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

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.

Association between Adenoid-Nasopharyngeal Ratio and Tympanogram Width in Adenoid Hypertrophy Patients

“…The measurement results of the A-N ratio were divided into three, namely mild (0.30–0.50), moderate (0.51–0.70), and severe (≥0.71). 11 12…”

Correlation of Clinical Score, Radiological Examination, and Nasopharyngeal Endoscopy in Adenoid Hypertrophy Patients as a Consideration of Adenoidectomy

“…Many researchers have correlated lateral cervical x-ray and nasopharyngoscopy. Several studies have stated a significant correlation between radiological examinations and endoscopic examinations, including Saedi, et al 13) in 2011, Lertsburapa, et al 7) in 2010, Kurien, et al 15) in 2005, Dawood and Khammas 24) in 2017, Hamza, et al 25) in 2019; Harugop, et al 12) in 2020. While the study conducted by Feres, et al 1) in 2014 and Jyothirmai, et al 11) in 2020 stated a weak relationship between radiological and endoscopic examinations.…”

“…Several studies were conducted to assess the efficacy of these examination modalities. 11,13,24) This research study looks for the correlation between clinical scores, lateral cervical x-ray, and nasopharyngoscopy so that an objective examination can support the subjective clinical aspects as a material for adenoidectomy decisions.…”

“…Nasopharyngoscopy is more recommended than lateral cervical x-ray in establishing the diagnosis of adenoid hypertrophy, especially to deciding on adenoidectomy. 11,12,15,24) The decision on adenoidectomy should be based on the gold standard examination, namely nasopharyngoscopy so that the procedure is carried out according to the indications and avoid mistakes in deciding on adenoidectomy. 3,7,10,16) The decision on adenoidectomy should be based on clinical considerations supported by supplementary examination.…”

Correlation between Clinical and Radiographic Findings in the Assessment of Adenoid Hypertrophy

“…The emergence of flexible fiberoptic nasopharyngoscopy has aided in better evaluation of adenoid hypertrophy. 9,10 It provides valuable information regarding correct patient selection for adenoidectomy, thus eliminating the possibility of unnecessary surgical intervention.…”