NASOPHARYNGOSCOPY VERSUS PLAIN RADIOGRAPHY IN ADENOID SIZE ASSESSMENT

Safaa Khalaf Faleh ,Husam Haider Salman ,Haidar Mohammed Salih

doi:10.33762/bsurg.2020.165495

Abstract

This is a prospective comparative study of adenoid size assessment by using radiography versus nasopharyngoscopy using examination of the adenoid under general anesthesia (GA) as a standard method. This study was conducted on 35 children presented with signs and symptoms of adenoid hypertrophy. All patients were examined by both lateral radiograph view of the postnasal space and nasopharyngoscopy, then both results were compared. The results for small size adenoid can not be calculated because of small sample size. For medium sized adenoid, the sensitivity for radiography and nasopharyngoscopy are 36.36%, 54.54% respectively, the specificity was 47.36%, 84.21% respectively and the accuracy was 43.33%, 73.33% respectively. For large sized adenoid the sensitivity for radiography and nasopharyngoscopy was 38.89%, 83.33% respectively, the specificity was 100%, 66.66% respectively, and the accuracy was 63.33%, 76.66% respectively. In conclusion, nasopharyngoscopy is a simple, safe, repeatable, readily available at the ENT unit, with no radiation hazards, and with negligible trauma. Over all, nasopharyngoscopy has a higher sensitivity, specificity and accuracy than radiography.

Highlights

This is a prospective comparative study of adenoid size assessment by using radiography versus nasopharyngoscopy using examination of the adenoid under general anesthesia (GA) as a standard method
In EUA of the postnasal space to assess the adenoid size there was only 1 small adenoid (1/30), 11 medium size adenoid (11/30), and 18 large adenoid (18/30) (Table I)
In the fiberoptic nasopharyngoscopy only one small size adenoid correlated (1/2), and 6 medium size adenoid correlated with the EUA (6/9), 15 large size adenoid correlated with the EUA(15/19) (Fig.5)

Summary

Introduction

This is a prospective comparative study of adenoid size assessment by using radiography versus nasopharyngoscopy using examination of the adenoid under general anesthesia (GA) as a standard method. The sensitivity for radiography and nasopharyngoscopy are 36.36%, 54.54% respectively, the specificity was 47.36%, 84.21% respectively and the accuracy was 43.33%, 73.33% respectively. For large sized adenoid the sensitivity for radiography and nasopharyngoscopy was 38.89%, 83.33% respectively, the specificity was 100%, 66.66% respectively, and the accuracy was 63.33%, 76.66% respectively. The shape of a full sized adenoid is like a truncated pyramid, its apex directed toward nasal septum and its base toward the junction of the posterior wall and the roof of the post nasal space[1]. We are attempting to validate both radiological assessment (lateral post nasal space plain X-ray film) and flexible fibreoptic nasopharyngoscopy for adenoid size assessment in comparison with examination under anesthesia of the postnasal space as a base line measurement for the fore mentioned two tools

Methods

Results

Discussion

Conclusion