title: Central incisor width as a predictor of appropriate curette size in adenoidectomy.
abstract: As inadvertent eustachian tube injury during adenoidectomy can have serious short- and long-term implications, a simple anatomic correlate that could predict the optimal curette choice for adenoidectomy, especially in severely hypertrophic cases, is beneficial. This study evaluates the correlation of the distance between the lateral borders of the upper central incisors and the distance between the tori tubarius in the nasopharynx. One hundred one consecutive patients undergoing adenoidectomy at a pediatric tertiary care hospital were enrolled in this study. The patients ranged in age from 7 months to 15 years. No complications were noted in any of the procedures. During the operation, the distance between the central upper incisors was measured in millimeters, as was the inter-tubarius width (ITW). A multiple regression analysis was completed to assess the correlation between central incisor width and ITW. Age and inter-incisor width were positively correlated with ITW in a statistically significant manner (p = .007 and p = .006, respectively). The distance between the lateral borders of the upper central incisors predicts the distance between the tori tubarius in the nasopharynx. Therefore, an adenoid curette the window of which does not overlap the lateral aspects of the central upper incisors can be used relatively safely, even in fields with poor visualization.
authors.affiliation: Department of Pediatric Otolaryngology-Head and Neck Surgery, St Christopher's Hospital for Children, Philadelphia, Pennsylvania 19134-1095, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Hohn
authors.forename: D G
authors.initials: DG
authors.lastname: Deschler
authors.forename: J A
authors.initials: JA
authors.lastname: Tucker
mesh_terms: D000233:Adenoidectomy / Q000295:instrumentation*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005064:Eustachian Tube / Q000293:injuries; D005260:Female; D005544:Forecasting; D006801:Humans; D007180:Incisor / Q000033:anatomy & histology*; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D013525:Surgical Instruments; D014947:Wounds and Injuries / Q000517:prevention & control