Diagnostic value of CBCT in Chinese children with adenoid hypertrophy

Abstract

Objective The main objectives of the study were to investigate the reliability and accuracy of cone‐beam computed tomography (CBCT) in the diagnosis of adenoid hypertrophy in Chinese children and to evaluate its value in clinical diagnosis. Methods From January 2019 to January 2020, 300 children with sleep snoring in Xinhua Hospital Affiliated to Medical College of Shanghai Jiaotong University were retrospectively studied. All patients underwent nasopharyngoscopy (NE) and CBCT scanning. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of CBCT were determined according to the diagnostic criteria of NE, and the consistency between CBCT and NE was evaluated. Results The clinical study of 300 children patients found that compared with NE, CBCT had a sensitivity of 87.3%, specificity of 89.2%, the positive predictive value of 93.20%, the negative predictive value of 80.5%, the positive likelihood ratio of 8.08, the negative likelihood ratio of 0.14, and Kappa value of .748. Conclusion CBCT is a reliable and accurate tool for the diagnosis of adenoid hypertrophy and can be used as an alternative examination method for children with contraindications or intolerance during NE. Level of Evidence 4.

The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing

“… 88 CBCT imaging may be indicated in cases of concomitant sinus pathologies or concerning masses, 89 and when nasal endoscopy is contraindicated, unavailable, or when the patient is uncooperative. 90 CBCT can be used to measure the hypertrophy of nasal turbinates, 91 and specific methods have been developed for turbinates grading in patients with cleft lip and palate. 92 Since turbinate hypertrophy is often a compensatory reaction to protect the nasal passage from cold and dry air in the presence of nasal septum abnormalities, 91 orthodontic intervention with RME may be beneficial.…”

“… 104 CBCT has good reliability and validity in the diagnosis of adenoid hypertrophy, but the assessments performed by orthodontist may be suboptimal 104 and reports supporting its validity in patients with SDB are scarce. 90 In addition, CBCT does not allow for the visualization of the mucosal status—including possible inflammation and infections—and the intramural soft tissue component. Thus, further MRI or endoscopy assessment may be indicated for accurate diagnosis.…”

“…While palatine tonsil hypertrophy is present mainly in adults with OSA, 106 swollen lingual tonsils are more relevant among children. 107 Isolated reports of palatine 90 and lingual tonsil 98 assessment via CBCT are available, but there is no indication for routine clinical use. Compared to the adenoids, which are supported by the sphenoid bone, lingual tonsils are attached to the tongue, which makes them mobile and subject to motion artefacts.…”