Trans-oral endoscopic assisted radio-frequency for adenoid ablation; A randomized prospective comparative clinical study.

Objective: This study compared the efficacy and safety of conventional adenoidectomy using a curette and the Radio-frequency (RF) adenoid ablation using endoscope via the trans-oral technique.

Methods: A randomized prospective comparative study was conducted in a tertiary care hospital. The study included 80 patients with a diagnosis of adenoid hypertrophy, which was confirmed by X-ray of a lateral view of the skull. The patients were submitted into two groups 40 for each: curettage group and Radiofrequency group. Patients with bleeding diathesis, congenital anomalies, previous adenoidectomy, and morbid illness were excluded from the study. We evaluated the time consumption, the adenoid tissue remnant by the endoscope, blood loss, and clinical correlations like pain by Visual Analog Scale, halitosis, and secondary bleeding in both study groups.

Results: Intra-operative blood loss was 20-40 ml in the Radio-frequency (RF) group, but in the curettage group was 36 - 55 ml. Post-operative pain in the (RF) group was lower than the curettage group. Secondary bleeding was reported mostly in the curettage group (15%). The duration of the operation in (RF) group was relatively long. Halitosis decreased mainly after curettage adenoidectomy.

Conclusion: The endoscopic radio-frequency adenoid ablation surpassed the conventional method. We encourage using Radio-frequency in adenoid surgery as a replacement for the traditional method.