ACE grading—A proposed endoscopic grading system for adenoids and its clinical correlation

Varghese, Ajoy Mathew; Naina, P.; Cheng, Alan; Syed, Kamran Asif; Kurien, Mary

doi:10.1016/j.ijporl.2016.02.002

Cited by 12 publications

(11 citation statements)

References 31 publications

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“…Storz 2.7 mm diameter Hopkins's rod endoscope with a Karl Storz-TELECAM1 SL II single chip camera was used for the procedure and the images were recorded onto a computer. ACE endoscopic grading of adenoids was used to grade of adenoids [8] (Fig. 1).…”

Section: Discussionmentioning

confidence: 99%

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A Case–Control Study on the Association Between Endoscopic ACE Grade of Adenoid Hypertrophy and Hearing Loss in Children and Its Impact on Speech and Language Development

Syed

Naina

Sebastian

et al. 2018

Indian J Otolaryngol Head Neck Surg

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To establish an association between adenoid hypertrophy and hearing loss and its impact on speech and language in pediatric age group. A prospective case control study done in a tertiary hospital in South India. Twenty children with hearing loss were recruited in the study group and twenty-four children as controls. These groups underwent at detailed otorhinolaryngologic examination, hearing and speech evaluation. The size of the adenoids was graded endoscopically. Findings between the two groups were compared and analysed. Our study found statistically significant association between adenoid hypertrophy with choanal obstruction and abutment of eustachian tube opening seen on endoscopy with hearing loss (p = 0.025). The children with hearing loss also had speech and language delay (p = 0.004). Children with enlarged adenoids obstructing the [ 50% of the choanae or abutting the eustachian tube opening are more likely to have hearing loss and may develop speech and language delay. The ACE endoscopic adenoid grading system is consistent and reliable in evaluation of adenoids.

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Section: Discussionmentioning

confidence: 99%

“…Varghese et al [8] proposed the ACE endoscopic grading of adenoids which was used in the present study has three components-the airway obstruction, the choanal obstruction and abutment of eustachian tube opening. Any anatomic variations can easily be accommodated in the ACE endoscopic grading system.…”

Section: Discussionmentioning

confidence: 99%

A Case–Control Study on the Association Between Endoscopic ACE Grade of Adenoid Hypertrophy and Hearing Loss in Children and Its Impact on Speech and Language Development

Syed

Naina

Sebastian

et al. 2018

Indian J Otolaryngol Head Neck Surg

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“…Airway/Choana/Eustachian tube (ACE) grading system classification was used to grade the adenoid enlargement. 2 In grade I, minimal enlargement, adenoid in the nasopharynx occupying <1/3 rd of choana, in grade II, moderate enlargement, adenoid occupying 2/3 rd of choana, in grade III, huge enlargement, adenoids completely filling the choana.…”

Section: Methodsmentioning

confidence: 99%

Persistent adenoids and their secondary effects

Rangaiah

Bhat

Yadav

2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Regression of adenoids is assumed to be a physiological phenomenon at puberty. However, it has been found that it can persist well beyond adolescence into early adulthood, cascading a series of after effects in the upper respiratory tract that can cause considerable morbidity leading to public health problems. This study aimed to explore the clinicopathological features of persistent adenoids and their secondary effects on the upper respiratory tract.Methods: This was a prospective controlled study of 100 eligible patients in the age group of 15-60 years presenting with enlarged adenoids confirmed by nasal endoscopy. Equal number of controls without enlarged adenoids was also taken. Both the groups were evaluated for secondary effects like chronic rhinosinusitis, otitis media with effusion, chronic otitis media and Eustachian tube dysfunction. The relationship between adenoid enlargement in adults and secondary effects was analysed statistically. Results: Seventy-seven patients with persistent adenoids had some or the other secondary effect. Eustachian tube dysfunction was present in 21, otitis media with effusion in 10, chronic otitis media in 29 and chronic rhinosinusitis in 33. In the control group only 46 had secondary effects. The association between the presence of adenoids and secondary effects was statistically significant.Conclusions: Adenoids can persist into early adulthood and majority of them can have secondary effects. Chronic rhinosinusitis was the commonest in this study. Careful evaluation by means of nasal endoscopy is required to identify them. This is crucial for the timely treatment of this condition in order to prevent the associated secondary effects.

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“…Endoscopic grading was done by the Adenoid/Choana/Eustachian Tube (ACE) grading. 6 Although published in 2016, it has been in use in our institution since 2012. On X-ray of the nasopharynx, the adenoids were graded by the Fujioka method (A/N ratio).…”

Section: Preoperative Evaluationthe Three-point Assessment Protocolmentioning

confidence: 99%

A Three Point Assessment Protocol for Tympanoplasty Outcomes: A Retrospective Analysis

Naina

Pokharel

Syed

et al. 2020

Int Arch Otorhinolaryngol

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Introduction The surgical outcome of chronic otitis media (COM) of the mucosal type in the pediatric population with high rates of recurrent tympanic membrane perforation is indeed a concern for the attending surgeon. Objective The present study was done to evaluate the outcome of tympanoplasty in children with chronic otitis media mucosal type. Methods A retrospective analysis of the medical records of all children, aged < 16 years old, who underwent tympanoplasty for COM of the mucosal type was performed. These patients were addressed by a three-point assessment, for predicting outcome of tympanoplasty, which included the age of the patient, addressing the nasal/pharyngeal issues, and the status of the COM (discharging or dry). Surgical success was assessed in terms of graft uptake and improvement of hearing. Factors affecting the surgical outcome were also analyzed. Results A total of 90 children underwent type 1 tympanoplasty; 7 were lost to follow-up and 10 had incomplete audiometric results. In the 73 tympanoplasties analyzed, graft uptake was seen in 91.7% of the patients. Children with longer duration of ear discharge (> 8 years) had greater hearing loss. Children aged > 8 years old showed statistically significant higher chance of graft uptake (p = 0.021). Five of the six children who had graft rejection had bilateral disease. Conclusion A three-point assessment in the management of pediatric COM of the mucosal type offers good outcomes with post-tympanoplasty graft uptake rates > 90%.

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ACE grading—A proposed endoscopic grading system for adenoids and its clinical correlation

Cited by 12 publications

References 31 publications

A Case–Control Study on the Association Between Endoscopic ACE Grade of Adenoid Hypertrophy and Hearing Loss in Children and Its Impact on Speech and Language Development

A Case–Control Study on the Association Between Endoscopic ACE Grade of Adenoid Hypertrophy and Hearing Loss in Children and Its Impact on Speech and Language Development

Persistent adenoids and their secondary effects

A Three Point Assessment Protocol for Tympanoplasty Outcomes: A Retrospective Analysis

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