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VOLUME 9 , ISSUE 1 ( January-April, 2017 ) > List of Articles

ORIGINAL ARTICLE

Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy

Mohammed R Dawood, Ammar H Khammas

Keywords : Adenoid hypertrophy,Nasal endoscopy,X-ray nasopharynx

Citation Information : Dawood MR, Khammas AH. Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy. Int J Otorhinolaryngol Clin 2017; 9 (1):6-9.

DOI: 10.5005/jp-journals-10003-1251

License: CC BY 3.0

Published Online: 01-04-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim

To clarify the diagnostic accuracy of the lateral X-ray of nasopharynx, and the flexible nasopharyngoscopy in the assessment of adenoid hypertrophy, with the preoperative rigid nasal endoscopic observation, as it was considered as a reference standard guide.

Materials and methods

This is a prospective observational study that included 80 children who planned to undergo adenoidectomy due to the symptoms found related to adenoid hypertrophy. All the children underwent a relevant clinical history and full ear, nose, and throat (ENT) examination, and the grading of adenoid hypertrophy was done preoperatively with the lateral X-ray of the nasopharynx and the flexible nasopharyngoscopy. These findings were analyzed and compared with the peroperative rigid nasal endoscopic assessment of adenoid hypertrophy, which was considered as a reference guide.

Results

There were 44 boys (55%) and 36 girls (45%), with mean age of 5.176 (±1.873) years, and the highest frequency of adenoid hypertrophy was found in the age group of 4 to 6 years (62.45%); the most common grade of the adenoid size in all the types of the assessment was grade 3. The assessment of adenoid grading by both flexible and peroperative rigid nasal endoscopy versus radiology was statistically significant, with p value of 0.0001, while the adenoid grading between flexible and peroperative rigid nasal endoscopic assessment was almost comparable, as no significant difference was found, with p value of 0.46.

Conclusion

Flexible nasopharyngoscopy was a more reliable diagnostic tool in the assessment of the adenoid size than lateral nasopharyngeal X-ray, as it correlates well with peroperative rigid nasal endoscopic finding.

How to cite this article

Dawood MR, Khammas AH. Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy. Int J Otorhinolaryngol Clin 2017;9(1):6-9.


  1. Tonsils and adenoids. In: David, AA; Michael, JC, editors. Scott-Brown's otolaryngology. 6th ed. Vol. 6. Oxford: Butterworth Heinemann; 1997. p. 6/18/1-16.
  2. Assessment of adenoid size in children. Res J Biol Sci 2008;3(7):747-749.
  3. Assessment of adenoid size: a comparison of lateral radiographic measurement, radiologist assessment, and nasal endoscopy. Int J Pediatr Otorhinolaryngol 2010 Nov;47(11):1281-1285.
  4. X-ray in the evaluation of adenoid hypertrophy: its role in endoscopic era. Indian J Otolaryngol Head Neck Surg 2005;57(1):45-47.
  5. Radiographic evaluation of adenoid size in children: adenoidal-nasopharyngeal ratio. AMJ radio 1979 Sep;133(3):401-404.
  6. Electrocautery versus curette adenoidectomy: comparison of postoperative results. Int J Pediatr Otorhinolaryngol 1998 Mar;43(2):115-122.
  7. How should adenoidal enlargement be measured? A radiological study based on inter observer agreement. Clin Radio 1981 May;32(3):337-340.
  8. Relationship between sinusitis and adenoid size in paediatric age group. Ann Otol Rhinol Laryngol 2007 Jul;116(7):550-553.
  9. Paediatric rhinosinusitis: report of the rhinosinusitis. Task Force Committee Meeting. Otolaryngol Head Neck Surg 1997 Sep;117(Suppl):S53-S57.
  10. Roentgen cephalometric studies of tonsil and adenoid in normal and pathological states. Ann Otol Rhinol Laryngol 1975 Mar;84:55-62.
  11. Comparison between radiological and nasopharyngolaryngoscopic assessments of adenoid tissue volume in mouth breathing children. Rev Bras Otorhinolaryngol 2005 Feb;71(1):23-27.
  12. Effect of respiration on nasopharyngeal radiographs when assessing adenoidal enlargement. J Laryngol Otol 1989 Jan;103(1):71-73.
  13. Laterally hypertrophic adenoid as contributory factor in otitis media. Int J Ped Otolaryngol 1998 Oct;45(3):207-214.
  14. Adenoid enlargement assessment by plain x-ray and nasoendoscopy. Iraqi J Comm Med 2012;1:88-91.
  15. Importance of nasal fiberoptic examination in the presence of a normal x-ray of the cavum. Int J Pediatr Otolaryngol 2000 Sep;55(1):29-32.
  16. Correlation of diagnostic system with adenoid tissue volume: a blind prospective study. Int J Ped Otolaryngol 2008 Aug;72(8):1235-1240.
  17. Sensitivity and specificity of nasal flexible fiberoptic endoscope in diagnosis of adenoid hypertrophy in children. Int J Ped Otolaryngol 2008 Jan; 72(1):63-67.
  18. The comparative roles of x-ray nasopharynx and nasal endoscopy in diagnosis of adenoid hypertrophy. Nepalese J ENT Head Neck 2013;4(1):26-28.
  19. Correlation between adenoid-nasopharynx ratio and endoscopic examination of adenoid hypertrophy: a blind prospective clinical study. Int J Pediatr Otolaryngol 2009 Nov;73(11):1532-1535.
  20. The assessment of adenoid size by radiological means. Clin Otolaryngol 1978 Feb;3(1):43-47.
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