A new clinical scoring system for adenoid hypertrophy in children

Abstract

Introduction: Chronic nasal obstruction due to adenoid hypertrophy is a very common disorder. Although the clinical assessment of adenoid hypertrophy is essential, its real value in young children is difficult to evaluate. The purpose of this prospective study was to validate a simple clinical score to predict the severity of adenoid obstruction and to evaluate the relationship between this method of clinical scoring with radiography and nasopharyngeal endoscopy.

Materials and methods: Ninety symptomatic children were enrolled into this study. The clinical score included difficulty of breathing during sleep, apnea, and snoring. We investigated the relationship between clinical scoring, nasal endoscopy, and radiographic findings.

Results: The clinical score correlated very well with endoscopic findings (P<0.000), but the correlation between the clinical score and radiologic findings (P>0.05) and endoscopic findings and imaging (P>0.05) was weak.

Conclusion: Clinical findings could be used to select children for adenoidectomy, especially when endoscopic examination is not available or cannot be performed.

Keywords: Adenoids; Endoscopy; Radiography; Signs and symptoms; Sleep apnea syndromes; Snoring.

Fig 1

Airway (black line) to soft palate (white line) ratio method of assessing adenoid enlargement on lateral neck radiography as described by Cohen and Konak

Fig 2

Distribution of categories of degree of severity of adenoid hypertrophy via endoscopic nasopharyngoscopy, lateral neck radiographs, and clinical scoring system

Fig 3

Correlation between clinical score and endoscopic findings

Fig 4

Correlation between endoscopic findings and lateral neck x-ray

Fig 5

Correlation between radiographical findings and clinical score