Odds and evens for endoscopic adenoidectomy - The Author’s reply

Dear Editor, We read with a great interest the article by Costantini et al. 1 entitled Videoendoscopic adenoidectomy with microdebrider (Acta Otorhinolaryngol Ital 2008;28:26-9). This procedure offers several advantages: an improved fi eld of vision, continuous suction of blood, and extreme precision in removing the adenoid tissue. In their study, the validity and safety of this videoendoscopic adenoidectomy with microdebrider has also been demonstrated . The advantages of endoscopic adenoidectomy were mentioned in several studies but there wasn’t enough emphasis on the disadvantages of this technique. Pagella et al. reported that no signifi cant intra-operative bleeding, post-operative haemorrhage or other complications have occurred . Over the years, there have been advances in the techniques of adenoidectomy, from the conventional trans-oral to endoscopic trans-nasal/transoral adenoidectomy. Also Jong and Gendeh emphasized the advantages of this procedure with respect to that of the conventional technique . But there are some disadvantages that we would like to mention. The endoscopic procedures need more operating time than the conventional methods. Adenoidectomy patients are usually children thus the operating area is relatively narrow and the surgeon has to be experienced before performing the operation. This new technique needs a set of endoscopic surgical instruments. Management of local complications, due to this new technique, such as bleeding, can be diffi cult on account of the narrow surgical area. Videoendoscopic adenoidectomy with microdebrider is a supply to control tissue removal but it must be performed alone or combined with the conventional method for selected cases. In our opinion, interest should be focused on some of the disadvantages of videoendoscopic adenoidectomy.