Radiographic adenoid evaluation - suggestion of referral parameters

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,...

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Bibliographic Details
Main Authors: Murilo F.N. Feres, Juliana S. Hermann, Ana C. Sallum, Shirley S.N. Pignatari
Format: Article
Language:English
Published: Elsevier 2014-06-01
Series:Jornal de Pediatria
Subjects:
Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0021-75572014000300279&lng=en&tlng=en
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Summary: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.
ISSN:1678-4782