Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-19T11:49:00.896Z Has data issue: false hasContentIssue false
  • English
  • Français

Evaluation of adenoidal obstruction in children: clinical symptoms compared with roentgenographic assessment

Published online by Cambridge University Press:  07 April 2008

F T Orji  and
B C Ezeanolue
F T Orji*
Affiliation:
Department of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, Nigeria
B C Ezeanolue
Affiliation:
Department of Otolaryngology, University of Nigeria Teaching Hospital, Enugu, Nigeria
*
Address for correspondence: Dr F T Orji, Department of Otolaryngology, University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu Enugu State, Nigeria. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Obstructive adenoid enlargement is commonly implicated as the major cause of chronic nasal obstruction in children. Although clinical assessment is considered essential, there is little consensus over its reliability. This study was conducted to determine the correlation between graded symptomatology assessment and roentgenographic assessment of adenoidal obstruction.

Method:

Symptoms assessed included snoring, mouth-breathing and obstructive breathing during sleep. Each symptom was rated on a four-point scale (absent = zero, mild = one, moderate = two and severe = three). We summed the ratings for each child to obtain the symptomatology score. We used an adenoidal–nasopharyngeal ratio parameter to classify roentgenographic assessment into minimal, moderate or marked obstruction.

Results:

Sixty-four children, 42 boys and 22 girls, aged one to 12 years were enrolled. The clinical symptomatology scores correlated significantly with the roentgenographic ratings of nasopharyngeal airway obstruction (r = 0.419; p = 0.001). The correlation was significant at roentgenographic ratings of minimal obstruction (p < 0.05) and gross obstruction (p < 0.001). Both the symptomatology score and the roentgenographic rating showed significant correlations with patient age (r = −0.657, p < 0.01 and r = −0.340, p < 0.01, respectively).

Conclusion:

Clinical rating of adenoidal symptoms in children provides a reasonably reliable assessment of the presence and severity of nasopharyngeal airway obstruction. This technique of assessment is easy to use and is particularly valid when obstruction is either minimal or gross.

Keywords

AdenoidAdenoidectomyRadiography
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 11 , November 2008 , pp. 1201 - 1205
Copyright
Copyright © JLO (1984) Limited 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Hibbert, J. The current status of adenoidectomy: a survey among otolaryngologists. Clin Otolaryngol 1977;2:239–47CrossRefGoogle ScholarPubMed
2 Hibbert, J, Tweedie, MCK. The value of signs and symptoms in the diagnosis of enlarged adenoids. Clin Otolaryngol 1977;2:297–304CrossRefGoogle ScholarPubMed
3 Hibbert, J, Stell, PM, Wright, A. Value of physical signs in the diagnosis of enlarged adenoids. Clin Otolaryngol 1980;5:191–4CrossRefGoogle ScholarPubMed
4 Jean, WD, Fernando, DC, Maw, AR. How should adenoidal enlargement be measured: a radiological study based on interobserver agreement. Int J Pediatr Otorhinolaryngol 2003;67:121–5Google Scholar
5 Pruzansky, S. Roentgencephalometric studies of tonsils and adenoids in normal and pathologic states. Ann Otol Rhinol Laryngol 1975;84:55–62CrossRefGoogle ScholarPubMed
6 Fujioka, M, Young, LW, Girdany, BR. Radiographic evaluation of adenoidal size in children: adenoidal – nasopharyngeal ratio. Am J Roentgenol 1979;133:401–4CrossRefGoogle ScholarPubMed
7 Elwany, S. The adenoidal-nasopharyngeal ratio: its validity in selecting children for adenoidectomy. J Laryngol Otol 1987;10:569–73CrossRefGoogle Scholar
8 Goldman, JL, Bachman, AL. Soft tissue roentgenography of the nasopharynx for adenoids. Laryngoscope 1958;68:1288–310CrossRefGoogle ScholarPubMed
9 Cohen, LM, Koltai, PJ, Scott, JR. Later cervical radiographs and adenoid size: do they correlate? Ear Nose Throat J 1992;7:638–42CrossRefGoogle Scholar
10 Paradise, JL, Bernard, BS, Colborn, DK, Janosky, JE. Assessment of adenoidal obstruction in children: clinical signs versus roentgenographic findings. Pediatr 1998;101:979–86CrossRefGoogle ScholarPubMed
11 Bitar, MA, Rahi, A, Khalifeh, M, Madanat, LS. A suggested clinical score to predict the severity of adenoidal obstruction in children. Eur Arch Otorhinolaryngol 2006;263:924–8CrossRefGoogle ScholarPubMed
12 Hibbert, J, Stell, PM. Critical evaluation of adenoidectomy. Lancet 1978;i:489–90CrossRefGoogle Scholar
13 Crepeau, J, Patriquin, HB, Poliquin, JF, Tetreault, L. Radiographic evaluation of the symptom-producing adenoid. Otolaryngol Head Neck Surg 1982;90:548–54CrossRefGoogle ScholarPubMed
14 Sorensen, H, Solow, B, Greve, E. Assessment of the nasopharyngeal airway. A rhinomanometric and radiographic study in children with adenoids. Acta Otolaryngol 1980;89:227–32CrossRefGoogle ScholarPubMed
15 Tankel, JW, Cheeseman, AD. Symptom relief by adenoidectomy and relationship to adenoid and post-nasal airway size. J Laryngol Otol 1986;100:637–40CrossRefGoogle ScholarPubMed
16 Maw, AR, Jeans, WD, Fernando, DCJ. Inter-observer variability in the clinical and radiological assessment of adenoid size, and the correlation with adenoid volume. Clin Otolaryngol 1981;6:317–22CrossRefGoogle ScholarPubMed
17 Haapaniemi, JJ. Adenoids in school-aged children. J Laryngol Otol 1995;109:196–202CrossRefGoogle ScholarPubMed
18 Johannesson, S. Roentgenologic investigation of the nasopharyngeal tonsil in children of different ages. Acta Radiol 1968;7:299–304Google ScholarPubMed
19 Jeans, WD, Fernando, DCJ, Maw, AR, Leighton, BC. A longitudinal study of the growth of the nasopharynx and its contents in normal children. British J Radiol 1981;54:117–21CrossRefGoogle ScholarPubMed