Elzayat Saad, Elsherif Hossam, Aouf Mohammad
Otorhinolaryngology, Faculty of Medicine, Kafr Elsheikh University, Egypt.
Otorhinolaryngology, Faculty of Medicine, Tanta University, Egypt.
Auris Nasus Larynx. 2021 Aug;48(4):710-717. doi: 10.1016/j.anl.2020.11.010. Epub 2020 Nov 28.
This study compared the efficacy and safety of conventional adenoidectomy using a curette and the Radio-frequency (RF) adenoid ablation using endoscope via the trans-oral technique.
A randomized prospective comparative study was conducted in a tertiary care hospital. The study included 80 patients with a diagnosis of adenoid hypertrophy, which was confirmed by X-ray of a lateral view of the skull. The patients were submitted into two groups 40 for each: curettage group and Radiofrequency group. Patients with bleeding diathesis, congenital anomalies, previous adenoidectomy, and morbid illness were excluded from the study. We evaluated the time consumption, the adenoid tissue remnant by the endoscope, blood loss, and clinical correlations like pain by Visual Analog Scale, halitosis, and secondary bleeding in both study groups.
Intra-operative blood loss was 20-40 ml in the Radio-frequency (RF) group, but in the curettage group was 36 - 55 ml. Post-operative pain in the (RF) group was lower than the curettage group. Secondary bleeding was reported mostly in the curettage group (15%). The duration of the operation in (RF) group was relatively long. Halitosis decreased mainly after curettage adenoidectomy.
The endoscopic radio-frequency adenoid ablation surpassed the conventional method. We encourage using Radio-frequency in adenoid surgery as a replacement for the traditional method.
本研究比较了使用刮匙进行传统腺样体切除术与经口内镜下射频(RF)腺样体消融术的疗效和安全性。
在一家三级医疗机构进行了一项随机前瞻性对照研究。该研究纳入了80例经头颅侧位X线确诊为腺样体肥大的患者。将患者分为两组,每组40例:刮除组和射频组。有出血倾向、先天性异常、既往腺样体切除术史和患有严重疾病的患者被排除在研究之外。我们评估了两组的手术时间、内镜下腺样体组织残留情况、失血量以及视觉模拟量表评估的疼痛、口臭和继发性出血等临床相关指标。
射频(RF)组术中失血量为20 - 40毫升,而刮除组为36 - 55毫升。射频组术后疼痛低于刮除组。继发性出血主要发生在刮除组(15%)。射频组手术时间相对较长。口臭主要在腺样体刮除术后有所减轻。
内镜下射频腺样体消融术优于传统方法。我们鼓励在腺样体手术中使用射频技术替代传统方法。