Effectiveness of transnasal endoscopic powered adenoidectomy in patients with choanal adenoids

Objectives: To demonstrate the technique and efficacy of powered assisted adenoidectomy using nasal endoscopy. Patients and methods: Between 2002 and 2003, forty children (age ranged from 3 to 17 years) with symptoms and signs suggestive of snoring and/or obstructive sleep apnea and choanal adenoids were randomly selected and distributed in two groups. Group A underwent transnasal endoscopic powered adenoidectomy (TEPA) and group B underwent curettage adenoidectomy (CA). Both groups underwent pre- and postoperative nasal endoscopy. Direct comparisons between the two groups were made with regards to operative time, amount of blood loss, postoperative morbidity, complications, and resolution of symptoms. Results: Male to female distribution was equal 1:1. The mean age of both groups was 8 years. In group A, the mean blood loss was 8.2 ml compared to 22.1 ml in group B (p < 0.05). The operative time in group A was 6.1 min vs 12.3 min in group B (p < 0.05). There were no operative or postoperative complications in both groups. Postoperative follow up and nasal endoscopy showed no recurrence of symptoms or adenoid remnants. Conclusion: Using TEPA for removing choanal adenoids is an adequate and safe method. The TEPA technique can be added to the armamentarium of techniques used by pediatric otolaryngologists. Crown Copyright (C) 2009 Published by Elsevier Ireland Ltd. All rights reserved.