THE EVALUATION OF RESIDUAL ADENOID TISSUE AT THE END OF CONVENTIONAL CURRETAGE ADENOIDECTOMY
1Ishakoğlu Çayeli Devlet Hastanesi, KBB, Rize, Türkiye2Ankara Çocuk Hematoloji Onkoloji Hastanesi, KBB, Ankara, Türkiye
3Mustafa Kemal Üniversitesi, KBB, Hatay, Türkiye
4Dışkapı Yıldırım Beyazıt Eğitim ve Araştırma Hastanesi, KBB, Ankara, Türkiye
5Karabük Üniversitesi, KBB, Karabük, Türkiye Background: Adenoidectomy is one of the most common surgical operations in daily otolaryngology practice. Conventional curettage adenoidectomy guided by digital palpation is a simple and quick procedure that has already been in use for a long time. Conventional curettage adenoidectomy carries a high risk of recurrence unless done by well-experienced surgeons. Some authors suggest that conventional curettage adenoidectomy resulted in the residual tissue up to 50 % of all patients. To determine the residual adenoid tissue by mirror and naso-endoscopic assessment in patients undergoing conventional curettage adenoidectomy was the aim in this study.
Material and Methods: 50 adenoidectomy operations were included in this study between January 2013 and July 2013. The history of previous surgery, anatomic anomaly and acute infection was accepted as an exclusion criterion. The narrowest segment and adenoid tissue volume were assessed with digital palpation, mirror and naso-endoscopic examination just before the surgery. Conventional curettage adenoidectomy with digital palpation was used in all patients as the operation technique. The residual adenoid tissues were assessed with trans-oral mirror andtrans-nasal nasendoscopic examination at the end of the operation. Residual tissue size and localization were measured and compared with each other.
Results: Pre-surgical nasal endoscopy and mirror examination revealed that the choana was narrowed by the adenoid tissue at an average of 81.1 % (range: 30-95 %). Residual adenoid tissue was detected in 24 (48 %) patients by mirror and naso-endoscopic examination at the end of operation. The incomplete removing of adenoid tissue was detected in nasopharyngeal roof (34 %), posterior pharyngeal wall (10 %) and Eustachian tube opening (6 %).
Conclusion: Conventional curettage adenoidectomy misses the residual adenoid tissue in nasopharyngeal roof, posterior pharyngeal wall, eustachian tube opening. Nasopharyngeal exploration is essential in conventional adenoidectomy. Trans-oral mirror examination or nasoendoscopy can be used for evaluation of residual tissue. Mirror examination may be an effective and easier way in small children and resident training.
Keywords : Adenoidectomy, Endoscope assisted adenoidectomy, Mirror assisted adenoidectomy