Assessment of Adenoids Hypertrophy by Plain X-ray and Nasoendoscopy in Karbala

Abstract

background: The pharyngeal tonsil, also called adenoids, is the upper extension of thelymphatic Waldeyer’s Ring and is located on the upper posterior wall of thenasopharynx. A great deal of interest has been given to diverse methods of examinations and parameters for identification and evaluation of adenoids hypertrophy.Objectives: To clarify the accuracy of both lateral plain x-ray of the soft tissue of the nasopharynx and nasoendoscope in evaluation of the adenoids size.Methods: One hundred-fifty patients presented with nasal obstruction or mouth breathing suspected to have adenoids hypertrophy were seen and examined in the outpatients clinic of E.N.T Department of Al-Hussain Teaching Hospital, Karbala from August to November, 2014. All of the patients evaluated clinically, by lateral plain x-ray of the soft tissue of the nasopharynx and nasoendoscope to determine the size of adenoids.Results: A total of 150 patients presented with nasal obstruction or mouth breathing, there were 83 (55%) males and 67 (45%) females patients (M/F 1.2:1). According to plain x-ray of the nasopharynx, large size adenoids was seen in 77 patients (51%) , moderate size in 49 patients (33%) , and small size seen in 24 patients (16%). According to endoscopic assessment, the commonest grade of adenoids size was the grade IV seen in 47 patients (31%) and the least common grade of adenoids size was grade I seen in 16 patients (10.7%), while grade II was seen in 44 patients (29.3%), and grade III seen in 43 patients (29%).Conclusions: Evaluation by endoscope was highly accurate than evaluation by X-ray. Hence, children with classical symptoms of upper respiratory tract obstruction, even without adenoids hypertrophy revealed by X-ray, suggested to be submitted to nasoendoscope for diagnostic accuracy, which is greatly relevant especially for more secure indication of adenoidectomy and help in avoiding unnecessary operation