PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “ADENOIDECTOMY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2000

Comparison of power-assisted adenoidectomy vs adenoid curette adenoidectomy.

OBJECTIVE: To compare the safety and efficacy of power-assisted adenoidectomy (PAA) vs adenoid curette adenoidectomy (ACA). DESIGN: A prospective randomized study. SETTING: Children's hospital of a tertiary care medical center. PATIENTS: Ninety patients (aged 1-13 years) underwent PAA, and 87 patients (aged 1-12 years) underwent ACA. MAIN OUTCOME MEASURES: The parameters evaluated were operative time, blood loss, completeness and depth of resection, injuries to surrounding structures, short- and long-term complications, surgeon satisfaction with the procedure, and parents' assessment of the patient's postoperative recovery period. RESULTS: The PAA was 20% faster (P<.001) and had 27% less blood loss (P<.001) than the ACA. It provided a more complete resection(P<.001) and better control of the depth of resection (P<.05). Surgeon satisfaction was greater with PAA (P<.001). There was no difference in the recovery period or parent satisfaction. One patient in the PAA group returned to the operating room for control of postoperative bleeding, and 1 child in the ACA group returned to the hospital for postoperative dehydration. CONCLUSION: The PAA provides a faster, dryer, more complete, and more surgically satisfying resection than the ACA.

Adenoidectomy↗
PubMed2003

[Guidelines for inpatient adenoidectomy].

BACKGROUND: Adenoidectomy, with or without tonsillectomy, remains as one of the most common surgical procedures. This study was undertaken to determine whether or not the criteria for adenoidectomy based on an inpatient basis in our hospital have to be revised and to evaluate the incidence of postoperative bleeding. MATERIAL AND METHODS: The data of 470 patients who underwent adenoidectomy during 1 year were analyzed in a prospective study. Age <1 year; age >16 years; underlying diseases that put the patient at increased pre-or postoperative cardiopulmonary, metabolic or general risk; >20 minutes driving time between hospital and home, lack of compliance; request of the patients/parents were criteria for adenoidectomy to be performed as an inpatient procedure. Due to the rarity of postoperative bleeding the rate of post-adenoidectomy hemorrhage was calculated in a retrospective study on the basis of the data of 8131 patients who had undergone adenoidectomy. RESULTS: A total of 249 patients underwent adenoidectomy on an outpatient basis (53%). Two patients required surgical treatment for postoperative bleeding under general anesthesia (0.43%), one of whom was initially scheduled for outpatient surgery. The parents of 17 children initially scheduled for outpatient surgery refused to take responsibility of postoperative care on the day of surgery. These children were admitted. Inpatient observation was scheduled in most cases because of the distance to the hospital (115 patients) or underlying diseases (7 patients). The rate of post-adenoidectomy hemorrhage in our retrospective study was 0.23%. There was only one adult with repeated bleeding on the day of surgery and 6 days postoperatively. 15 of 19 episodes of bleeding occurred on the day of surgery, the latest episode 6 days postoperatively. There was no case with lethal outcome. No blood transfusions or major surgical procedures at the neck were required to stop the bleeding. CONCLUSIONS: Inpatient observation should be considered in patients with underlying general diseases, postoperative bleeding, poor compliance or request of the patients/parents. Age, general risk of post-adenoidectomy hemorrhage and distance to the hospital are not criteria significant enough to indicate inpatient observation in patients who undergo adenoidectomy.

Adenoidectomy↗
PubMedDate not supplied

Efficacy of adenoidectomy in recurrent otitis media. Historical overview and preliminary results from a randomized, controlled trial.

Adenoidectomy is well established as a procedure for treating children with recurrent or persistent otitis media. Many physicians also believe that when adenoidectomy is undertaken for otitis media, tonsillectomy also should be done routinely. Thus otitis media serves as the justification for a substantial proportion of the tonsil and adenoid operations carried out on children. Nonetheless, evidence supporting the efficacy of adenoidectomy, or tonsillectomy and adenoidectomy (T&A), for otitis media is scant and inconclusive. Only six prospective studies have been reported, and in all but two of them, the combination of adenoidectomy with tonsillectomy, rather than adenoidectomy alone, was tested. The results were contradictory, perhaps because of all the studies contained flaws in design or methodology or both. Whether adenoidectomy or T&A are efficacious remains entirely uncertain. We are attempting to address the question currently in a prospective study in which children considered at high risk for otitis media are entered into a randomized, controlled clinical trial of adenoidectomy. The trial is complicated by the need to take adequate account of subject variables such as age, sex, adenoid size, and the presence or absence of allergy, and of the important treatment variables of concomitant myringotomy with tympanostomy tube insertion. Outcome measurements employed in the trial include the number of episodes per year of acute otitis media, the persistence of middle ear effusion, and the frequency of subsequent myringotomy. Data thus far collected in the study are not sufficient to reach a conclusion for or against the efficacy of adenoidectomy for otitis media, but it is apparent that adenoidectomy by no means eliminates the problem.

