Sethi N, Egan P, Ward V M M
Department of Otolaryngology, Mid Yorkshire NHS Trust, Pinderfields Hospital, Wakefield, UK.
Department of Precancer Genomics, Leeds Institute of Molecular Medicine, St James' University Hospital, UK.
J Laryngol Otol. 2014 Jan;128(1):78-81. doi: 10.1017/S0022215113003411. Epub 2014 Jan 14.
Adenoidectomy is often carried out in children for conditions such as nasal obstruction, otitis media with effusion, and obstructive sleep apnoea. Traditionally, it is performed as a blind procedure with a St Clair Thomson curette. An acceptable alternative technique is suction diathermy adenoidectomy. This study aimed to ensure that the complication rate of this latter technique was within published rates and national guidelines.
A retrospective case note review was conducted, and information regarding surgery, indications and complications was collected.
Post-operative haemorrhage was recorded for 2 of 121 patients (at days 10 and 11 post-operatively): 1 returned to the operating theatre and the other was managed conservatively. Two patients were diagnosed with infection post-operatively and managed with oral antibiotics. A further four patients re-presented with pain; in all cases, this was recorded as secondary to tonsillar fossa infection, rather than being pain related to adenoidectomy.
Given the rare but serious potential complications, the authors support National Institute for Health and Clinical Excellence guidance, which recommends that only surgeons with specific training perform this technique. By using the standard procedures for clinical governance, it is possible to ensure safe practice of even little-used techniques.
