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Open Access 26-07-2023 | Review Article

Coblator adenoidectomy in pediatric patients: a state-of-the-art review

Authors: Christian Calvo-Henriquez, María RuedaFernandez-Rueda, Ainhoa Garcia-Lliberos, Byron Maldonado-Alvarado, Xenia Mota-Rojas, Antonino Maniaci, Giannicola Iannella, Ignacio Jimenez-Huerta

Published in: European Archives of Oto-Rhino-Laryngology | Issue 10/2023

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Abstract

Introduction

Adenoid hypertrophy is one of the main causes of nasal obstruction in ‘children. Adenoid hypertrophy can be approached either with nasal corticosteroids, or surgically when medical treatment fails. Different adenoidectomy techniques have been proposed to reduce morbidity and surgical risks, with a consequent marked increase in the use of new surgical procedures in recent years, with a progressive increase in the use of coblation. This state-of-the-art review aims to systematically review the current literature on the role of coblation in adenoidectomy.

Methods

The selection criteria included children submitted to adenoidectomy with coblator vs other techniques. 11 research questions were defined. 4 databases were explored by four authors: PubMed (Medline), the Cochrane Library, EMBASE and SciELO. The level of evidence and quality of the selected articles were assessed according to assessed according to the Quality Assessment Checklist of the National Institute for Health and Clinical Excellence.

Results

20 studies met the inclusion criteria: 2 metanalysis, 12 randomized clinical trial, 2 non-randomized clinical trial, 1 prospective cohort study, and 3 retrospective cohort study. It encompassed a total population of 8375 participants. Regarding the different surgical techniques, 18 studies (excluding metanalysis) performed coblation (n = 1550), 6 microdebridement (n = 883), 15 curettage (n = 4016), and 1 suction coagulation (n = 1926).

Conclusion

Coblator adenoidectomy appears to offer better adenoid control compared to curettage, with a possible, although not confirmed lower rate of revision surgery. Similarly, this greater resection of adenoid tissue seems to be related to a greater reduction of nasal obstruction. The advantages of this technique are mainly less surgical bleeding—although it is not clear this is a clinically relevant difference, and less postoperative pain compared to cold curettage. The difference in pain is small, as adenoidectomy is not a painful surgery in general. There is little evidence on the control of OME and comparison with other techniques such as microdebrider adenoidectomy.
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Metadata
Title
Coblator adenoidectomy in pediatric patients: a state-of-the-art review
Authors
Christian Calvo-Henriquez
María RuedaFernandez-Rueda
Ainhoa Garcia-Lliberos
Byron Maldonado-Alvarado
Xenia Mota-Rojas
Antonino Maniaci
Giannicola Iannella
Ignacio Jimenez-Huerta
Publication date
26-07-2023
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Oto-Rhino-Laryngology / Issue 10/2023
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-023-08094-7

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