Comparison of Traditional Curettage to Endoscopic Techniques in Pediatric Adenoidectomy: A Systematic Review of Post-operative Outcomes

Adenoidectomy is a common pediatric procedure with generally low complication rates; however, postoperative ear pain, pressure symptoms, and Eustachian tube dysfunction remain reported concerns. This systematic review compares traditional curettage with endoscopic techniques - specifically endoscopic microdebrider adenoidectomy (EMA) and endoscopic coblation adenoidectomy (ECA) - in terms of postoperative outcomes in the pediatric population. A systematic literature search was conducted across PubMed, Cochrane, and ScienceDirect databases between April and June 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Studies published in English within the past 10 years were included. Only randomized controlled trials (RCTs) were eligible. Eleven RCTs met the inclusion criteria. A total of 11 studies were included. Evaluated outcomes included middle ear pressure, hearing threshold, intraoperative time, bleeding, postoperative pain, and residual adenoid tissue. Endoscopic techniques demonstrated superior short-term postoperative results, with lower pain scores and improved middle ear pressure within the early recovery period; however, these differences were largely transient. Traditional curettage was associated with shorter operative time and slightly less intraoperative bleeding, while endoscopic techniques achieved more complete adenoid resection. Endoscopic adenoidectomy - particularly coblation - offers improved short-term recovery and more complete tissue removal compared to traditional curettage, though early advantages tend to normalize over time. Further large-scale RCTs with standardized pain scoring and cost analysis are warranted to optimize surgical decision-making.