Electrocautery versus curette adenoidectomy: comparison of postoperative results.
OBJECTIVE
Identify differences in adenoidectomy performed by curettage versus electrocautery ablation.


METHODS
To receive adenoidectomy by curettage or electrocautery ablation 38 patients undergoing adenoidectomy or adenotonsillectomy were prospectively randomized. The study was completed by 24 patients. All tonsillectomy patients received electrocautery dissection of the tonsils. Preoperative and at least 1 month postoperative video-nasopharyngoscopy was performed. Video tapes were reviewed by the authors blinded to patient identity and procedure to evaluate choanal obstruction. Preoperative and postoperative lateral neck radiographs were obtained. Blood loss and postoperative complications were recorded.


METHODS
A single, tertiary care pediatric facility.


METHODS
Electrocautery ablation of the adenoid was performed with suction cautery. Curettage was performed with standard adenoid curettes.


METHODS
A grading system for adenoid size was developed using radiographs and endoscopic parameters. The grade of preoperative and postoperative adenoid tissue was compared between the curettage and electrocautery ablation groups. Operative blood loss was compared between the groups. The postoperative course and complications were compared.


RESULTS
The preoperative grade of choanal obstruction in both groups was the same. No differences could be found in the postoperative grade between the curettage and the electrocautery ablation groups. No postoperative complications were recorded in either group. The estimated blood loss in the curettage group was 54.5 ml (S.D. 50.7) while the electrocautery ablation group averaged 3.75 ml (S.D. 6.4; p = 0.0053).


CONCLUSIONS
There are no differences in the postoperative results of adenoidectomy performed by electrocautery ablation or curettage. There are no complications recorded in either group. Estimated blood loss was lower in the electrocautery ablation group. Decreased blood loss during the procedure makes the electrocautery ablation method of adenoidectomy attractive.
Clemens
J
J
Department of Pediatric Otolaryngology and Maxillofacial Surgery, Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
McMurray
J S
JS
Willging
J P
JP
D000233:Adenoidectomy / Q000379:methods*; D000234:Adenoids / Q000473:pathology; D016063:Blood Loss, Surgical; D002648:Child; D002675:Child, Preschool; D003475:Curettage; D004564:Electrocoagulation; D006801:Humans; D011183:Postoperative Complications; D011446:Prospective Studies; D014068:Tonsillectomy