Radiographic adenoid evaluation - suggestion of referral parameters

Author(s)

Feres, Murilo F. N. ^[1] ; Hermann, Juliana S. ^[2] ; Sallum, Ana C. ^[2] ; Pignatari, Shirley S. N. ^[2]

Affiliation

^[1] Univ Sao Francisco, Fac Odontol, BR-12900000 Braganca Paulista, SP - Brazil

^[2] Univ Fed Sao Paulo UNIFESP, Dept Otorhinolaryngol Head & Neck Surg, Sao Paulo - Brazil

• Document type: Journal article
• Source: Jornal de Pediatria; v. 90, n. 3, p. 279-285, MAY-JUN 2014.
• Web of Science Citations: 1

Abstract

OBJECTIVE:this study aimed to evaluate the usefulness of current radiographic measurements, which were originally conceived to evaluate adenoid hypertrophy, as potential referral parameters.METHODS:children aged from 4 to 14 years, of both genders, who presented nasal obstruction complaints, were subjected to cavum radiography. Radiographic examinations (n = 120) were evaluated according to categorical and quantitative parameters, and data were compared to gold-standard videonasopharyngoscopic examination, regarding accuracy (sensitivity, negative predictive value, specificity, and positive predictive value).RESULTS:radiographic grading systems presented low sensitivity for the identification of patients with two-thirds choanal space obstruction. However, some of these parameters presented relatively high specificity rates when three-quarters adenoid obstruction was the threshold of interest. Amongst the quantitative variables, a mathematical model was found to be more suitable for identifying patients with more than two-thirds obstruction.CONCLUSION:this model was shown to be potentially useful as a screening tool to include patients with, at least, two-thirds adenoid obstruction. Moreover, one of the categorical parameters was demonstrated to be relatively more useful, as well as a potentially safer assessment tool to exclude patients with less than three-quarters obstruction, to be indicated for adenoidectomy. (AU)