Adenoidectomy↗
PubMed2002

Obstructive adenoid tissue: an indication for powered-shaver adenoidectomy.

OBJECTIVES: To quantify the incidence of intranasal extension of adenoid tissue and residual adenoidal obstruction of the posterior choanae following traditional curette adenoidectomy to determine the efficiency of adenoid curettage and the usefulness of intraoperative endoscopic examination and powered-shaver adenoidectomy in achieving better postnasal patency. DESIGN: Prospective intraoperative endoscopic evaluation of the posterior choanae and nasopharynx of a case series of 130 patients before and after curette and powered-shaver adenoidectomy. SETTING: Tertiary referral center. PATIENTS: One hundred thirty consecutive pediatric patients with obstructive adenoidal hypertrophy undergoing adenoidectomy. MAIN OUTCOME MEASURES: The degree of residual postnasal obstruction due to adenoid tissue was assessed endoscopically (grades 0-3) after curette and adjuvant powered-shaver adenoidectomy. The presence of intranasal adenoid tissue was also recorded. RESULTS: Following traditional curette adenoidectomy, 51 (39%) of 130 patients had residual obstructive adenoid with 42 patients (32%) having occlusive intranasal adenoid tissue. Having determined the presence of remaining obstructive tissue with intraoperative nasal endoscopy in these 51 patients, complete airway patency was achieved with powered-shaver adenoidectomy. CONCLUSION: The presence of intranasal extension of adenoids obstructing the posterior choanae is common in children with adenoid hypertrophy. Traditional adenoidectomy is ineffective in removing this tissue and may also leave obstructive tissue high in the nasopharynx. Intraoperative nasal endoscopy allows assessment of the completeness of surgery. Powered-shaver adenoidectomy enables complete removal of obstructive adenoid tissue thereby ensuring postnasal patency.

Adenoidectomy↗
PubMed1992

Adenoidectomy and otitis media.

Adenoid enlargement has traditionally been considered a factor in otitis media; adenoid size, however, does not appear to be correlated with otitis media occurrence. Presence of pathogenic bacteria in the adenoids of children with otitis media has been shown, and adenoidectomy appears to affect the middle ear primarily by removal of the source of infection in the nasopharynx. Three recent randomized, controlled studies showed the efficacy of adenoidectomy in the treatment of chronic secretory otitis media. In one study comparing no treatment, adenoidectomy, and adenotonsillectomy, a significant benefit was seen with adenoidectomy that was not enhanced by tonsillectomy. Another study that compared adenoidectomy, tympanostomy tubes, and a combination of the two showed a significant reduction in effusion time and less surgical retreatment over 2 years in the two adenoidectomy groups. The third study demonstrated the effect of adenoidectomy in children with recurrent chronic otitis media with effusion after failure of tympanostomy tube insertion. All three studies showed that the effect of adenoidectomy was independent of adenoid size. This review discusses current concepts of adenoid physiology and pathology, the major adenoidectomy studies, and indications for the procedure.

Adenoidectomy↗
PubMed2000

Consequences of adenoidectomy in conjunction with tonsillectomy in children.

OBJECTIVE: The purpose of this prospective study was to investigate the role of adenoidectomy in children undergoing elective adenotonsillectomy. PATIENTS AND METHODS: All consecutive children less than 15 years of age operated on over a 12-month period were included. Adenoidectomy was done with curettes and forceps under mirror visualization and tonsillectomy with a unipolar electrodissection technique. Duration of the operation, intra-operative blood loss, and post-operative complications were recorded. RESULTS: Adenotonsillectomy was done in 98 children with a mean age of 7.8 years. The mean duration of adenoidectomy was 10.3 min (S.E. 0.7), 51.8% of the time used for adenotonsillectomy and 25. 9% of the total operating room time. The blood loss was 43.6 ml (S.E. 5.4) and 7.8 ml (S.E. 2.5) for adenoidectomy and tonsillectomy, respectively. Both the duration (P=0.04) and blood loss (P=0.0005) of adenoidectomy increased significantly with the increasing age of children. Post-adenoidectomy complications did not occur. CONCLUSION: Even though adenoidectomy prolonged the operating time and increased the intra-operative blood loss, especially in older children the procedure in general remained relatively short and safe. However, adding adenoidectomy to tonsillectomy should always be carefully considered, particularly in children 10 years or older operated on principally because of palatine tonsil disease.

