Comparison Between Radiological Versus Endoscopic Assessment of Adenoid Tissue in Patients of Chronic Adenoiditis

Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):981-985. doi: 10.1007/s12070-019-01669-z. Epub 2019 Jun 8.

Abstract

The adenoids are a common cause for morbidity in pre-school and school going children. Adenoid hypertrophy is common cause of nasal obstruction in pediatric population. The assessment of the size of palatine tonsil hypertrophy is quiet easy to perform, however, measuring the size of nasopharyngeal tonsil and establishing its connection with the given symptoms is more difficult. This is basically due to the location of a tonsil in the nasopharyngeal cavity. Since the cavity is inaccessible directly and cannot be examined visually, many direct and indirect methods of adenoid size evaluation have been developed. The objective of this study is to compare the diagnostic efficacy of both X-ray soft tissue nasopharynx lateral view and nasoendoscopy in evaluation of adenoid size in patients having chronic adenoiditis. Our study included 50 children in age group of 3-14 years who had signs and symptoms of adenoiditis clinically. After comparing X-ray and endoscopic findings we found that there was good agreement between X-ray and endoscopic method. Sensitivity of X-ray was 79.41% and specificity of 75% whereas sensitivity of nasoendoscopy was 87.10% and specificity was 63.16%. Nasal endoscopy is good screening method and more accurate method to assess the size of adenoids in patients of chronic adenoiditis.

Keywords: Chronic adenoiditis; Clemens classification; Cohen and Konak method; Fujiokas method; Nasoendoscopy; X-ray soft tissue nasopharynx.