Abstract

Introduction: Adenoidectomy is a widely performed surgical procedure for managing chronic adenoid hypertrophy, which can contribute to nasal obstruction, recurrent otitis media, and obstructive sleep apnea in children. Conventional curettage adenoidectomy has been the standard technique; however, concerns regarding residual adenoid tissue, intraoperative bleeding, and postoperative morbidity have led to the adoption of newer techniques, including Coblation, Microdebrider-assisted, Suction Diathermy, and Endoscopic-assisted adenoidectomy. This study aims to compare the efficacy and safety of these techniques with conventional curettage adenoidectomy in terms of intraoperative blood loss, operative time, residual adenoid tissue, and postoperative complications. Materials and Methods: This prospective, comparative study included 100 pediatric patients (aged 3–12 years) undergoing adenoidectomy. Patients were randomly assigned to one of five groups: Conventional curettage, Coblation, Microdebrider assisted, Suction Diathermy, and Endoscopic-assisted adenoidectomy. Primary outcomes assessed included operative time, intraoperative blood loss, and completeness of adenoid removal via postoperative endoscopy. Secondary outcomes included postoperative pain scores, time to resume normal diet, and complications such as bleeding and velopharyngeal insufficiency. Statistical analysis was performed using SPSS software, with significance set at p <0.05.Results: Coblation demonstrated the shortest operative time (9.7 minutes), significantly lower intraoperative blood loss (20.5 ml), and the least residual adenoid tissue (15%) compared to conventional curettage (20.1 minutes, 50.9 ml blood loss, and 70% residual tissue). Postoperative pain scores were lowest in the Coblation group (3.6), whereas the highest was observed in the conventional curettage group (6.3). The complication rate was lowest in Coblation (5%) compared to Conventional (20%) and Suction Diathermy (25%). Conclusion: Coblation adenoidectomy offers significant advantages over conventional curettage, including reduced operative time, minimal intraoperative blood loss, and lower residual adenoid tissue with fewer complications. These findings suggest that Coblation may be the preferred technique for pediatric adenoidectomy. However, further long-term studies are warranted to validate these findings.

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