Efficacy and Safety of Transoral Endoscopic Microdebrider-assisted Adenoidectomy

經口內視鏡微創腺樣體切除手術之效益與安全性

邱顯育(Shien-Yu Chiu) ； 黃弘孟(Hung-Meng Huang)

《台灣耳鼻喉頭頸外科雜誌》 48卷1期 (2013/03) Pp. 39-44

https://doi.org/10.6286/2013.48.1.39

摘要

OBJECTIVE: The aim of the study was to evaluate the efficacy of transoral endoscopic microdebrider-assisted adenoidectomy (TEMA) compared to a combined method of conventional adenoidectomy with transnasal endoscopic adenoidectomy (CCTEA) for one year follow-up.METHODS: We enrolled 120 children with obstructive adenoid hypertrophy in the study. All patients had chronic nasal obstruction; they were randomly classified into the TEMA and CCTEA groups, each comprising 60 patients. Using a 90-degree endoscope, the patients in the CCTEA group underwent adenoidectomy using an adenoid curette transorally, whereas patients in the TEMA group underwent adenoidectomy using microdebrider transorally. Surgical outcomes were assessed with respect to operating time, blood loss, patency of the posterior choana, visual analogue scale. Assessments were conducted prior to and one year subsequent to surgery completion.RESULTS: The operative time for TEMA group was shorter than that of CCTEA. (p ＜ 0.001) The TEMA group had less blood loss than that of CCTEA group. (p ＜ 0.001) Four of the 60 patients in CCTEA had postoperative hemorrhage, while none of the TEMA group had. Compared to preoperative values, subjective complaints (nasal obstruction, rhinorrhea, and snoring) showed significant improvement 1 year postoperatively in both groups (p ＜ .05 for both). No significant difference was noted among the subjective complaints between TEMA and CCTEA.CONCLUSIONS: TEMA was equally effective in relieving nasal obstruction 1 year after surgery, compared to CCTEA. Furthermore, it provides a better option for prevention of complications than CCTEA because of its better control of manipulation.

關鍵字

腺樣體切除手術 ； 內視鏡 ； 孩童

並列摘要

OBJECTIVE: The aim of the study was to evaluate the efficacy of transoral endoscopic microdebrider-assisted adenoidectomy (TEMA) compared to a combined method of conventional adenoidectomy with transnasal endoscopic adenoidectomy (CCTEA) for one year follow-up.METHODS: We enrolled 120 children with obstructive adenoid hypertrophy in the study. All patients had chronic nasal obstruction; they were randomly classified into the TEMA and CCTEA groups, each comprising 60 patients. Using a 90-degree endoscope, the patients in the CCTEA group underwent adenoidectomy using an adenoid curette transorally, whereas patients in the TEMA group underwent adenoidectomy using microdebrider transorally. Surgical outcomes were assessed with respect to operating time, blood loss, patency of the posterior choana, visual analogue scale. Assessments were conducted prior to and one year subsequent to surgery completion.RESULTS: The operative time for TEMA group was shorter than that of CCTEA. (p ＜ 0.001) The TEMA group had less blood loss than that of CCTEA group. (p ＜ 0.001) Four of the 60 patients in CCTEA had postoperative hemorrhage, while none of the TEMA group had. Compared to preoperative values, subjective complaints (nasal obstruction, rhinorrhea, and snoring) showed significant improvement 1 year postoperatively in both groups (p ＜ .05 for both). No significant difference was noted among the subjective complaints between TEMA and CCTEA.CONCLUSIONS: TEMA was equally effective in relieving nasal obstruction 1 year after surgery, compared to CCTEA. Furthermore, it provides a better option for prevention of complications than CCTEA because of its better control of manipulation.

並列關鍵字

adenoidectomy ； endoscopy ； children