Publication:

Endoscopic microdebrider-assisted versus conventional curette adenoidectomy in paediatric adenoid hypertrophy: a randomized controlled study

Background To compare the clinical and endoscopic outcomes of endoscopic microdebrider-assisted adenoidectomy with conventional curette adenoidectomy in paediatric patients with symptomatic adenoid hypertrophy.

Methods This prospective randomized controlled study was conducted in 50 children aged 5–15 years with symptomatic adenoid hypertrophy. Patients were randomly allocated into two groups of 25 each. Group A underwent endoscopic microdebrider-assisted adenoidectomy, whereas Group B underwent conventional curette adenoidectomy. Clinical symptoms, endoscopic adenoid grading, and nasal airway patency were assessed preoperatively and at postoperative days 15 and 30. Statistical analysis was performed using appropriate parametric and non-parametric tests, with p<0.05 considered statistically significant.

Results Complete resolution of mouth breathing, snoring, recurrent upper respiratory tract infections, and otologic symptoms was observed in all patients undergoing microdebrider-assisted adenoidectomy, whereas residual symptoms persisted in the conventional curette group. Endoscopic evaluation demonstrated complete conversion to Grade I adenoid tissue in all patients in Group A, while residual Grade II hypertrophy was observed in 44% of patients in Group B. Mean nasal airway patency improved from 39% to 92% in the microdebrider group compared with 32% to 80% in the conventional group. Both groups showed statistically significant postoperative improvement (p<0.05), with significantly better outcomes in the microdebrider-assisted group.

Conclusions Endoscopic microdebrider-assisted adenoidectomy provides superior symptomatic relief, greater improvement in nasal airway patency, and more complete removal of adenoid tissue than conventional curette adenoidectomy. The technique is safe, effective, and offers important clinical advantages in the surgical management of paediatric adenoid hypertrophy.