ELECTROCAUTERY VERSUS CURETTE ADENOIDECTOMY - COMPARISON OF POSTOPERATIVE RESULTS

Objective: Identify differences in adenoidectomy performed by curettag e versus electrocautery ablation. Design: To receive adenoidectomy by curettage or electrocautery ablation 38 patients undergoing adenoidect omy or adenotonsillectomy were prospectively randomized. The study was completed by 24 patients. All tonsillectomy patients received electro cautery dissection of the tonsils. Preoperative and at least 1 month p ostoperative video-nasopharyngoscopy was performed. Video tapes were r eviewed by the authors blinded to patient identity and procedure to ev aluate choanal obstruction. Preoperative and postoperative lateral nec k radiographs were obtained. Blood loss and postoperative complication s were recorded. Setting: A single, tertiary care pediatric facility. Interventions: Electrocautery ablation of the adenoid was performed wi th suction cautery. Curettage was performed with standard adenoid cure ttes. Main outcome measured: A grading system for adenoid size was dev eloped using radiographs and endoscopic parameters. The grade of preop erative and postoperative adenoid tissue was compared between the cure ttage and electrocautery ablation groups. Operative blood loss was com pared between the groups. The postoperative course and complications w ere compared. Results: The preoperative grade of choanal obstruction i n both groups was the same. No differences could be found in the posto perative grade between the curettage and the electrocautery ablation g roups. No postoperative complications were recorded in either group. T he estimated blood loss in the curettage group was 54.5 mi (S.D. 50.7) while the electrocautery ablation group averaged 3.75 mi (S.D. 6.4; p = 0.0053). Conclusion: There are no differences in the postoperative results of adenoidectomy performed by electrocautery ablation or curet tage. There are no complications recorded in either group. Estimated b lood loss was lower in the electrocautery ablation group. Decreased bl ood loss during the procedure makes the electrocautery ablation method of adenoidectomy attractive. (C) 1998 Elsevier Science Ireland Ltd. A ll rights reserved.