Adenoidectomy is one of the surgical operations that is performed the most frequently in the field of pediatric otorhinolaryngology. It is generally indicated for the treatment of adenoid hypertrophy that results in nasal obstruction, recurrent upper respiratory tract infections, and otitis media with effusion [1]. Cold instrumentation procedures, such as curettage, have traditionally been utilized in the process of performing adenoidectomy. This approach, despite its effectiveness, is frequently linked with a number of drawbacks, such as partial removal, increased intraoperative bleeding, and a larger likelihood of remaining tissue [2, 3].

Because of advancements in visualization and precision, powered instrumentation techniques have been increasingly popular in recent years. In particular, the utilization of a microdebrider has contributed to this trend. It is possible that microdebrider-assisted adenoidectomy may result in better surgical results, fewer blood loss, and lower recurrence rates [4, 5]. This is because it will allow for the targeted removal of adenoid tissue under endoscopic guidance when performing the procedure. However, there are still issues over the increased amount of time required for operations, the expense, and the requirement for specialist equipment [6, 7].

The postoperative morbidity, which includes conditions such as pain, bleeding, infection, and recovery time, continues to be an important factor to take into consideration while choosing the surgical approach. It is vital to do a comparative analysis of the microdebrider and conventional cold instrumentation in order to establish the most effective method that guarantees effectiveness while reducing complications [8-10].

The purpose of this study was to examine the postoperative results and morbidity of a group of thirty patients who underwent microdebrider-assisted adenoidectomy in comparison to traditional cold instrumentation.

A prospective comparative study was conducted to evaluate postoperative outcomes and morbidity in patients undergoing adenoidectomy using microdebrider versus cold instrumentation techniques. This study was conducted at the Department of ENT, Chettinad Institute of Medical Sciences (CIMS), Manami, East Coast Road (ECR), Chennai, Tamil Nadu, between August 2024 to July 2025. A total of 30 pediatric patients indicated for adenoidectomy were included and randomly divided into two groups: Group M (Microdebrider, n=15) and Group C (Cold instrumentation, n=15). Ethical approval was obtained from the Institutional Ethics Committee prior to the study. Procedure: All patients underwent adenoidectomy under general anesthesia. In Group M, adenoidectomy was performed using a microdebrider under endoscopic guidance, ensuring precise and complete removal of adenoid tissue. In Group C, conventional curettage (cold instrumentation) was used. Intraoperative parameters such as operative time and blood loss were recorded. Patients were monitored postoperatively for complications and recovery. Data Collection: Data were collected using a structured proforma. Parameters recorded included demographic details (age, gender), operative time (minutes), intraoperative blood loss (ml), postoperative pain using Visual Analog Scale (VAS) at 24 hours, and postoperative complications such as nausea/vomiting, sore throat, dehydration, secondary hemorrhage, and duration of hospital stay (hours). Inclusion Criteria: • Pediatric patients aged 3–12 years • Patients diagnosed with adenoid hypertrophy requiring adenoidectomy • Patients whose guardians provided informed consent Exclusion Criteria: • Patients with bleeding disorders • Patients with craniofacial anomalies or syndromic conditions • Patients undergoing combined procedures (e.g., tonsillectomy) • Patients with previous adenoid surgery Statistical Analysis: Data were entered into Microsoft Excel and analyzed using statistical software. Continuous variables were expressed as mean ± standard deviation, and categorical variables as frequencies and percentages. The independent t-test was used for comparison of continuous variables, and chi-square test for categorical variables. A p-value of less than 0.05 was considered statistically significant.

A total of 30 pediatric patients undergoing adenoidectomy were included in the study and divided equally into two groups: Group M (Microdebrider, n=15) and Group C (Cold instrumentation, n=15). The outcomes are summarized below.

Table 1: Demographic Characteristics of Study Population

In terms of demographics, there was little to no difference between the two sets of data (Table 1).

Table 2: Intraoperative Parameters

Table 2 shows that compared to Group C, Group M had substantially less intraoperative blood loss and a shorter operating duration.

Table 3: Postoperative Pain Assessment (VAS at 24 hours)

Table 3 shows that compared to the cold instrumentation group, the microdebrider group had much less postoperative pain.

Table 4: Postoperative Morbidity – Gastrointestinal Symptoms

According to Table 4, there was a notable difference in the incidence of postoperative nausea and vomiting between Group M and Group C.

Table 5: Postoperative Morbidity – Local Complications

There was no statistically significant difference between the groups with regard to subsequent hemorrhage or dehydration, however Group M had a considerably reduced rate of local postoperative symptoms such sore throat (Table 5).

This study found that microdebrider-assisted adenoidectomy yielded markedly superior intraoperative and postoperative results compared to traditional cold instrumentation. The average operating duration and intraoperative hemorrhage were significantly reduced in the microdebrider cohort, signifying enhanced surgical efficiency and accuracy [11, 12]. The prior study found analogous findings, indicating that powered instrumentation facilitated enhanced visibility and precise tissue excision, consequently decreasing operational time and hemorrhage [13]. This study found that postoperative pain scores were markedly reduced in patients who received microdebrider-assisted adenoidectomy. This may be ascribed to the technique's minimally stressful characteristics and diminished manipulation of adjacent tissues. The prior study indicated that diminished tissue trauma is directly associated with reduced postoperative pain and expedited recovery, corroborating the results of the current investigation [14-16]. This study found that postoperative morbidity, such as nausea/vomiting and sore throat, was considerably reduced in the microdebrider group. While dehydration and subsequent bleeding occurred less frequently in the microdebrider group, the differences lacked statistical significance. The prior study saw analogous patterns, indicating that increased surgical precision led to a reduction in postoperative problems and an improvement in patient comfort [17-19]. This study found that the length of hospital stay was markedly reduced in patients receiving microdebrider-assisted adenoidectomy. This indicates accelerated surgical recovery and lower complication rates. The prior study indicated that shorter hospitalizations were correlated with minimally invasive procedures and enhanced perioperative management [20, 21]. This study demonstrated that the demographic parameters of the two groups were equivalent, thereby reducing potential confounding factors and enhancing the validity of the observed outcomes. The prior study also underscored the importance of balanced group distribution to provide accurate comparisons between surgical procedures [22, 23]. This study's findings align with existing literature, demonstrating that microdebrider-assisted adenoidectomy provides considerable benefits compared to traditional cold instrumentation. The advantages encompass shorter operating duration, reduced hemorrhage, less postoperative discomfort, and lower morbidity, rendering it a preferred procedure in pediatric patients [24, 25].

Compared to traditional cold instrumentation, microdebrider-assisted adenoidectomy yielded better results in this investigation. Postoperative pain levels were lower, intraoperative blood loss was lowered, and the frequency of postoperative morbidity was reduced. These outcomes were linked to the use of this technique. In addition, the microdebrider group had shorter hospital stays, which means they recovered faster and were more comfortable overall. When comparing the two methods, microdebrider-assisted adenoidectomy stands out for its superior surgical accuracy and recovery time. As a result, it's a better and safer option than conventional cold instrumentation, especially for young children. To confirm these results and provide credence to their broader therapeutic application, more research with bigger samples is suggested.

Funding

None

Conflict of Interest:

None

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