A study to evaluate combined approach of endoscopy guided conventional adenoidectomy

Background: Adenoidectomy is one of the most common surgical procedures performed by Otorhinolaryngologists in the paediatric population. Most commonly used method for adenoidectomy being digital palpation of adenoids followed by their blind curettage using adenoid curette. This leads to incomplete removal of adenoids and also has risks of injuring surrounding structures. Objective of our study was to evaluate the role of intra-operative endoscopic inspection of conventional adenoidectomy. Methodology: Eighty patients attending ENT OPDs at Chigateri district hospital and Bapuji hospital, teaching hospitals attached to our institute during the period from October 2016 to October 2018 with symptoms and radiographic evidence of enlarged adenoids and who fulfill all inclusion and exclusion criteria and are willing to participate in the study were selected, informed and written consent was taken from all cases. A thorough clinical examination and required investigations were performed and diagnosis of enlarged adenoids was made. Patients were operated by Conventional adenoidectomy, followed by visualization and removal of remnants in the nasopharynx using a rigid endoscope. The number of patients benefited with remnants removal was noted. Results: The mean age of patients in our study was 8.8 years with male preponderance. Most common presenting complaints were mouth breathing, nasal obstruction, and snoring. Adenoidectomy with tonsillectomy was the most common procedure performed. Adenoid remnants were detected using endoscopic visualization in 92.5% of the cases in our study, with nasopharyngeal roof being the most common site. Conclusion: Endoscopic assisted adenoidectomy allows complete removal of adenoid tissue there by reducing the chances of developing recurrent adenoid, obstructive symptoms and reducing the bacterial reservoir in the nasopharynx.