ADENOIDECTOMY BY CRURETTAGE AND MICRODEBRIDER TECHNIQUES: A COMPARATIVE PROSPECTIVE STUDY
Sushant Duddala, Snigdha Shanti Cheela, Saai Ram Thejas*
ABSTRACT
Introduction: Adenoids, which is part of the immune system and part of the Waldeyer Ring helps in protecting the body from virus and bacteria. Hypertrophy of adenoid occurs due to infections or allergies. In the presence of Adenoids, there is airway obstruction which leads to breathing problems, ear infections or other complications which result in snoring and/or sleep apnea at night. Adenoidectomy can be performed by various methods which include Coblation, bipolar coagulation under endoscopic vision, conventional crurettage cold steel technique or using a Microdebrider. Materials and Methods: A comparative, randomized trial of patients aged 5 to 14 years undergoing adenoidectomy was conducted. Patients were randomized to undergo either Crurettage adenoidectomy (Group A – 75 cases) or Microdebrider-assisted adenoidectomy (Group B – 75 cases). Observations and Results: A total of 70 boys and 80 girls were included in the study. The amount of residual disease was much lesser in Group B as compared to Group A. The surgery was done a bit quicker in Group B as compared to Group A whereas the amount of blood loss was almost the same. The pain after surgery was almost the same in the first 8 hours but it significantly dropped in Group B after 24 hours. Conclusion: Although the amount of blood loss was found to be similar in both groups, the pain scores after surgery and residual disease was much lesser in Group B as compared to Group A. Although nasal endoscopes are fast becoming basic tools, powered instrumentation like microdebriders are not common. The need for special equipment and the cost of the procedure have to be borne in mind. Thus, we conclude that if cost is not a factor the use of a Microdebrider is safer and more effective.
Keywords: Chronic Adenoiditis; Microdebrider Adenoidectomy; Crurettage Adenoidectomy.
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