Endoscopic Coblation Adenoidectomy
Conditions
Keywords
Adenoidectomy; Coblation; Cold curettage; Pediatric otolaryngology; Residual adenoid tissue; Postoperative pain; Halitosis; Intraoperative blood loss
Brief summary
Adenoidectomy is a common pediatric otolaryngologic procedure. While cold curettage remains widely practiced, endoscopic coblation has been developed to enhance precision, minimize intraoperative complications, and reduce residual tissue. This study compared outcomes of conventional cold curettage adenoidectomy and coblation-assisted adenoidectomy in pediatric patients.
Detailed description
A total of 128 pediatric patients aged 3-11 years who underwent adenoidectomy between August 2024 and August 2025 was prospectively evaluated with a follow-up duration of 6-12 months. (Table 1) Of these, 64 underwent adenoidectomy and/or myringotomy with ventilation tube insertion using the conventional cold curettage method, while the remaining 64 underwent the same procedures using the endoscopic coblation technique with 0° or 70° endoscopes. All patients had been diagnosed with adenoid hypertrophy and were unresponsive to medical treatment. Indications for surgery included nasal obstruction and associated symptoms such as snoring, apnea, mouth breathing during sleep, recurrent otitis media, and hearing loss due to serous otitis media. Exclusion criteria included patients who underwent concurrent tonsillectomy, dental procedures, or nasal surgeries such as septoplasty and/or turbinate reduction. Patients with chronic neurological disorders or cleft palate were also excluded. Informed consent was obtained from all participants prior to inclusion in the study. All patients underwent a detailed anamnesis and clinical examination. Following the application of a nasal decongestant spray, nasal endoscopy was performed, and the size and position of the adenoid tissue were scored from 1 to 4 using the McMurray and Clemens scoring system.4 In patients who were uncooperative or for whom endoscopic examination could not be performed, lateral nasopharyngeal radiographs were taken to allow for grading. During the operation, the size and extent of the adenoid tissue were confirmed transnasally or transorally using 0° or 70° rigid endoscopes.
Interventions
PROCEDURECold Curettage Adenoidectomy
After achieving adequate exposure under general anesthesia using a Boyle-Davis mouth gag, the soft palate and adenoid tissue were manually palpated, and curettage was performed using a suitably sized adenotome. Residual tissue areas suspected upon digital palpation and laryngeal mirror examination were further curetted using a smaller adenotome.
PROCEDURECoblation-Assisted Adenoidectomy
The nasopharynx and choanae were fully visualized using a 2.7 mm 0° pediatric transnasal endoscope and a 70° 4 mm transoral endoscope, then adenoidectomy was completed using a coblation technique. The procedure was performed using the Coblator II cold radiofrequency coblation device equipped with the PROcise XP plasma rod system, which can be shaped to reach all areas of the adenoid tissue (especially the upper part of the nasopharynx and the opening to the eustachian tubes) and is designed for soft tissue ablation and dissection.
Sponsors
Medipol University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Two different surgeries; Conventional cold curettage adenoidectomy Coblation-assisted adenoidectomy
Eligibility
Sex/Gender
ALL
Age
3 Years to 11 Years
Healthy volunteers
No
Inclusion criteria
Adenoid hypertrophy and were unresponsive to medical treatment. Indications for surgery included nasal obstruction and associated symptoms such as snoring, apnea, mouth breathing during sleep, recurrent otitis media, and hearing loss due to serous otitis media. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Residual Adenoid Tissue Rate | During the follow-up assessments at 1, 6, and 12 months postoperatively | Presence of residual adenoid tissue evaluated postoperatively. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Operative Time | During surgery | Duration of the surgical procedure. |
| Intraoperative Complications | During Surgery | Occurrence of intraoperative complications such as bleeding or mucosal injury. |
| Intraoperative Blood Loss | During Surgery | The total blood loss was calculated by subtracting the amount of saline used from the total fluid volume in the suction canister and adding the estimated amount from the gauze. |
| Postoperative Pain | Post operative 24 hours and at the 72nd hour | Postoperative pain was assessed using a Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst pain ever experienced). Parents were asked to rate their child's pain at the first 24 hours and at the 72nd hour based on their child's behavior such as crying and discomfort |
| Halitosis | Postoperative two weeks | Postoperative halitosis was assessed based on parental observation. Parents were instructed to approach their child from a distance of approximately 10 cm and to record the presence or absence of unpleasant oral odor |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORLÜTFÜ ŞENELDİR, Associate Professor
Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, İstanbul Medipol University.
Outcome results
None listed