Endoscopic-assisted versus curettage adenoidectomy: a prospective, randomized, double-blind study with objective outcome measures.

OBJECTIVE: To establish whether there is both objectively and subjectively improved recovery in children receiving endoscopic-assisted adenoidectomy, compared with children receiving curettage adenoidectomy.

STUDY DESIGN: Prospective, randomized, double-blinded study.

METHODS: Thirty-eight patients who underwent adenoidectomy alone or in combination with tonsillectomy before the planned tympanomastoid surgery with an age range from 8 to 12 years were enrolled in the study. Children were prospectively and randomly assigned into two groups: the endoscopic-assisted adenoidectomy and the curettage adenoidectomy. The main subjective parameters were the nasopharyngoscopy and the symptom improvement scale, whereas the main objective parameter was the midsagittal reformatted images of the temporal bone computerized tomographies of patients who underwent adenoidectomy before the planned tympanomastoid surgery. To adequately compare the utility of one technique versus the other, blood loss and operative time were also reviewed.

RESULTS: Evaluation of the temporal bone computerized tomographies of patients by adenoidal/nasopharyngeal ratios revealed a statistically significant difference with a mean ratio of 0.41 in the curettage and 0.30 in the endoscopic-assisted group. However, both groups had a significant improvement in the symptom improvement scale with no evidence for a significant difference between the endoscopic-assisted and curettage groups.

CONCLUSIONS: Although, objective outcomes reveal that endoscopic-assisted adenoidectomy technique was superior to curettage adenoidectomy in reducing adenoidal size after surgery, subjectively no differences were noted between two methods.