Abstract
Background
Endoscopic assisted adenoidectomy (EAA) is a natural progression of a newer technology that allows a more complete adenoidectomy. The most common indication for adenoidectomy is adenoid hypertrophy with obstructive sleep apnea. Other indications are recurrent otitis media with effusion, nasal obstruction, and sinusitis. Techniques and instruments for adenoidectomy have evolved over time especially with the use of endoscopes, electrocautery, and power-assisted instruments. All these developments aim at better hemostasis, clearer visualization of the nasopharyngeal region of a child, shorter operative time, and less post- operative pain.
Aim of this study is to review the experience with endoscopic power assisted Adenoidectomy, demonstrating its safety and efficacy
Patients and Methods
This was a cross sectional study conducted in the Shepherd Specialist Hospital Sokoto, Nigeria. After obtaining approval of this study by the institutional medical ethics committee, from January 2018 until November 2023. A preoperative diagnostic rigid nasal endoscopy with zero degree endoscope was done to assess the grade of the adenoid hypertrophy and to help select the candidate for surgery. It also ruled out any nasal pathology. Statistical analysis was carried out using SPSS version 25.0 (IBM SPSS, US) software with regression modules installed. Data was analyzed using percentage and ratio analysis with suitable diagrams.
Complete airway patency and no remnant of adenoids were seen in all patients assessed by endoscopic evaluation at follow up.
Results
The mean age of the patients was 5.05 ± 1.99 SD. Obstructive Sleep apnoea in 54 patients (39.7%), Nasal obstruction 49(36.0%), Snoring and breathing by mouth in 19 patients
(14.0%) were the most common indications for the surgery. Other indications were recurrent otitis media and otitis media with effusion 8 (5.9%), and recurrent Upper Airway infections 6 (4.4%). Every patient had one or more of these complaints. More males 85 (62.5%) participated in the study than females 51 (37.5%) with male to female ratio of 1.7:1. Complete airway patency and no remnant of adenoids were seen in all patients assessed by endoscopic evaluation at follow up.
Conclusion
Although nasal endoscopes are fast becoming basic tools, powered instrumentation like Microdebrider are not common. The need for special equipment and the cost of the procedure have to be borne in mind. The newer method of endoscopic-assisted powered adenoidectomy was found to be a safe and useful tool for adenoidectomy.