Adenoidectomy by different techniques (comparative study)

Background: Adenoidectomy is one of the most common pediatric ambulatory procedure in the world, multiple techniques are present for adenoidectomy with relative advantages and dis advantages of each technique. Objectives: Providing a comparative study of adenoidectomy by electrocautary with suction diathermy, conventional and microdebrider techniques. Patients and Methods: Randomized prospective study included 60 child patients with age ranged from (3-12y) of both genders (28 males and 32 females), all suffering from hypertrophied adenoid tissue, presented clinically with mouth breathing, snoring, partial nasal obstruction and/or discharge and evidenced radiologically with plain X-ray film lateral view to the nasopharynx. All cases presented to Al-Azhar University Hospitals (Al-Hussin & Sayed galal) during the period from July 2018 to December 2018. Results: The mean blood loss in suction diathermy technique was (5.56ml) while in conventional and microdebrider techniques were 43.45ml and 31.90ml respectively and this found to be of highly statistical significance. Also in complete of removal of adenoid tissue there were significant statistical difference between conventional and microdebrider (p-value:0.02) also between conventional technique and suction diathermy technique (p-value < 0.03) but as regard operative time there was highly significant statistical difference between conventional and microdebrider (p-value < 0.001). Conclusion: The suction diathermy adenoidectomy is the technique of choice in lowering intraoperative blood loss compared to other tow techniques, also sharing microdebrider technique in visibility of the surgical field and completeness of resection, when the cost and availability are affordable it will be the gold standard technique for adenoidectomy, the conventional technique have a disadvantages of bleeding, traumatic and incomplete of resection but still cheapest, simplest and most available one.