Correlation among Diagnostic Methods for Adenoid Hypertrophy in Children

Cheong, Ki Woong; Lee, Seung Ju; Lee, Lae Hyung

Abstract

BACKGROUND AND OBJECTIVES
To determine correlation among diagnostic methods for adenoid hypertrophy in children.
SUBJECTS AND METHOD
We included 29 patients who visited our clinic with the complaints of upper airway obstruction. To estimate the extent to which the adenoid narrowed the choana, evaluations were made using the skull lateral film, video fluoroscopy and nasal endoscopy. Adenoid-nasopharynx (A/N) ratio was calculated from the skull lateral film using the Fujioka Method and airway-soft palate (A/S) ratio was determined from the skull lateral film and video fluoroscopy using the Cohen and Konak method. Digital images obtained during endoscopic examination were evaluated on computer and obstruction ratios [adenoid-choana (A/C) height and area ratio] were calculated. Five ratios of each patient were then compared. The Spearman correlation test was used to statistically evaluate the data.
RESULTS
The mean A/N ratio was 0.62+/-0.07 (range: 0.47-0.79). The mean A/S ratio of the skull lateral film and video fluoroscopy was 0.85+/-0.34 (range: 0.2-1.96) and 1.02+/-0.33 (range: 0.49-2.02), respectively. There was no correlation between A/N and A/S ratios. In the nasal endoscopy, the mean A/C height ratio was 0.77+/-0.09 (range: 0.59-0.94) and the mean A/C area ratio was 0.70+/-0.10 (range: 0.48-0.90). There was a statistically significant correlation between the A/C height and the area ratio (r=0.92; p<0.001). The A/S ratio calculated from the skull lateral film showed a good correlation with nasal endoscopic findings (p<0.01), but the A/S ratio from the video fluoroscopy did not.
CONCLUSION
The A/S ratio in the skull lateral film and A/C ratios showed a good correlation. They can be used to properly evaluate the upper airway and the adenoid in children.