Veronica Dianitta-Devapriya, Jambunathan Prabaakharan
Department of Otorhinolaryngology and Head and Neck Surgery, ACS Medical College Hospital, Dr. MGR Educational and Research Institute, Chennai-India.
Iran J Otorhinolaryngol. 2025;37(4):179-186. doi: 10.22038/ijorl.2025.84811.3855.
Chronic nasal obstruction, frequent respiratory infections, recurrent ear blocks, earaches, and pediatric obstructive sleep apnea may indicate adenoid enlargement, one of the most common conditions encountered in pediatric otorhinolaryngology practice. Adenoidectomy is a simple procedure with certain limitations, which has led to various innovations in surgical techniques in the recent past. The study aimed to compare two different adenoidectomy techniques: the endoscopy-assisted coblation adenoidectomy and the conventional curettage adenoidectomy.
In this prospective randomized interventional study involving 40 patients, 20 patients in Group A underwent curettage adenoidectomy, and 20 patients in Group B underwent endoscopic coblation adenoidectomy. Complete adenoid tissue removal, surgical blood loss, operative duration, postoperative pain, and recovery time are the outcome measures.
Endoscopy-assisted coblation adenoidectomy enabled complete adenoid removal better than conventional adenoidectomy, 15 patients (75%) had complete removal versus 3 patients (15%) in the conventional group (p-value of 0.0003). The mean blood loss was 30 ± 5.60 mL in Group A and 10.75 ± 2.93 mL in Group B (p = 0.0001). The pain score assessed using the visual analog scale was 4 ± 0.44 in Group A and 3 ± 0.36 in Group B (p = 0.0001). The mean time taken for recovery in Group A was 3.14 ± 0.62 days and that in Group B was 2.64 ± 0.64 days (p = 0.001).
Coblation adenoidectomy under endoscopic guidance enabled complete adenoid removal, reduction in surgical blood loss and postoperative pain, and shortened recovery time.
慢性鼻塞、频繁呼吸道感染、反复耳闷、耳痛以及小儿阻塞性睡眠呼吸暂停可能提示腺样体肥大，这是小儿耳鼻咽喉科临床最常见的病症之一。腺样体切除术是一种存在一定局限性的简单手术，这促使近年来手术技术出现了各种创新。本研究旨在比较两种不同的腺样体切除技术：内镜辅助下低温等离子腺样体切除术和传统刮除腺样体切除术。
在这项纳入40例患者的前瞻性随机干预研究中，A组20例患者接受刮除腺样体切除术，B组20例患者接受内镜下低温等离子腺样体切除术。腺样体组织完整切除情况、手术失血量、手术时长、术后疼痛及恢复时间为观察指标。
内镜辅助下低温等离子腺样体切除术在腺样体完整切除方面优于传统切除术，A组15例（75%）实现完整切除，而传统组仅3例（15%）（p值为0.0003）。A组平均失血量为30±5.60 mL，B组为10.75±2.93 mL（p = 0.0001）。采用视觉模拟量表评估的疼痛评分，A组为4±0.44，B组为3±0.36（p = 0.0001）。A组平均恢复时间为3.14±0.62天，B组为2.64±0.64天（p = 0.001）。
内镜引导下低温等离子腺样体切除术能够实现腺样体完整切除，减少手术失血量及术后疼痛，并缩短恢复时间。
