IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 2 Ser.2 (February. 2020), PP 46-50 www.iosrjournals.org DOI: 10.9790/0853-1902024650 www.iosrjournals.org 46 | Page Adenoidectomy: Blind Curettage or Endoscopic Assisted Curettage? A Comparative Study Dr. Anuj Kansara 1 , Dr. Tarun Ojha 2 1, 2 (ENT-HNS Department, Mahatma Gandhi Medical College & Hospital, Jaipur, Rajasthan, India) Abstract: Introduction: Adenoidectomy is one of the commonest operations performed all over the world. Most frequently done procedure is conventional curette adenoidectomy. Numerous methods have been developed such as laser, microdebrider, radiofrequency, coblation and endoscopic-assisted techniques.The objective of this study is to compare the efficacy of conventional and endoscopic assisted curettage adenoidectomy (EAA). Materials and Methods: 120 patients between the age of 7-15 years and requiring adenoidectomy for various symptoms were enrolled in the study. All the study participants underwent a preoperative assessment which includes clinical examination for nasal patency, ear examination, nasal endoscopy and radiography of post- nasal space. All the patients were randomized into two groups, each of sixty. Group A underwent blind curettage technique and Group B underwent endoscopic assisted curettage adenoidectomy Results: Residual adenoid tissues were found in 22 patients (36.66%) of Group B while the same was seen in 40 patients (66.66%) of Group A. In Group A, 12 (20%) patients were seen to have injury to adjacent structures whereas in Group B only 4 (6.66%) patients showed injury. Blood loss was more in endoscopic assisted curettage adenoidectomy method as compared to conventional method. Conclusion: Endoscopic assisted curettage adenoidectomy is a superior alternative as it gives better visualization and complete resection. Key Word: Adenoidectomy, conventional curette adenoidectomy, Endoscopic assisted curettage Adenoidectomy --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 17-01-2020 Date of Acceptance: 05-02-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction: Adenoid hypertrophy is a common condition in children causing symptoms such as nasal obstruction, nasal discharge, mouth breathing, snoring, sleep apnea and other sleep related breathing disorders besides contributing to rhino sinusitis, recurrent otitis media and otitis media with effusion (1) . Adenoidectomy is among the most commonly performed surgical procedure all over the world. The adenoids are nasopharyngeal lymphoid tissues constituting the Waldeyer’s ring, firstly explained in 1868 by Meyer (2) . The hypertrophy in these lymphoid tissues result in chronic nasal obstruction, recurrent otitis media, recurrent sinusitis, apnoeic episodes, rhinorrhea, snoring, mouth breathing while sleeping, feeding difficulties, craniofacial deformities, and hypo nasal voice (3) . In long-standing cases, they may lead to long-term upper airway obstruction which includes learning difficulties, failure to thrive, behavioral changes, pulmonary hypertension and even cardiac hypertrophy in severe cases (4) . Adenoidectomy is either performed alone or combined with other procedures like tonsillectomy and/or myringotomy. It has been a subject for several clinical research studies, to enhance its quality, improve outcome and to reduce postoperative complications (5) . The operative procedure of choice for adenoidectomy should attain a safe removal criteria, which includes minimum blood loss, less postoperative morbidity, no or minimum recurrence (6) . Most commonly used conventional curettage adenoidectomy was first explained in 1885 (7) . There are many drawbacks of this procedure which includes more bleeding, inadequate success, Eustachian tube or nasopharyngeal stenosis (8) . Hence, there was a need to develop newer technologies and operative procedures which improve the post-operative outcome. Numerous methods have been developed such as monopolar and bipolar diathermy, laser, microdebrider, radiofrequency, coblation and endoscopic assisted techniques. All the above procedures were introduced with the aim to decrease the operative time, blood loss and morbidity. Post adenoidectomy morbidity consists of postoperative pain, postoperative infection, primary or reactionary haemorrhage and secondary or delayed haemorrhage (9) . Endoscopic assisted curettage adenoidectomy had been proposed to enable complete to near-complete removal of adenoidectomy under direct visualization. The aim of the present study is to compare the advantages and disadvantages of the Endoscopic assisted curettage adenoidectomy with the conventional curettage technique in the operation of adenoidectomy.