BACKGROUND AND OBJECTIVESTo assess the possibility of adenoid size asymmetry in both nasal sides by nasopharyngoscopy.DESIGN AND SETTINGSThis is a prospective study involving 100 children, with age ranging between 1 and 12 years, performed in Saudi Arabia between January 2010 and December 2011.METHODSAdenoid was examined and graded I–IV in relation to posterior choana bilaterally by flexible nasopharyngoscopy. The adenoid grade was compared with the other side in each child.RESULTSThe findings from endoscopy were analyzed: there was a high degree of agreement in grading both sides, that was 92% with kappa=0.868. Moreover, there was grade asymmetry in 8% of the cases.CONCLUSIONAdenoid grading using flexible nasopharyngoscopy through one side of the nose may not represent the adenoid grade of the other side in all cases.
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