Coblation adenoidectomy our experience

Aim of our study is to compare the efficacy and safety of coblation adenoidectomy versus conventional cold steel adenoidectomy. The study design included 40 children between age groups 4 – 8. Twenty of these children underwent coblation adenoidectomy while the other group of 20 underwent conventional cold steel adenoidectomy. The parameters taken into consideration for comparison included Post operative pain, operating time, intraoperative bleeding and presence of residual adenoid tissue 6 weeks after surgery. In this study the coblation group demonstrated less post operative pain, less intraoperative bleeding and more complete removal of adenoid tissue. Operative time was found to be significantly higher in coblation group when compared to conventional cold steel adenoidectomy group. Introduction: Adenoid is the lymphoid aggregation seen in the nasopharyx. This tissue is a component of inner waldayer’s ring. This tissue undergoes hypertrophy till the child reaches the age of 4 after which the proportional increase of the size of nasopharyx makes it appear reduced in size which is followed by a reduction of symptoms. Adenoidectomy is the commonly performed surgery in children. As with any other surgical procedure there are complications associated with adenoidectomy. These complications are fortunately rare 2. Various methods of performing adenoidectomy include: 1. Conventional cold steel technique using curette 2. Bipolar coagulation under endoscopic vision 3. Adenoidectomy using microdebrider 3 4. Coblation adenoidectomy For purposes of classification and management adenoid hypertrophy has been graded according to the size of the tissue taking into consideration the relationship of the hypertrophied tissue with vomer, soft palate and torus tubaris . Grade Anatomical structure in contact with adenoid tissue Grade I None Grade II Torus tubaris Grade III Torus tubaris, Vomer Grade IV Torus tubaris, Vomer and soft palate at rest Materials and methods: Pediatric patients of age group ranging between 4 and 8 were included in the study. Parents of the children taken up for study were not aware of the procedure followed during surgery. Patients were chosen randomly for the procedure by an intern by draw of lots. This random choice averted surgeon bias 5 . All the surgical procedures were performed by the same surgeon. Children with co morbid conditions like anemia, upper and lower respiratory infections were excluded from the study. The size of adenoid tissue was graded using the grading system discussed above. Size of adenoid is assessed by performing diagnostic nasal endoscopic examination under topical anesthesia. Age distribution of patients who underwent coblation adenoidectomy Age distribution of patients who underwent cold steel adenoidectomy