Rhoda Wynn1, Richard M Rosenfeld. 1. Department of Otolaryngology, State University of New York Downstate Medical Center, 134 Atlantic Ave, Brooklyn, NY 11201, USA. Rhoda_Wynn@hotmail.com
Abstract
OBJECTIVES: To assess the feasibility of suction coagulator adenoidectomy relative to adenoid size and to document patient-based outcomes and satisfaction with surgery. DESIGN: Historical cohort study. SETTING: Referral-based academic pediatric otolaryngology practice. PARTICIPANTS: Consecutive series of 118 children older than 3 years (mean age, 6.5 years) undergoing adenoidectomy alone. INTERVENTION: Video nasopharyngoscopy followed by suction coagulator adenoidectomy as part of routine clinical care. An outcome survey was completed by telephone. OUTCOME MEASURES: Duration of surgery, estimated blood loss, complications, parent satisfaction, and clinical outcomes. RESULTS: The distribution of preoperative adenoid grades as determined by nasal endoscopy were as follows: grade 2 (>or=33% to <66% choanal obstruction), 7%; grade 3 (>or=66% to <90% obstruction), 48%; and grade 4 (90%-100% obstruction), 45%. The mean (SD) surgical time of 10.5 (3.0) minutes was unrelated to adenoid grade (R = 0.014; P =.88). All blood loss was less than 15 mL (<5 mL for 67%), and the only complication was a loose tooth. The parents of 98 patients (83%) were contacted a mean of 30.4 days after surgery: 95 (97%) reported less-labored breathing, and 94 (96%) were satisfied with the surgical results. Only 5 patients (5%) required a follow-up visit within 30 days of surgery. CONCLUSIONS: Suction coagulator adenoidectomy proved safe and rapid, regardless of the adenoid size. Surgical outcomes were very favorable, with nearly all parents reporting satisfaction with the procedure and improvement in their child's breathing.
OBJECTIVES: To assess the feasibility of suction coagulator adenoidectomy relative to adenoid size and to document patient-based outcomes and satisfaction with surgery. DESIGN: Historical cohort study. SETTING: Referral-based academic pediatric otolaryngology practice. PARTICIPANTS: Consecutive series of 118 children older than 3 years (mean age, 6.5 years) undergoing adenoidectomy alone. INTERVENTION: Video nasopharyngoscopy followed by suction coagulator adenoidectomy as part of routine clinical care. An outcome survey was completed by telephone. OUTCOME MEASURES: Duration of surgery, estimated blood loss, complications, parent satisfaction, and clinical outcomes. RESULTS: The distribution of preoperative adenoid grades as determined by nasal endoscopy were as follows: grade 2 (>or=33% to <66% choanal obstruction), 7%; grade 3 (>or=66% to <90% obstruction), 48%; and grade 4 (90%-100% obstruction), 45%. The mean (SD) surgical time of 10.5 (3.0) minutes was unrelated to adenoid grade (R = 0.014; P =.88). All blood loss was less than 15 mL (<5 mL for 67%), and the only complication was a loose tooth. The parents of 98 patients (83%) were contacted a mean of 30.4 days after surgery: 95 (97%) reported less-labored breathing, and 94 (96%) were satisfied with the surgical results. Only 5 patients (5%) required a follow-up visit within 30 days of surgery. CONCLUSIONS: Suction coagulator adenoidectomy proved safe and rapid, regardless of the adenoid size. Surgical outcomes were very favorable, with nearly all parents reporting satisfaction with the procedure and improvement in their child's breathing.