Plain radiographic evaluation of children with obstructive adenoids

Abstract

Background There are several methods of evaluating adenoidal size pre-operatively. Plain nasopharyngeal radiography is a common investigative modality: it has been advocated, and also condemned. Aim This study was intended to assess nasopharyngeal airway obstruction by the adenoids using plain X-rays; and also to find correlation if any, with the symptomatology. Methods This is a retrospective study carried out between January and December 2008. The case notes and plain X-rays of the nasopharynx of 34 paediatric patients with clinical features of obstructive adenoids were analyzed. Results A total of 34 children were studied, 22 (64.7%) were males and 12 (35.3%) were females. Their ages ranged between 7 months and 10 years: mean age was 3.55 years, standard deviation 2.723. Majority (67.6%) of the children were in the age group 0–4 years. The lowest symptomatology assessment score was 0 and the highest was 3. Children 4 years and below had the highest symptomatology scores. The minimum adenoidal–nasopharyngeal ratio was 0.35 and the maximum was 0.94. There was no significant difference in the mean adenoidal–nasopharyngeal ratio of males and females ( t = 0.407; p = 0.692). Many (75.0%) of the children with moderate to severe nasopharyngeal airway obstruction by the adenoids were in the age bracket 0–4 years. The lowest adenoidal–nasopharyngeal ratio score was 0 and the highest was 3. Children 4 years and below had the highest adenoidal–nasopharyngeal ratio scores. There was a very weak nonsignificant correlation between the symptomatology assessment score and the radiological assessment score ( r = 0.168; p = 0.375). Conclusion The adenoidal–nasopharyngeal ratio is reliable in assessing the nasopharyngeal airway in children with obstructive adenoids.