An International Journal Clinical Rhinology

Register      Login

VOLUME 13 , ISSUE 1 ( January-April, 2020 ) > List of Articles

Original Article

A Comparative Clinical Study between X-ray Nasopharynx and Nasal Endoscopy in the Diagnosis of Chronic Adenoiditis: Our Experience

Anoop Muraleedhara Ghosh, Shobhit Gupta, Amarveer S Mehta

Keywords : Adenoid–nasopharyngeal ratio, Chronic adenoiditis, Nasal endoscopy, Otitis media with effusion, X-ray nasopharynx

Citation Information : Ghosh AM, Gupta S, Mehta AS. A Comparative Clinical Study between X-ray Nasopharynx and Nasal Endoscopy in the Diagnosis of Chronic Adenoiditis: Our Experience. Clin Rhinol An Int J 2020; 13 (1):9-14.

DOI: 10.5005/jp-journals-10013-1373

License: CC BY-NC 4.0

Published Online: 00-04-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aims and objectives: In our study, we tried to analyze the utility of X-ray nasopharynx and nasal endoscopy in assessing the size of the adenoid tissue and thereby grading chronic adenoiditis. The grading of adenoids was correlated clinically with the severity of symptoms attributed to chronic adenoiditis. Materials and methods: Our study was an observational prospective study of 80 children with a diagnosis of chronic adenoiditis conducted in the Dept of ENT from January 2019 to 2020. The digital X-ray nasopharynx lateral view and nasal endoscopic results of all patients were analyzed, graded, and compared. Results: The most common age group was 5–7 years which included 34 children (42.5%). Mean adenoid–nasopharyngeal ratio for which otitis media with effusion (OME) was present was 0.72 which corresponds to X-ray grade II. It was also noticed that 71.4% X-ray grade III had OME and 65.8% of cases of endoscopic grade III adenoid had OME. Conclusion: X-ray nasopharynx was found to be a simple, less costly, practically easy option in a day-to-day practice in assessing the size of adenoid tissue; whereas nasal endoscopy is a more scientific approach providing three-dimensional views of the adenoids in the nasopharyngeal compartment. Lateral extensions of adenoids to eustachian tube orifices can be noticed in nasal endoscopy. Nasal endoscopy is considered the gold standard in diagnosing chronic adenoiditis. Reaching the correct diagnosis of chronic adenoiditis at the earliest is the main key in treatment to prevent complications and sequelae related to this clinical condition. Clinical significance: Both X-ray nasopharynx and nasal endoscopy are useful tools in the diagnosis of chronic adenoiditis. Grading of adenoids can be done in both techniques. While X-ray tomogram is a cheap and convenient method, nasal endoscopy is more scientific and accurate in giving a three-dimensional view of adenoids.


PDF Share
  1. Robb PR, Browning GG, Burton MJ, et al. The adenoid and adenoidectomy, Scott-Brown's otorhinolaryngology. Head and Neck surgery, vol. 1 7th ed., London: Hodder and Arnold; 2008. pp. 1094–1099.
  2. Pederson PM. Adenoidectomy: an evaluation of the original technique. AMA Archiv Otolaryngol 1957;66(5):517–524. DOI: 10.1001/archotol.1957.03830290023004.
  3. Rubin RM. Effects of nasal airway obstruction on facial growth. Ear Nose Throat J 1987;66(5):212–219.
  4. Lourenço EA, Lopes KC, Pontes Á, et al. Comparison between radiological and nasopharyngoscopic assessment of adenoid tissue volume in mouth breathing children. Braz J Otorhinolaryngol 2005;71(1):23–27. DOI: 10.1016/S1808-8694(15)31280-5.
  5. Wormald PJ, Prescott CA. Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings. J Laryngol Otol 1992;106(04):342–344. DOI: 10.1017/S0022215100119449.
  6. Ysunza A, Pamplona MC, Ortega JM, et al. Video fluoroscopy for evaluating adenoid hypertrophy in children. Int J Pediatr Otorhinolaryngol 2008;72(8):1159–1165. DOI: 10.1016/j.ijporl.2008.03.022.
  7. Kubba H, Bingham BJ. Endoscopy in the assessment of children with nasal obstruction. J Laryngol Otol 2001;115(05):380–384. DOI: 10.1258/0022215011907929.
  8. Cassano P, Gelardi M, Cassano M, et al. Adenoid tissue rhinopharyngeal obstruction grading based on fibre-endoscopic findings: a novel approach to therapeutic management. Int J Paediatric Otorhino Laryngol 2003;67(12):1303–1309. DOI: 10.1016/j.ijporl.2003.07.018.
  9. Mlynarek A, Tewfik MA, Hagr A, et al. Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size. J Otolaryngol 2004;33(6):360–365. DOI: 10.2310/7070.2004.03074.
  10. Orji FT, Okolugho NE, Ezeanolue BC. The role of adenoidal obstruction in the pathogenesis of otitis media with efficiency in Nigeries children. Nigerian J Med 2010;19(1):62–68.
  11. Fujioka M, Young LW, Gridang BR. Radiographic evaluation of adenoidal size in children; adenoidal-nasopharyngeal ratio. Am J Radiol 1979;133(3):401–404. DOI: 10.2214/ajr.133.3.401.
  12. Wright ED, Pearl AJ, Manoukian JJ. Laterally hypertrophic adenoids as a contributing factor in otitis media. Int J Paediat Otorhinolaryn 1998;45(3):207–214. DOI: 10.1016/S0165-5876(98)00113-X.
  13. Cohen LM, Koltai PJ, Scott JR. Lateral cervical radiographs and adenoid size: do they correlate? Ear Nose Throat J 1992;71(12):638–642. DOI: 10.1177/014556139207101207.
  14. Yilmaz I, Caylakli F, Yilmazee C, et al. Correlation of diagnostic systems with adenoidal tissue volume: a blind prospective study. Int J Paediat Otorhinolaryn 2008;72(8):1235–1240. DOI: 10.1016/j.ijporl.2008.05.002.
  15. Kinderman CA, Roithmann R, Netu JF. Sensitivity and specificity of nasal flexible fiberoptic endoscopy in the diagnosis of adenoid hypertrophy in children. Int J Peadiat Otolaryngol 2008;72(1):63–67. DOI: 10.1016/j.ijporl.2007.09.013.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.