Endoscopic adenoidectomy: a systematic analysis of outcomes and complications in 1006 patients
Alberto Maria Saibene, Cecilia Rosso, Carlotta Pipolo, Paolo Lozza, Alberto Scotti, Filippo Ghelma, Fabiana Allevi, Alberto Maccari, Giovanni Felisati
Abstract
Adenoid hypertrophy (AH) is an extremely common condition in the pediatric population, relating to different pathological scenarios. Failure in responding to medical therapy in these scenarios often leads to adenoidectomy. While traditional adenoidectomy is indeed a relatively “blind” procedure, endoscopic procedures allow more radical resections, bleeding monitoring and complete Eustachian tubes sparing, making adenoidectomy a safer, more manageable and functional procedure. Though literature widely describes endoscopic adenoidectomy, only small case series are available and the procedure itself has never really taken a hold in otolaryngology practice. Aim of this article is to report data on endoscopic adenoidectomy in a wide single center patient population. We retrospectively evaluated the medical records of 1006 children who underwent endoscopic adenoidectomy with or without tonsillectomy (respectively 493 and 513 patients). Data concerning surgical time, blood loss, hospital stay, short and long-term complications, recurrences and post-operative pain were collected. Our data analysis showed that the endoscopic approach requires a longer surgical time, but it determines less intraoperative blood loss, a lower complication rate and less treatment failures when compared to large contemporary case series of either traditional or power-assisted approaches. The overall better outcomes are more noticeable when comparing our data with classic technique case series than with power-assisted case series. Endoscopic adenoidectomy should therefore be regarded as a solid technique, which, in expert hands, lowers complication and recurrence rates at the expense of a slightly increased surgical time.