Microdebrider-assisted Adenoidectomy Versus Coblation-assisted Adenoidectomy for Management of Adenoid: A Comparative Study

Abstract

Background: Adenoidectomy procedures involving coblation tend to be less painful than other surgical procedures. However, Superiority of coblation is still a debate. This study aimed to compare the results and the outcome of microdebrider versus coblation under endoscopic guidance for the management of adenoid and address the surgical difficulties. Patients and methods: We carried out non-randomized controlled study on 40 patients with nasal blockage, mouth breathing due to adenoid. They were divided randomly and equally into two groups and underwent trans-oral 70◦ endoscopic-assisted adenoidectomy using microdebrider (Group A) or coblation (Group B). The two techniques were compared regarding the intraoperative time, bleeding, completeness of removal, adjacent structures injury. Postoperatively, the patients were assessed for complications. Results: In group A, the median operative time was statistically significant shorter (P-value = 0.011) than group B (25 vs 30 minutes). The median blood loss in group A was 20 ml, while in group B the blood loss was less than 10 ml in all patients with a statistically significant difference (P < 0.001) between both groups. Ten patients (50%) in group A had mild to moderate postoperative neck pain, while two patients (10%) in group B had mild postoperative neck pain with a statistically significant difference between the both groups (P-value = 0.006). Conclusion: Trans-oral endoscopic-assisted adenoidectomy by coblation or microdebrider is efficacious in the complete removal of adenoid tissue under vision. Coblation-assisted adenoidectomy demonstrated less intraoperative blood loss, postoperative throat and neck pain, halitosis. Whilst, microdebrider-assisted adenoidectomy has a shorter operative time.