Coblation and Traditional Adenoidectomy: A Comparative Study

COMPARATIVE ANALYSIS OF COLD CURETTAGE AND COBLATION ADENOIDECTOMY: SURGICAL AND POSTOPERATIVE OUTCOMES WITH 0° AND 70° ENDOSCOPIC TECHNIQUES

Adenoidectomy is a common pediatric otolaryngologic procedure. While cold curettage remains widely practiced, endoscopic coblation has been developed to enhance precision, minimize intraoperative complications, and reduce residual tissue. This study compared outcomes of conventional cold curettage adenoidectomy and coblation-assisted adenoidectomy in pediatric patients.

Study Overview

• Status: Completed
• Conditions: Endoscopic Coblation Adenoidectomy
• Intervention / Treatment: Procedure: Cold Curettage Adenoidectomy; Procedure: Coblation-Assisted Adenoidectomy

Detailed Description

A total of 128 pediatric patients aged 3-11 years who underwent adenoidectomy between August 2024 and August 2025 was prospectively evaluated with a follow-up duration of 6-12 months. (Table 1) Of these, 64 underwent adenoidectomy and/or myringotomy with ventilation tube insertion using the conventional cold curettage method, while the remaining 64 underwent the same procedures using the endoscopic coblation technique with 0° or 70° endoscopes. All patients had been diagnosed with adenoid hypertrophy and were unresponsive to medical treatment. Indications for surgery included nasal obstruction and associated symptoms such as snoring, apnea, mouth breathing during sleep, recurrent otitis media, and hearing loss due to serous otitis media.

Exclusion criteria included patients who underwent concurrent tonsillectomy, dental procedures, or nasal surgeries such as septoplasty and/or turbinate reduction. Patients with chronic neurological disorders or cleft palate were also excluded. Informed consent was obtained from all participants prior to inclusion in the study.

All patients underwent a detailed anamnesis and clinical examination. Following the application of a nasal decongestant spray, nasal endoscopy was performed, and the size and position of the adenoid tissue were scored from 1 to 4 using the McMurray and Clemens scoring system.4 In patients who were uncooperative or for whom endoscopic examination could not be performed, lateral nasopharyngeal radiographs were taken to allow for grading. During the operation, the size and extent of the adenoid tissue were confirmed transnasally or transorally using 0° or 70° rigid endoscopes.

• Study Type: Interventional
• Enrollment (Actual): 128
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bagcılar
    • Istanbul, Bagcılar, Turkey (Türkiye), 34214
      • Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, İstanbul Medipol University.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria: Adenoid hypertrophy and were unresponsive to medical treatment. Indications for surgery included nasal obstruction and associated symptoms such as snoring, apnea, mouth breathing during sleep, recurrent otitis media, and hearing loss due to serous otitis media.

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Exclusion Criteria: Exclusion criteria included patients who underwent concurrent tonsillectomy, dental procedures, or nasal surgeries such as septoplasty and/or turbinate reduction. Patients with chronic neurological disorders or cleft palate were also excluded

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Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Cold Curettage Adenoidectomy; Conventional adenoidectomy performed using cold curettage technique.	Procedure: Cold Curettage Adenoidectomy; After achieving adequate exposure under general anesthesia using a Boyle-Davis mouth gag, the soft palate and adenoid tissue were manually palpated, and curettage was performed using a suitably sized adenotome. Residual tissue areas suspected upon digital palpation and laryngeal mirror examination were further curetted using a smaller adenotome.
Experimental: Coblation-Assisted Adenoidectomy; Endoscopic adenoidectomy performed using coblation technology.	Procedure: Coblation-Assisted Adenoidectomy; The nasopharynx and choanae were fully visualized using a 2.7 mm 0° pediatric transnasal endoscope and a 70° 4 mm transoral endoscope, then adenoidectomy was completed using a coblation technique. The procedure was performed using the Coblator II cold radiofrequency coblation device equipped with the PROcise XP plasma rod system, which can be shaped to reach all areas of the adenoid tissue (especially the upper part of the nasopharynx and the opening to the eustachian tubes) and is designed for soft tissue ablation and dissection.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Residual Adenoid Tissue Rate	Presence of residual adenoid tissue evaluated postoperatively.	During the follow-up assessments at 1, 6, and 12 months postoperatively

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Operative Time	Duration of the surgical procedure.	During surgery
Intraoperative Complications	Occurrence of intraoperative complications such as bleeding or mucosal injury.	During Surgery
Intraoperative Blood Loss	The total blood loss was calculated by subtracting the amount of saline used from the total fluid volume in the suction canister and adding the estimated amount from the gauze.	During Surgery
Postoperative Pain	Postoperative pain was assessed using a Visual Analog Scale (VAS), ranging from 0 (no pain) to 10 (worst pain ever experienced). Parents were asked to rate their child's pain at the first 24 hours and at the 72nd hour based on their child's behavior such as crying and discomfort	Post operative 24 hours and at the 72nd hour
Halitosis	Postoperative halitosis was assessed based on parental observation. Parents were instructed to approach their child from a distance of approximately 10 cm and to record the presence or absence of unpleasant oral odor	Postoperative two weeks

Collaborators and Investigators

• Sponsor: Medipol University
• Investigators: Principal Investigator: LÜTFÜ ŞENELDİR, Associate Professor, Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, İstanbul Medipol University.

Study record dates

Study Major Dates

• Study Start (Actual): August 1, 2024
• Primary Completion (Actual): August 30, 2025
• Study Completion (Actual): October 1, 2025

Study Registration Dates

• First Submitted: February 10, 2026
• First Submitted That Met QC Criteria: February 10, 2026
• First Posted (Actual): February 18, 2026

Study Record Updates

• Last Update Posted (Actual): February 18, 2026
• Last Update Submitted That Met QC Criteria: February 10, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Adenoidectomy; Coblation; Cold curettage; Pediatric otolaryngology; Residual adenoid tissue; Postoperative pain; Halitosis; Intraoperative blood loss
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Postoperative Complications; Pathologic Processes; Signs and Symptoms, Digestive; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Halitosis
• Other Study ID Numbers: E-10840098-202.3.02-5336

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No