Adenoidectomy↗
PubMed2003

Adenoidectomy during early life and the risk of asthma.

The objective of the study was to evaluate the risk of asthma in children who had undergone an adenoidectomy, an operation frequently performed on children with glue ear or recurrent otitis media. Two surveys were carried out, a nation-wide questionnaire returned by 483 individuals (survey A) and a survey of hospital discharge records involving 1616 children who had undergone an adenoidectomy and 161 control children who had undergone probing of the nasolacrimal duct due to congenital obstruction (survey B). The questionnaire (survey A) showed that an adenoidectomy before the age of 4 years was associated with asthma (OR 3.19, 95% CI 1.25; 8.13) and with allergy to animal dust (OR 2.50, 95% CI 1.27; 4.95). In survey B, asthma diagnosis was retrieved from the national asthma register. It showed also that adenoidectomy at an early age was associated with an increased risk of asthma (OR 6.74, 95% CI 2.99; 15.2). There was an association between asthma and adenoidectomy, even before adenoidectomy had actually been performed. The risk of asthma was highest among children who had had adenoidectomy because of recurrent otitis media. The observed association between an adenoidectomy and asthma may be explained by an underlying factor predisposing to both recurrent otitis media and asthma.

Adenoidectomy↗
PubMed2001

Pediatric adenoidectomy under vision using suction-diathermy ablation.

OBJECTIVES: To compare adenoidectomy using suction-diathermy ablation with adenoidectomy by way of curettage in a pediatric tertiary care setting. STUDY DESIGN: A prospective series of 68 children undergoing adenoidectomy (without tonsillectomy) under vision using a suction-diathermy ablation technique over 2 years was compared with an historical control group of 58 children undergoing adenoidectomy (without tonsillectomy) by way of curettage over 2 years. METHOD: Intraoperative blood loss was recorded and compared. Efficacy in improving nasal symptomatology was compared between the two groups using an ordinal "nasal symptom score" preoperatively and postoperatively. Complications were recorded and compared. Analysis was performed using two-tailed t tests. RESULTS: The two groups were well matched for age, weight, and adenoid size (P > .4). Follow-up ranged from 4 to 48 months. Adenoidectomy using suction-diathermy resulted in significantly less blood loss (P < .001). The technique was no less efficacious in terms of reducing the nasal symptom score than conventional adenoidectomy by way of curettage (P = .07). Complication rates were no different. No recurrences were identified and no instances of nasopharyngeal stenosis were recognized. CONCLUSIONS: Routine use of suction-diathermy ablation for adenoidectomy converts a difficult, often bloody procedure into a surgically precise operation. It is especially applicable to children. It may have additional advantages in aiding the prevention of the spread of the human form of bovine spongiform encephalopathy (variant Creutzfeldt-Jakob disease [CJD]). Compared with other recently introduced techniques for adenoidectomy, it is considerably less expensive.

Adenoidectomy↗
PubMed1983

Current thinking on tonsillectomy and adenoidectomy.

Tonsillectomy and adenoidectomy, though less frequently performed now than in the 1930s, remain among the most common surgical procedures in the United States. The need for and benefits of tonsillectomy and adenoidectomy have been a source of controversy for several decades. Nonetheless, there are situations in which these procedures definitely are beneficial. Tonsillectomy and adenoidectomy are two distinct procedures with separate indications, and they are performed concurrently only when the specific indications for each coexist. Tonsillectomy is indicated by recurrent tonsillitis, peritonsillar abscess, chronic tonsillitis, tonsillar neoplasm, or tonsillar hypertrophy that is obstructive to the upper aerodigestive tract (respiratory distress, dysphagia, or interference with performance of an adenoidectomy). Adenoidectomy is indicated for nasal airway obstruction due to adenoidal enlargement from hypertrophic or inflammatory processes. Although correlation exists among obstructive adenoids, mouth breathing, and dentofacial anomalies, present evidence is not sufficient to justify adenoidectomy solely on the basis of craniofacial or dentofacial abnormalities. Today, elimination of an occult source of infection (once called focal infection) in patients with disorders such as rheumatic fever or serous otitis media is not a valid indication for either operation. Contraindications to tonsillectomy and adenoidectomy include bleeding disorders, familial anesthetic intolerance, velopharyngeal insufficiency, and concurrent disease that may enhance operative risks. Like all surgical procedures, tonsillectomy and adenoidectomy entail morbidity and risk of mortality. The most frequent complication of these operations is hemorrhage. Risk of mortality is approximately 0.006%. Mortality and morbidity can be minimized by appropriate preoperative evaluation, complete control of the airway with endotracheal anesthesia, and meticulous surgical technique.

