Endoscopic Grading, Radiological Grading and Clinical Features in Children with Chronic Adenoid Hypertrophy: A...

Area of Science:

• Pediatric Otorhinolaryngology
• Pediatric Radiology
• Medical Diagnostics

Background:

• Chronic adenoid hypertrophy significantly impacts children's health, causing symptoms like nasal obstruction and recurrent rhinitis.
• Accurate assessment of adenoid hypertrophy is crucial for effective treatment planning.
• Existing diagnostic methods, including X-rays and nasal endoscopy, have varying degrees of correlation with clinical presentation.

Purpose of the Study:

• To correlate endoscopic findings, radiological assessments, and clinical features in children with symptomatic chronic adenoid hypertrophy.
• To determine the most accurate method for evaluating the severity and clinical significance of adenoid hypertrophy in pediatric patients.

Main Methods:

• A cross-sectional study involving 42 pediatric patients (3-14 years) with symptomatic chronic adenoid hypertrophy.
• Data collection included history taking, ENT examination, rigid nasal endoscopy (ACE grading), and lateral X-ray nasopharynx (Adenoid-Nasopharyngeal ratio).
• Correlation analysis was performed between endoscopic, radiological, and clinical findings.

Main Results:

• Male predominance was observed, with mouth breathing, snoring, and nasal obstruction as common symptoms.
• Endoscopic grading showed a stronger correlation with clinical grading than X-ray grading.
• While X-ray's Adenoid-Nasopharyngeal ratio correlated with endoscopic grading and choanal obstruction, nasal endoscopy proved more accurate for assessing clinical significance and Eustachian tube involvement.

Conclusions:

• Nasal endoscopy is the gold standard for assessing clinically significant adenoid hypertrophy in children.
• Endoscopic grading is more reliable than X-ray measurements for evaluating adenoid size and its impact on symptoms.
• Clinical correlation is better with endoscopic findings, highlighting its superiority in diagnostic accuracy.