Cold versus hot adenoidectomy: A prospective, randomized controlled trial

Adenoidectomy can be performed using the cold method (mainly adenoid curettes) or the hot method (suction diathermy). Both techniques have similar intra and postoperative outcomes. However, the long-term clinical outcome of improving sleep disorder symptoms has not been well established. The objective of this study was to compare outcomes of hot method and cold method adenoidectomy one year following the surgery. A prospective, randomized, single-blinded study of children under age 16 years who underwent adenoidectomy during the years 2014–2017. Patients were randomized to hot or cold adenoidectomy techniques. A tertiary health care referral center. The final analysis included 58 children, mean age 5.9 years (range 1.2–15). The primary outcome was change in the Pediatric Sleep Questionnaire (PSQ) scores one month and one year after surgery. The secondary outcome was complication rate. Clinical and demographic parameters were similar between the patients in the hot method group (n = 30) and the cold method group (n = 28). Adenoid size and estimated bleeding were similar between the groups. At one month after surgery, PSQ score was improved by a mean + 0.31 in the hot method group compared to +0.32 in the cold method group (p = 0.54). Improvement in PSQ scores was greater following hot than cold adenoidectomy at one year after surgery (+0.31 points vs. +0.22 points, p = 0.009). Hot adenoidectomy is associated with better outcome than the cold technique, as reflected by PSQ scores one year after the surgery.