Assessment of adenoid hypertrophy with clinical grading versus radiology and endoscopy- A cross-sectional study

Abstract

Chronic adenoid hypertrophy is the most common presentation seeking medical advice in pediatric age group. Evaluation of adenoid enlargement is usually done clinically, but its reliability in young children is questionable. Although various diagnostic procedures have been proposed to diagnose adenoid hypertrophy, there is poor concordance on the ideal method by clinicians. The purpose of this study is to corroborate a clinical grading that could guide the clinicians in accurate diagnosis of adenoid hypertrophy and to warrant the cases needing adenoidectomy and to calibrate this clinical grading with endoscopic and x-ray findings.A cross-sectional study was conducted in a tertiary health care among 60 children aged between 3-14 years who presented with signs and symptoms of chronic adenoid hypertrophy are evaluated with clinical grading, endoscopy, lateral neck x-ray, and findings were documented. The proposed clinical grading comprised of nasal and paranasal symptoms, ear complaints, craniofacial abnormalities, and sleep disturbances.The statistical analysis was done with Pearsons Chi square test and the correlation between endoscopic and clinical grading is highly significant (p=0.0006), and there is also a strong correlation between radiological and endoscopic grading (p=0.0003), the correlation between clinical grading and radiological finding (p=0.04) was significant.Clinical grading was found to be a reliable parameter for assessment of the severity of adenoid hypertrophy. Though x-ray is a convenient procedure for diagnosing adenoid hypertrophy, it was found to be less accurate in assessing the clinical implications when compared to endoscopy.