The clinical significance of adenoid-choanae area ratio in children with adenoid hypertrophy.

OBJECTIVE We designed a method to compare the adenoid-choanae area ratio (A/C ratio) measured in children with symptoms of adenoid hypertrophy with those from children without any symptoms related to adenoid hypertrophy. METHODS A prospective analysis of A/C ratio of 42 patients undergoing adenoidectomy and tonsillectomy from January 2000 to September 2003 in a medical center was compared with 28 patients receiving treatment other than the above-mentioned procedures in the same period. We used 0 degrees telescope to take pictures of the nasopharynx under general anesthesia preoperatively. The pictures were transformed digitally. The A/C ratio was calculated by the program we developed after these pictures were processed by the Photoshop 6.0 (Adobe, USA) software. RESULTS The A/C ratio in adenoid hypertrophy group (0.863+/-0.0983) is significantly higher (p<0.001) than that of control group (0.445+/-0.1431). Mouth breathing, nasal obstruction and snoring were found to be more severe in children with high A/C ratio (p<0.001). CONCLUSIONS The A/C ratio provided the two-dimensional information of the nasopharyngeal airway. The A/C area ratio is significantly higher in the group of symptomatic adenoid hypertrophy when compared with symptomatic-free group. For practical purposes, the adenoid with an A/C ratio more than 2/3 is considered a pathological enlargement.

[1]  J. Janosky,et al.  Assessment of adenoidal obstruction in children: clinical signs versus roentgenographic findings. , 1998, Pediatrics.

[2]  A. Wright,et al.  Value of physical signs in the diagnosis of enlarged adenoids. , 1980, Clinical otolaryngology and allied sciences.

[3]  S. Jóhannesson.  Roentgenologic Investigation of the Nasopharyngeal Tonsil in Children of Different Ages , 1968, Acta radiologica: diagnosis.

[4]  L. Kaufman,et al.  Assessment of adenoid size in children by fibreoptic examination. , 1997, Clinical otolaryngology and allied sciences.

[5]  P. Stell,et al.  A radiological study of the adenoid in normal children. , 1979, Clinical otolaryngology and allied sciences.

[6]  H. Patriquin,et al.  Radiographic Evaluation of the Symptom-Producing Adenoid , 1982, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[7]  D. H. Lee,et al.  Size assessment of adenoid and nasopharyngeal airway by acoustic rhinometry in children , 1999, The Journal of Laryngology & Otology.

[8]  S. Pruzansky.  Roentgencephalometric Studies of Tonsils and Adenoids in Normal and Pathologic States , 1975 .

[9]  S. Elwany.  The adenoidal-nasopharyngeal ratio (AN ratio) , 1987, The Journal of Laryngology & Otology.

[10]  B R Girdany,et al.  Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio. , 1979, AJR. American journal of roentgenology.

[11]  K. Agren,et al.  The nasopharynx and the middle ear. Inflammatory reactions in middle ear disease. , 2000, Vaccine.

[12]  G. Whitehouse,et al.  The assessment of adenoidal size by radiological means. , 1978, Clinical otolaryngology and allied sciences.

[13]  L. Donnelly,et al.  Correlation on cine MR imaging of size of adenoid and palatine tonsils with degree of upper airway motion in asymptomatic sedated children. , 2002, AJR. American journal of roentgenology.