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Powered Partial Adenoidectomy
Nicole Murray, MD;
Philip Fitzpatrick, MD;
J. Lindhe Guarisco, MD
Arch Otolaryngol Head Neck Surg. 2002;128:792-796.
Objective To confirm our clinical impression that the powered microdebrider is
superior to curettes for performing partial adenoidectomy (removal of the
superior one half to three fourths of the adenoid pad).
Design Observational study of 100 children undergoing partial adenoidectomy
with the powered microdebrider compared with 40 children undergoing conventional
partial adenoidectomy with curettes.
Setting Private and public tertiary care centers.
Patients All patients younger than 20 years undergoing partial adenoidectomy
at the respective institutions during the study period.
Interventions Partial adenoidectomy as indicated for chronic otitis media, airway
obstruction, or chronic or recurrent tonsillitis with either the powered microdebrider
or curettes.
Main Outcomes Measures Operative time (with specific quantification of the time required for
tissue removal and hemostasis), blood loss, complications, and subjective
ease of use.
Results Operative time was 59% shorter for the microdebrider group (mean, 3
minutes 22 seconds; range, 1 minute 6 seconds to 12 minutes 45 seconds) than
for the conventional group (mean, 8 minutes 8 seconds; range, 1 minute 2 seconds
to 22 minutes 0 seconds) (P<.001). Blood loss
was comparable for both groups (powered group: mean, 2.0 mL/kg; range, 0.4
to 9.4 mL/kg; conventional group: mean, 2.0 mL/kg; range, 0.3 to 6.7 mL/kg; P=.34). There were no intraoperative or postoperative complications
in either group. Surgeon satisfaction with the microdebrider was high.
Conclusions The powered microdebrider for partial adenoidectomy is quicker and is
not associated with blood loss or complications above that of conventional
partial adenoidectomy. The degree of control afforded by the microdebrider
technique is of utmost value in preventing complications such as velopharyngeal
insufficiency, and this is now our procedure of choice.
From the Department of Otolaryngology, Head and Neck Surgery, Ochsner
Clinic and Alton Ochsner Medical Foundation, New Orleans, La. Dr Guarisco
was a stockholder of Medtronic Xomed.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Postoperative Recovery After Microdebrider Intracapsular or Monopolar Electrocautery Tonsillectomy: A Prospective, Randomized, Single-blinded Study.
Sobol et al.
Arch Otolaryngol Head Neck Surg 2006;132:270-274.
ABSTRACT
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