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Accuracy of ultrasonography for the diagnosis of paediatric adenoid hypertrophy: protocol for a systematic review and

Feifei Chen¹, Jie Liao², Daili Mou³

¹Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

|January 21, 2026

Insights

This systematic review evaluates ultrasonography for diagnosing childhood adenoid hypertrophy (AH). It synthesizes data to determine its accuracy compared to existing methods, aiding clinical decisions.

Area of Science:

Otolaryngology
Pediatric diagnostics
Medical imaging

Background:

Adenoid hypertrophy (AH) is common in children (3-10 years), impacting growth.
Current diagnostics include endoscopy, radiography, CT, and MRI.
Ultrasonography is an emerging tool for AH diagnosis.

Purpose of the Study:

To systematically review and evaluate the diagnostic performance of ultrasonography for pediatric adenoid hypertrophy.
To compare ultrasonography's accuracy against established diagnostic methods.

Main Methods:

Systematic literature search across five databases (PubMed, MEDLINE, Embase, Cochrane, CNKI) until March 2025.
Independent screening and data extraction by two reviewers.
Quality assessment using QUADAS-2 and meta-analysis of diagnostic accuracy (sensitivity, specificity, likelihood ratios) using bivariate random-effects model.

Main Results:

Pooled estimates of sensitivity, specificity, and likelihood ratios will be calculated.
Subgroup analyses and meta-regression will explore heterogeneity factors (country, probe type, operator experience).

Conclusions:

This review will provide a comprehensive assessment of ultrasonography's diagnostic accuracy for pediatric AH.
Findings will inform clinical practice regarding the utility of ultrasonography in diagnosing AH.

Read full analysis

Abstract

Introduction:

Adenoid hypertrophy (AH) is a prevalent otolaryngological condition that primarily affects children aged 3-10 years and may adversely impact their growth and development. The choice of treatment largely hinges on the severity of hypertrophy. Currently, the main diagnostic modalities for AH include nasal endoscopy, lateral nasopharyngeal radiography, CT and MRI. In recent years, ultrasonography has emerged as a novel diagnostic tool for AH. This review aims to comprehensively evaluate the diagnostic performance of ultrasonography for detecting AH in children.

Methods And Analysis:

We will conduct a systematic literature search in five databases-PubMed, MEDLINE, Embase, the Cochrane Library and CNKI-to identify studies evaluating the use of ultrasonography for the diagnosis of paediatric AH. The search period will span from database inception to 31 March 2025. Only studies published in Chinese or English will be considered. All retrieved records will be independently screened by two reviewers at the title and abstract level to identify eligible studies. Data extraction will also be independently performed by two reviewers. The methodological quality of the included studies will be evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. To synthesise diagnostic accuracy, pooled estimates of sensitivity, specificity and likelihood ratios will be obtained through a bivariate random-effects approach in combination with the hierarchical summary receiver operating characteristic model. When notable heterogeneity is detected, subgroup analyses and meta-regression will be conducted to examine whether estimates of diagnostic accuracy differ according to country, ultrasound probe type or operator experience.

Ethics And Dissemination:

As this review is based exclusively on previously published studies, ethical approval is not required. The findings will be disseminated through publication in peer-reviewed journals and presentations at academic conferences.

Study Registration:

PROSPERO, CRD420251080754.

Keywords:

Adolescents China Meta-Analysis Ultrasonography

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