Conventional Curettage For Adenoidectomy. Is This Procedure Justified In The Endoscopic Era

Conventional blind curettage technique is frequently adopted for adenoidectomy either alone or in conjunction with tonsillectomy. Despite living in an endoscopic era, many E.N.T. surgeons continue to use blind curetting which may leave adenoid remnants along with persistence of symptoms. The aim of this study was to evaluate the completeness of removal of adenoid tissue following conventional blind curetting for adenoidectomy.The study design was single arm blinded prospective study with an intervention. Thirty consecutive children of the age 16 years and below, posted for adenoidectomy alone or along with tonsillectomy were included in the study. They underwent endoscopic grading of the adenoids prior to, and after conventional adenoidectomy (the surgeon being blinded to the endoscopic findings). Remnants, if any, were then removed under endoscopic guidance. The pre and post curettage gradings were then analyzed using statistical software SPSS Version 16. Evaluation of adenoids by endoscopy following blind curettage revealed remnant adenoid tissue mainly around the Eustachian tube orifice and in the choanae which was statistically significant. It appears that conventional adenoidectomy invariably results in significant adenoid remnant in the nasopharynx. Hence endoscopic assisted removal is to be considered as a superior and effective alternative technique for adenoidectomy.