Adenoid size assessment: a comparison of palpation, nasendoscopy and mirror examination

Abstract

If nasendoscopy is considered the gold standard, then palpation is a poor measure of adenoid hypertrophy and mirror examination consistently underestimates choanal occlusion.

Assessment of adenoid size: A comparison of lateral radiographic measurements, radiologist assessment, and nasal endoscopy

“…Intra-operative mirror nasopharyngoscopy is supported in the literature as correlating strongly with volume of adenoid tissue and endoscopic nasopharyngoscopy [13,17]. In addition, this was also the only examination that could be done easily with the entire study population, especially with the younger children who do not generally tolerate endoscopic nasopharyngoscopy while awake.…”

“…Endoscopic nasopharyngoscopy is thought to be among the most accurate methods of assessment of the nasopharynx [3][4][5][6][7][8], as it provides a direct view of the adenoid pad [5]. Some investigators consider endoscopic nasopharyngoscopy the current standard [5,17]. However, endoscopic nasopharyngoscopy is subjective and has poor inter-rater reliability [4,5].…”

“…Intraoperative mirror nasopharyngoscopy has been shown to correlate strongly with volume of adenoid tissue [13]. In addition, there has been significant correlation between endoscopic nasopharyngoscopy and intra-operative mirror nasopharyngoscopy [17].…”

Is Transnasal Endoscopic Examination Necessary Before and After Adenoidectomy?

“…Recently, endoscopic examination is the gold standard for nasopharynx examination [10]. The most significant feature of the method is that although providing a 2-dimensional image, it allows dynamic 3-dimensional assessment when the endoscope is moved.…”

Commentary on ‘Intranasal corticosteroids for nasal airway obstruction in children with moderate to severe adenoidal hypertrophy’

“…However, issues of restricted availability, increased cost and limited cooperation still render this diagnostic procedure difficult to implement in a wider clinical setting. Alternative diagnostic approaches also include the clinical Nasal Obstruction Index (NOI), a lateral neck radiograph and trans-oral mirror visualization of the enlarged adenoids with limited so far evidence on agreement (5,6). The current common clinical practice advocates adenoidectomy in cases of severe obstruction causing obstructive sleep apnea and cardiorespiratory syndrome (7), although the role of adenoidectomy alone is unclear; adenoidectomy is less strongly recommended *Correspondence to: Evangelia E. Ntzani, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, 45 110 Ioannina, Greece.…”