The role of acoustic rhinometry in the diagnosis of adenoidal hypertrophy in pre-school children.

Abstract

Adenoidal hypertrophy is a common problem in pre-school children and diagnosis depends mostly on evaluation of clinical symptoms and signs. Investigative techniques to assess adenoidal size often do not add to this information. Recent reports have suggested a role for acoustic rhinometry in this situation. A total of 49 children consecutively referred to the Department of Otorhinolaryngology, University of Mainz, with evidence of adenoidal enlargement underwent acoustic rhinometry pre- and post-operatively and were compared to an age-matched control group from a local kindergarten school. Adenoidal size was visually estimated at surgery and questionnaires were completed by parents of symptomatic children. Acoustic rhinometry was not able to differentiate controls (mean nasopharyngeal cross-sectional area 1.34+/-0.47 cm2, n = 35) from symptomatic children admitted for adenoidectomy (mean nasopharyngeal cross-sectional area 1.66 +/- 0.83 cm2, n = 42, P = 0.53). Acoustic rhinometry was advantageous for patients with adenoidal hypertrophy in two situations. Firstly a sub-group of patients with complete nasopharyngeal obstruction could be identified (P = 0.03) and secondly all patients with a postnasal space less than 1.2 cm2 clinically benefited from adenoidectomy. Acoustic rhinometry, in general, is not suitable for assessing adenoidal size in pre-school children. Physical limitations of currently available acoustic rhinometers are likely to explain the limited clinical value of this investigative technique.