Reliability of radiographic parameters in adenoid evaluation

Braz J Otorhinolaryngol. Jul-Aug 2012;78(4):80-90.
[Article in English, Portuguese]


The assessment of adenoids by x-ray imaging has been the topic of heated debate, but few studies have looked into the reliability of most existing radiographic parameters.

Objective: This study aims to verify the intra-examiner and inter-examiner reproducibility of the adenoid radiographic assessment methods.

Materials and methods: This is a cross-sectional case series study. Forty children of both genders aged between 4 and 14 were enrolled. They were selected based on complaints of nasal obstruction or mouth breathing and suspicion of pharyngeal tonsil hypertrophy. Cavum x-rays and orthodontic teleradiographs were assessed by two examiners in quantitative and categorical terms.

Results: All quantitative parameters in both x-ray modes showed excellent intra and inter-examiner reproducibility. Relatively better performance was observed in categorical parameters used in cavum x-ray assessment by C-Kurien, C-Wang, C-Fujioka, and C-Elwany over C-Cohen and C-Ysunza. As for orthodontic teleradiograph grading systems, C-McNamara has been proven to be more reliable than C-Holmberg.

Conclusion: Most instruments showed adequate reproducibility levels. However, more research is needed to properly determine the accuracy and viability of each method.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoids / diagnostic imaging*
  • Adenoids / pathology
  • Adolescent
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertrophy / diagnostic imaging
  • Male
  • Mouth Breathing / diagnostic imaging*
  • Mouth Breathing / etiology
  • Nasal Obstruction / diagnostic imaging*
  • Nasal Obstruction / etiology
  • Observer Variation
  • Radiography
  • Reproducibility of Results
  • Teleradiology