Comparison of three different adenoidectomy techniques in children - has the conventional technique been surpassed?

Pharyngeal tonsil hyperplasia is the most frequent cause of nasal obstruction and chronic mouth breathing during childhood. Adenoidectomy is the procedure of choice for the resolution of these symptoms. It is not yet known, however, whether the conventional technique (“blind curettage”) has been sur...

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Veröffentlicht in:International journal of pediatric otorhinolaryngology 2018-01, Vol.104, p.145-149
Hauptverfasser: Ferreira, Mayra Soares, Mangussi-Gomes, João, Ximendes, Roberta, Evangelista, Anne Rosso, Miranda, Eloá Lumi, Garcia, Leonardo Bomediano, Stamm, Aldo C.
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container_title International journal of pediatric otorhinolaryngology
container_volume 104
creator Ferreira, Mayra Soares
Mangussi-Gomes, João
Ximendes, Roberta
Evangelista, Anne Rosso
Miranda, Eloá Lumi
Garcia, Leonardo Bomediano
Stamm, Aldo C.
description Pharyngeal tonsil hyperplasia is the most frequent cause of nasal obstruction and chronic mouth breathing during childhood. Adenoidectomy is the procedure of choice for the resolution of these symptoms. It is not yet known, however, whether the conventional technique (“blind curettage”) has been surpassed by more modern adenoidectomy techniques (video-assisted, with the aid of instruments). This study aimed to compare the conventional adenoidectomy technique with two other emerging techniques, performed in a reference otorhinolaryngology center. This is a prospective and observational study of 33 children submitted to adenoidectomy using 3 different techniques that were followed up for a period of 3 months after surgery. The patients were divided into 3 different groups, according to the adenoidectomy technique: Group A (conventional technique - "blind curettage”); Group B (video-assisted adenoidectomy with microdebrider); Group C (video-assisted adenoidectomy with radiofrequency – Coblation®). The surgical time of each procedure was measured, being considered from the moment of insertion of the mouth gag until complete hemostasis was achieved. The questionnaire for quality of life OSA-18 was applied to all caregivers on the day of the surgery and 30–90 days after the procedure. Postoperative complications were also analyzed. For the entire patient sample, there was an improvement in quality of life after the surgery (p  0.05). Regarding the duration of the procedure, the conventional technique showed the shortest surgical time when compared to the others (p 
doi_str_mv 10.1016/j.ijporl.2017.11.012
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Adenoidectomy is the procedure of choice for the resolution of these symptoms. It is not yet known, however, whether the conventional technique (“blind curettage”) has been surpassed by more modern adenoidectomy techniques (video-assisted, with the aid of instruments). This study aimed to compare the conventional adenoidectomy technique with two other emerging techniques, performed in a reference otorhinolaryngology center. This is a prospective and observational study of 33 children submitted to adenoidectomy using 3 different techniques that were followed up for a period of 3 months after surgery. The patients were divided into 3 different groups, according to the adenoidectomy technique: Group A (conventional technique - "blind curettage”); Group B (video-assisted adenoidectomy with microdebrider); Group C (video-assisted adenoidectomy with radiofrequency – Coblation®). The surgical time of each procedure was measured, being considered from the moment of insertion of the mouth gag until complete hemostasis was achieved. The questionnaire for quality of life OSA-18 was applied to all caregivers on the day of the surgery and 30–90 days after the procedure. Postoperative complications were also analyzed. For the entire patient sample, there was an improvement in quality of life after the surgery (p &lt; 0.05). When analyzing the evolution of OSA-18 index, all groups showed statistically significant improvement, for all assessed domains. There were no statistically significant differences between the 3 techniques assessed for quality of life improvement after the surgery (p &gt; 0.05). Regarding the duration of the procedure, the conventional technique showed the shortest surgical time when compared to the others (p &lt; 0.05). No postoperative complications were noted, for any patient. 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The surgical time of each procedure was measured, being considered from the moment of insertion of the mouth gag until complete hemostasis was achieved. The questionnaire for quality of life OSA-18 was applied to all caregivers on the day of the surgery and 30–90 days after the procedure. Postoperative complications were also analyzed. For the entire patient sample, there was an improvement in quality of life after the surgery (p &lt; 0.05). When analyzing the evolution of OSA-18 index, all groups showed statistically significant improvement, for all assessed domains. There were no statistically significant differences between the 3 techniques assessed for quality of life improvement after the surgery (p &gt; 0.05). Regarding the duration of the procedure, the conventional technique showed the shortest surgical time when compared to the others (p &lt; 0.05). No postoperative complications were noted, for any patient. The adenoidectomy resulted in improvement of quality of life, and there were no major postoperative complications, for all operated children, regardless of the technique used. 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subjects Adenoidectomy
Endoscopy
Microdebrider
Quality of life
Radiofrequency
title Comparison of three different adenoidectomy techniques in children - has the conventional technique been surpassed?
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