Abstract To evaluate the value of using trans- oral rigid endoscopic examination of nasopharynx after conventional curettage adenoidectomy for complete removal and prevention of recurrence. A Prospective study of 50 children with adenoid hypertrophy was done at Misurata Central Hospital. They presented clinically with symptoms of nasal obstruction, mouth breathing and snoring confirmed radiologically with plan x ray nasopharynx lateral view, of both sex ageing from 1.5 years to 15 years, with mean age of 6.9 years and S.D± 3.44, carried out in a period of 6months from January 2015 Patients were divided into two groups. Group A underwent conventional curettage adenoidectomy only, while group B underwent a conventional curettage adenoidectomy and at the end trans-oral endoscopic visualization of nasopharynx done, using 70 degree rigid endoscope to detect and subsequently to remove any residual adenoid tissue transorally by curettage. In group B, at the end of conventional curettage adenoidectomy, endoscopic examination of nasopharynx detected the remnant of adenoid tissue in 13 patients, 8 patients(61.54%) in roof, 2 patients(15.38%) at Eustachian tube opening, 2patients(15.38%) over posterior wall, and 1 patient(7.70%) posterior wall+ roof indicate that conventional curettage used alone failed to remove the adenoid tissue completely. There was a significant difference in rate of adenoid recurrence between both groups was statistically significant (P =0.04) (6months postoperatively).At the end of 6 months postoperatively 16 patients (64%) in group A and 23 patients (92%) in group B were symptoms free. Examination of nasopharynx of patients with persistence of symptoms of nasal obstruction, 9 patients (36%) in Group A showed the adenoid recurrence, 7patients (78%) in roof and 2 patients (22%) in posterior wall. While 2 patients (8%) in group B with persistence of symptoms of nasal obstruction did not revealed any recurrence of adenoid tissue but showed hypertrophied inferior turbinate. Conventional curettage adenoidectomy missed the residual adenoid tissue, Rigid endoscopic examination of nasopharynx is necessary after conventional adenoidectomy for detecting any residual adenoid tissue to remove subsequently thus reducing the recurrence.
Keywords Adenoidectomy, conventional curette, rigid endoscopic examination.