Adenoidectomy↗
PubMed2002

Powered partial adenoidectomy.

OBJECTIVE: To confirm our clinical impression that the powered microdebrider is superior to curettes for performing partial adenoidectomy (removal of the superior one half to three fourths of the adenoid pad). DESIGN: Observational study of 100 children undergoing partial adenoidectomy with the powered microdebrider compared with 40 children undergoing conventional partial adenoidectomy with curettes. SETTING: Private and public tertiary care centers. PATIENTS: All patients younger than 20 years undergoing partial adenoidectomy at the respective institutions during the study period. INTERVENTIONS: Partial adenoidectomy as indicated for chronic otitis media, airway obstruction, or chronic or recurrent tonsillitis with either the powered microdebrider or curettes. MAIN OUTCOMES MEASURES: Operative time (with specific quantification of the time required for tissue removal and hemostasis), blood loss, complications, and subjective ease of use. RESULTS: Operative time was 59% shorter for the microdebrider group (mean, 3 minutes 22 seconds; range, 1 minute 6 seconds to 12 minutes 45 seconds) than for the conventional group (mean, 8 minutes 8 seconds; range, 1 minute 2 seconds to 22 minutes 0 seconds) (P<.001). Blood loss was comparable for both groups (powered group: mean, 2.0 mL/kg; range, 0.4 to 9.4 mL/kg; conventional group: mean, 2.0 mL/kg; range, 0.3 to 6.7 mL/kg; P=.34). There were no intraoperative or postoperative complications in either group. Surgeon satisfaction with the microdebrider was high. CONCLUSIONS: The powered microdebrider for partial adenoidectomy is quicker and is not associated with blood loss or complications above that of conventional partial adenoidectomy. The degree of control afforded by the microdebrider technique is of utmost value in preventing complications such as velopharyngeal insufficiency, and this is now our procedure of choice.

Adenoidectomy↗
PubMed2004

Efficacy of adenoidectomy in the treatment of nasal and middle ear symptoms in children with Down syndrome.

OBJECTIVE: To compare the efficacy of adenoidectomy in children with Down syndrome and control patients. METHODS: Medical records were reviewed for preoperative symptoms, ear complaints, date and reason for adenoidectomy, and postoperative symptoms in 27 children (mean age, 6.0 years; range, 1.6-14.5 years) with Down syndrome and 53 age- and sex-matched controls who had adenoidectomy between January 1978 and September 1997. Long-term follow-up was aided by telephone interviews. Improvement in nasal and middle ear symptoms after adenoidectomy was calculated as the percentage of patients symptom-free postoperatively among those with symptoms preoperatively. RESULTS: After adenoidectomy, more controls than patients with Down syndrome had improvement in symptoms, including nasal obstruction (86.7% versus 50.0%; P=0.005); snoring (73.2% versus 40.9%; P=0.01); mouth breathing (84.1% versus 40.9%; P<0.001); and middle ear disease (68.0% versus 23.1%; P<0.001). Patients with Down syndrome were 7.7 times (95% confidence interval, 2.3-25.3) more likely to have chronic ear drainage after adenoidectomy. CONCLUSIONS: The results of the study suggest that the efficacy of adenoidectomy in children with Down syndrome is significantly less than that in controls and should influence surgical decision making in these children.

Adenoidectomy↗
PubMed1998

Safety of powered instrumentation for adenoidectomy.

A recent study established the utility of an endoscopic shaver for adenoidectomy in children by the transoral approach and showed that power assisted adenoidectomy (PAA) was significantly faster with a trend toward decreased blood loss. The purpose of this study was to demonstrate the safety of power assisted adenoidectomy in a large cohort of patients. A retrospective review was performed of 329 patients who had adenoidectomy by powered instrumentation. Postoperative complications were documented and compared with a similar group that had curette adenoidectomy. Complications watched for included prolonged recovery, postoperative hemorrhage, readmission for dehydration, velopharyngeal insufficiency, and nasopharyngeal stenosis. No postoperative complications were seen in the power assisted adenoidectomy group. This review confirms the safety of power assisted adenoidectomy.

