Pediatric adenoidectomy under vision using suction-diathermy ablation

Objectives. To compare adenoidectomy using suction-diathermy ablation with adenoidectomy by way of curettage in a pediatric tertiary care setting. Stu dy Design. A prospective series of 68 children undergoing adenoidectomy (wi thout tonsillectomy) under vision using a suction-diathermy ablation techni que over 2 years was compared with an historical control group of 58 childr en undergoing adenoidectomy (without tonsillectomy) by way of curettage ove r 2 years. Method. Intraoperative blood loss was recorded and compared. Eff icacy in improving nasal symptomatology was compared between the two groups using an ordinal "nasal symptom score" preoperatively and postoperatively. Complications were recorded and compared. Analysis was performed using two -tailed t tests. Results. The two groups were well matched for age, weight, and adenoid size (P > .4). Follow-up ranged from 4 to 48 months. Adenoidec tomy using suction-diathermy resulted in significantly less blood loss (P < .001). The technique was no less efficacious in terms of reducing the nasa l symptom score than conventional adenoidectomy by way of curettage (P = .0 7). Complication rates were no different. No recurrences were identified an d no instances of nasopharyngeal stenosis were recognized. Conclusions; Rou tine use of suction-diathermy ablation for adenoidectomy converts a difficu lt, often bloody procedure into a surgically precise operation. It is espec ially applicable to children. It may have additional advantages in aiding t he prevention of the spread of the human form of bovine spongiform encephal opathy (variant Creutzfeldt-Jakob disease [CJD]). Compared with other recen tly introduced techniques for adenoidectomy, it is considerably less expens ive.