bangad SV. Endoscopic adenoidectomy with microdebrider. Indian J Otolaryngol Head Neck Surg. 2010;64(4):427-31

19. Benito Orejas JI, Alonso Mesonero M, Almaraz Gomez A, Morais Perez D, Santos Perez J. Trend changes in adenotonsillar surgery. An Otorhinolaryngol Ibero Am. 2006;33(6):537-81.

20. Mori H, Kitahara K, Kita M, Takahashi H, Nakai Y. Analysis of tympanograms in relation to the treatment of adenoid vegetation. Nippon Jibiinkoka Gakkai Kaiho.1980;83(4):415-23.