title: Combined Conventional and Endoscopic Microdebrider-Assisted Adenoidectomy: A Tertiary Centre Experience.
abstract: BACKGROUND
  Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy.
  
  
  OBJECTIVE
  To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure.
  
  
  METHODS
  This is a prospective study of 60 child patients who underwent combined conventional and endoscopic microdebrider-assisted adenoidectomy. The study was conducted from September 2013 to September 2015. Only child patients with grade 3 and grade 4 Adenoid Hypertrophy (AH) was included in the study. At the end of conventional adenoidectomy and after combined procedure, the AH was graded again. Post-operative complications like neck pain, hypernasality and swallowing problems were noted. Their symptom score was reviewed before surgery and after one month and one year of surgery. The duration of surgery and amount of blood loss was recorded.
  
  
  RESULTS
  By this technique, complete clearance of adenoid tissue was obtained in all 60 (100%) cases. The mean pre-operative symptom score for AH was 3.7, which improved to 0 after one month of combined conventional and endoscopic microdebrider-assisted adenoidectomy. All child patients were symptom-free at the end of one month and one year. The duration of conventional adenoidectomy was 5 minutes 12 seconds while total duration of the combined conventional and endoscopic microdebrider-assisted adenoidectomy was 14 minutes 45 seconds. There was no significant blood loss (15±3 ml approximately). There were no major complications in this study.
  
  
  CONCLUSIONS
  The combined approach of conventional curette along with endoscopic microdebrider-assisted adenoidectomy is a safe and effective method for complete and accurate removal of large adenoids.
authors.affiliation: Assistant Professor, Department of ENT and HNS, DM Wayanad Institute of Medical Sciences , Wayanad, Kerala, India .
authors.forename: Amal T
authors.initials: AT
authors.lastname: Das
authors.affiliation: Associate Professor, Department of ENT and HNS, DM Wayanad Institute of Medical Sciences , Wayanad, Kerala, India .
authors.forename: S B
authors.initials: SB
authors.lastname: Prakash
authors.affiliation: Assistant Professor, Department of ENT and HNS, DM Wayanad Institute of Medical Sciences , Wayanad, Kerala, India .
authors.forename: V
authors.initials: V
authors.lastname: Priyadarshini
keywords: Curettage; Endoscopy; Powered adenoidectomy