RESUMEN
BACKGROUND: Obstructive adenoid enlargement is commonly implicated as the major cause of chronic nasal obstruction in children. Although clinical assessment is considered essential, there is little consensus over its reliability. This study was conducted to determine the correlation between graded symptomatology assessment and roentgenographic assessment of adenoidal obstruction. METHOD: Symptoms assessed included snoring, mouth-breathing and obstructive breathing during sleep. Each symptom was rated on a four-point scale (absent = zero, mild = one, moderate = two and severe = three). We summed the ratings for each child to obtain the symptomatology score. We used an adenoidal-nasopharyngeal ratio parameter to classify roentgenographic assessment into minimal, moderate or marked obstruction. RESULTS: Sixty-four children, 42 boys and 22 girls, aged one to 12 years were enrolled. The clinical symptomatology scores correlated significantly with the roentgenographic ratings of nasopharyngeal airway obstruction (r = 0.419; p = 0.001). The correlation was significant at roentgenographic ratings of minimal obstruction (p < 0.05) and gross obstruction (p < 0.001). Both the symptomatology score and the roentgenographic rating showed significant correlations with patient age (r = -0.657, p < 0.01 and r = -0.340, p < 0.01, respectively). CONCLUSION: Clinical rating of adenoidal symptoms in children provides a reasonably reliable assessment of the presence and severity of nasopharyngeal airway obstruction. This technique of assessment is easy to use and is particularly valid when obstruction is either minimal or gross.
Asunto(s)
Tonsila Faríngea/diagnóstico por imagen , Obstrucción Nasal/diagnóstico por imagen , Enfermedades Nasofaríngeas/diagnóstico por imagen , Nasofaringe/diagnóstico por imagen , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Respiración por la Boca/fisiopatología , Obstrucción Nasal/etiología , Enfermedades Nasofaríngeas/fisiopatología , Variaciones Dependientes del Observador , Valor Predictivo de las Pruebas , Radiografía , Índice de Severidad de la Enfermedad , Síndromes de la Apnea del Sueño/fisiopatología , Ronquido/fisiopatología , Estadística como AsuntoRESUMEN
The relationship between adenoidal-nasopharyngeal ratios (AN ratios) and sinusitis were evaluated in 404 children. The AN ratios of children with snoring, mouth breathing, or nasal obstruction (major symptoms of adenoidal enlargement) were significantly higher than those of children without these symptoms. However, the AN ratios of children with sinusitis were almost equal to those of normal children.