Adenoidectomy↗
PubMed1999

Endoscopic-assisted adenoidectomy.

Adenoidectomy is a commonly performed procedure. The advent of endoscopic sinus surgery has popularized the use of endoscopes. Endoscopic-assisted adenoidectomy (EAA) is a natural progression of this technology to allow a more complete adenoidectomy. Two hundred thirty-six patients undergoing adenoidectomy were evaluated with an endoscopic technique. A routine transoral adenoidectomy was performed first. Then a 4-mm 0 degrees telescope was used transnasally, and residual adenoid tissue was removed from the anterior superior nasopharynx. Invariably, residual adenoid tissue was found after transoral adenoidectomy. The EAA technique is minimally invasive, adds less than 5 minutes to the procedure, and is not associated with excessive bleeding. Readily available telescope and endoscopic equipment is used. The EAA technique is advocated for use as an adjunct to a more complete adenoidectomy.

Adenoidectomy↗
PubMed2002

Monopolar electrocautery in adenoidectomy as a possible risk factor for Grisel's syndrome.

OBJECTIVES/HYPOTHESIS: Grisel syndrome is a nontraumatic atlantoaxial subluxation after an inflammatory process in the upper cervical region. It results from a peripharyngeal infection as well as a rare complication following adenotonsillectomy. After the introduction of monopolar suction electrocautery in adenoidectomy, an increased incidence of Grisel's syndrome has been observed. The purpose of the study was to evaluate monopolar suction electrocautery as a possible risk factor. STUDY DESIGN: Retrospective chart review along with current measurements of monopolar and bipolar electrocautery during adenoidectomy. METHODS: The charts of 1431 consecutive cases of adenoidectomy were reviewed before (n = 710) and after (n = 721) the introduction of monopolar suction electrocautery for intraoperative hemostasis. Moreover, energy of delivered current of electrocautery was measured in 30 pediatric patients during adenoidectomy. RESULTS: Three cases of Grisel's syndrome occurred as a postoperative complication in 721 adenoidectomies (0.4%) after the introduction of monopolar suction electrocautery. In contrast, no Grisel's syndrome was observed in 710 procedures before the use of monopolar electrocautery. Current measurements demonstrate an almost fourfold higher level of electrical energy using monopolar electrocautery compared with bipolar coagulation for bleeding control in adenoidectomy. CONCLUSION: Monopolar suction cautery in adenoidectomy may be considered as a risk factor for Grisel's syndrome.

Adenoidectomy↗
PubMed1982

Partial adenoidectomy.

Adenoidectomy in the presence of an inadequate palate may result in velopharyngeal insufficiency. When an adenoidectomy is indicated in a child whose palate is not fully adequate, a partial adenoidectomy may be considered. Partial adenoidectomy involves removing the upper part of the adenoid for relief of nasal obstruction while leaving the lower portion of the adenoid intact to ensure velopharyngeal competence. Fifty-eight children underwent partial adenoidectomy over a 4-year period; 55 of these children had preoperative nasal obstruction; 49 had a tonsillectomy done at the same time; and 2 had had a previous T&A. The rationale for retaining the lower portion of the adenoid includes a short soft palate, decreased palatal mobility, a mild submucous cleft palate, huge tonsils pushing the palate anteriorly, and a short hard palate. The relief of nasal obstruction was excellent. There were no primary postoperative hemorrhages, and none of the 58 children developed velopharyngeal insufficiency following partial adenoidectomy.

Adenoidectomy↗
PubMed2002

Electrocautery adenoidectomy compared with curettage and power-assisted methods.

OBJECTIVE: To compare electrocautery adenoidectomy with conventional (curettage) and power-assisted (endoscopic shaver) methods. STUDY DESIGN: Comparative review. METHODS: Prospective and retrospective studies comparing electrocautery adenoidectomy and conventional curettage or power-assisted methods were reviewed to provide direct comparisons regarding specific outcome variables. RESULTS: Electrocautery adenoidectomy is a precise, effective technique for removing adenoid tissue. Compared with curettage techniques, electrocautery involves less blood loss and shorter operating times. Power-assisted adenoidectomy also offers shorter operating times and less blood loss, but the necessary equipment is more expensive and more experience is required to attain proficiency with the technique. CONCLUSION: Electrocautery adenoidectomy provides the benefits of minimization of operating time and blood loss at a lower cost than power-assisted adenoidectomy.

Adenoidectomy↗