Radiological and Audiological Assessment in Patients with Adenoid Hypertrophy Undergoing Adenoidectomy

Area of Science:

• Otolaryngology
• Pediatric Radiology
• Audiology

Background:

• Enlarged adenoids can obstruct the Eustachian tube (ET), causing negative intratympanic pressure and otitis media with effusion (OME).
• Accurate assessment of adenoid size is crucial for timely intervention.
• The Adenoid-Nasopharyngeal Ratio (ANR) is a cost-effective imaging metric.

Purpose of the Study:

• To evaluate the reliability of the Adenoid-Nasopharyngeal Ratio (ANR) in assessing adenoid hypertrophy.
• To correlate ANR with audiological findings and endoscopic assessments in pediatric patients.
• To determine ANR's utility as a pre-operative tool for adenoidectomy.

Main Methods:

• Lateral radiographs of the nasopharynx were used to calculate the ANR in children aged 5+ undergoing adenoidectomy.
• Patients also underwent Pure Tone Audiometry (PTA) and tympanometry.
• ANR was graded and compared with PTA, tympanometry, and endoscopic findings.

Main Results:

• A significant correlation was found between ANR and PTA/impedance (p=0.002) using a cut-off value of 0.835.
• 71% of patients with ANR > 0.835 showed abnormal PTA and tympanometry results.
• 30.8% of patients with ANR < 0.835 had abnormal audiological findings.

Conclusions:

• ANR is a valuable pre-operative tool for identifying the need for adenoidectomy in pediatric patients, especially those reluctant to undergo endoscopy.
• The ANR provides a reliable, cost-effective measure of adenoid size relative to the nasopharyngeal space.
• A limitation is the inability of ANR to assess the lateral extent of adenoids.