Comparison between curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy in terms of Eustachian tube dysfunction

Abstract Introduction Adenoidectomy can be performed with many ways, including curettage and microdebrider endoscopic-assisted adenoidectomy. Those two techniques have advantages and disadvantages. Objective The objective of this study is to research the effects of curettage adenoidectomy and endoscopic-assisted microdebrider adenoidectomy on the tympanum pressures in pediatric patients with adenoid hypertrophy without otitis media with effusion. Methods This prospective descriptive study was performed with 65 patients who had a normal tympanic membrane and normal tympanogram and then underwent adenoidectomy or adenotonsillectomy for adenoid and tonsil hypertrophy. The subjects were randomly divided into two groups: curettage adenoidectomy group and endoscopic microdebrider-assisted adenoidectomy group. They underwent tympanometry, and the preoperative as well as 1st and 7th day postoperative values of the tympanum pressures were compared within and among the groups. Results There were 32 patients in the curettage adenoidectomy group and 33 patients in the microdebrider adenoidectomy group. Statistically significant differences were observed in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears with curettage adenoidectomy (p < 0.001, p < 0.001). This difference occurred on the 1st postoperative day, and the value returned to normal on the 7th day. There was no significant difference in the median tympanum pressure on the preoperative and 1st and 7th postoperative days for both the left and right ears in the microdebrider adenoidectomy group (p = 0.376, p = 0.128). Conclusion Postoperative Eustachian tube dysfunction is seen less often with the endoscopic-assisted microdebrider adenoidectomy technique than with the conventional adenoidectomy technique.摘要：腺样体切除术（adenoidectomy）可采用多种术式，包括刮匙腺样体切除术（curettage adenoidectomy）与内镜辅助显微吸切腺样体切除术（endoscopic-assisted microdebrider adenoidectomy），两类术式各有优劣。本研究旨在探讨刮匙腺样体切除术与内镜辅助显微吸切腺样体切除术对伴腺样体肥大（adenoid hypertrophy）且无分泌性中耳炎（otitis media with effusion）的儿科患者鼓室压（tympanum pressures）的影响。本研究为前瞻性描述性研究，纳入65例鼓膜（tympanic membrane）及鼓室图（tympanogram）均正常、因腺样体及扁桃体肥大接受腺样体切除术或腺样体扁桃体切除术（adenotonsillectomy）的受试者。将受试者随机分为两组：刮匙腺样体切除术组与内镜辅助显微吸切腺样体切除术组。对两组患者术前及术后第1、7天的鼓室压行鼓室压测量（tympanometry），并在组内及组间比较相关测量值。刮匙腺样体切除术组共32例患者，显微吸切腺样体切除术组共33例患者。刮匙腺样体切除术组左右耳的术前、术后第1、7天的中位鼓室压均存在统计学差异（p < 0.001, p < 0.001）；该差异于术后第1天显现，并于术后第7天恢复至正常水平。而显微吸切腺样体切除术组左右耳的术前、术后第1、7天的中位鼓室压均无显著统计学差异（p = 0.376, p = 0.128）。相较于传统刮匙腺样体切除术，内镜辅助显微吸切腺样体切除术术后出现咽鼓管功能障碍（Eustachian tube dysfunction）的概率更低。