EFFECT OF CONVENTIONAL Vs ENDOSCOPIC MICRODEBRIDER ASSISTED
ADENOIDECTOMY ON MIDDLE EAR FUNCTION
Abstract
Introduction: Adenoidectomy is one of the most commonly performed
operation worldwide. Most widely used approach for surgery is
conventional curettage method. However, as this method is associated
with high incidence of residual adenoid tissue at the end of surgery
which results in recurrence of disease, a newer endoscopic microdebrider
assisted approach is becoming popular these days. Though various studies
have shown its efficacy in more complete removal of adenoids, its
functional outcome on middle ear function remains to be explored.
Objectives: To compare pre and post operative pure tone audiometric and
impedance audiometric analysis following conventional and endoscopic
micodebrider assisted adenoidectomy. Materials and Methods: Patients
were diagnosed cases of chronic adenoiditis which were divided in groups
of 25 each. Patients in first group underwent conventional curettage
adenoidectomy while in second group patient underwent endoscopic
microdebrider assisted adenoidectomy. Pre and postoperative pure tone
and impedance audiometry were performed for all the patients and the
outcomes were compared. Results: Endoscopic microdebrider assisted
method resulted in better outcomes which were statistically significant
as compared to the conventional curettage. Criteria such as hearing
threshold (p value 0.004 at second follow up), peak pressure (p value
0.045 at first follow up), tympanogram (p value 0.016) showed that
endoscopic method was better while peak compliance (P value 0.340 at
first follow up) didn’t show any significant difference between the
groups. Conclusion: Endoscopic microdebrider assisted method of
adenoidectomy has a definite advantage of better visualization and
results in more complete removal of tissue and hence results in better
improvement in middle ear functions as compared to the conventional
curettage.