Electrosurgical adenoid ablation.

Abstract

OBJECTIVE: The technique of adenoidectomy has undergone many refinements over the years with, most recently, the addition of electrosurgery alone as a viable method for removal of adenoid tissue. Several studies have suggested good efficacy with this method. The objective of this study is to examine the effectiveness of adenoidectomy by electrosurgical ablation by the following measures: reduction of the adenoid size, blood loss, and postoperative complications. DESIGN AND METHODS: In this prospective study, we reviewed patients who underwent electrosurgical adenoid ablation for either nasal obstructive symptoms or chronic otitis media with effusion requiring a second or greater set of pressure equalization tubes and adenoidectomy. Preoperative and postoperative videonasopharyngoscopy were performed and evaluated. A grading system for adenoid size for the endoscopic parameters was used. The amount of blood loss and postoperative complications were recorded. RESULTS: On preoperative nasopharyngoscopy, 7 of 23 children had a grade II adenoid size, 15 of 23 had grade III adenoid pads, and 1 of 23 had grade IV adenoid size. Postoperative follow-up at 6 to 8 weeks revealed that 19 of 23 children showed no evidence of adenoid tissue. Three of 23 children had only tiny residual tissue that fell into grade I and one had regrowth of tissue to fit into grade III. Eight patients were seen at 6 months postoperatively, four of whom were followed up to 12 months postoperatively; all showed no evidence of regrowth of adenoid tissue. Average blood loss for the procedure was 2.6 cc. No postoperative complications (postoperative bleed, dehydration requiring hospitalization, infection, velopharyngeal insufficiency) were encountered. CONCLUSIONS: Electrosurgical adenoid ablation is a safe method with minimal intraoperative blood loss and postoperative complications. Follow-up at 6 to 8 weeks and up to 1 year postoperatively suggests that it is an effective method in removing adenoid tissue and alleviating nasal obstruction.