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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol
DOI: 10.1055/s-0044-1779434
Original Research

Endoscopic Evaluation after Conventional Adenoid Curettage

Ahmed Abdelfattah Bayomy Nofal 
1   ENT Department, Reem Hospital, Abu Dhabi, United Arab Emirates
2   Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
,
Mohamed Abdelmohsen Alnemr
2   Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
,
Ahmed Hassan Sweed
2   Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
,
Alsayed Abdulmageed
2   Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt
› Author Affiliations Funding The authors declare that they have received no financial support from agencies in the public, private or non-profit sectors for the conduction of the present study.
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Abstract

Introduction Adenoidectomy is one of the most common procedures performed by otolaryngologists. Traditional adenoid curettage is performed blindly, which can result in inadequate removal of the adenoid and injury to the surrounding structures.

Objective To perform transnasal endoscopic examinations to assess the nasopharynx after conventional curettage adenoidectomy.

Methods The present prospective study included 100 children with a mean age of 4.2 ± 3.07 years. It is composed of two steps: conventional curettage adenoidectomy by a resident trainee; and endoscopic evaluation of the nasopharynx through a 0° telescope to assess adenoidal remnants, injury to the surgical field or adjacent structures, and bleeding points.

Results Adenoid remnants were observed in 42% of the cases after conventional adenoid curettage in multiple locations, such as the roof of the nasopharynx over the choana (24%), the tubal tonsil (12%), the posterior pharyngeal wall (4%), and the posterior end of the nasal septum (2%). Injury to the surgical field and adjacent structures was observed in 46% of the cases (posterior pharyngeal wall: 23%; lateral pharyngeal wall: 11%; Passavant ridge: 10%; and the Eustachian tube orifice: 2%). Endoscopic bleeding was observed in 29% of the cases; 13% of the cases were from adenoid remnants, 10%, from the mucosa, and 6%, from the pharyngeal muscles. Bleeding was mild in 19% of the cases, moderate in 9%, and severe in 1%.

Conclusion Endoscopic evaluation of the nasopharynx following conventional adenoid curettage provides important data regarding adenoid remnants, injury to the surgical field or nearby structures, and bleeding points, which aids in the provision of optimal care and in the achievement of a better outcome.

Keywords

adenoidectomy - endoscopy - nasopharynx - curettage

Ethical Approval and Consent to Participate

The Zagazig University Institutional Review Board approved the present study (ZU-IRB #10194/6–12–2022) and written informed consent was taken from the patients.


Availability of Data and Material

All the data and materials are available from the authors upon reasonable request.


Contributions of the Authors

All authors have read and approved the manuscript:


AABN: Suggested and developed the research idea, reviewed the literature, defined the study protocol, performed endoscopic work, collected data, kept record of patient information, interpreted the data, wrote and revised the manuscript, and prepared the figure.


MAA: Reviewed the literature, performed data analysis, data interpretation, and statistical analysis, assisted in preparing the table and figure, reviewed the manuscript, and assisted in the final revision of the manuscript.


AHS: Modified the research idea, reviewed the literature, performed data analysis, data interpretation, and statistical analysis, assisted in preparing the table and figure, reviewed the manuscript, and assisted in the final revision of the manuscript.


AA: Modified the research idea, reviewed the literature, performed data analysis, data interpretation, and statistical analysis, assisted in preparing the table and figure, reviewed the manuscript, and assisted in the final revision of the manuscript.




Publication History

Received: 17 June 2023

Accepted: 27 December 2023

Article published online:
16 February 2024

© 2024. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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