The clinical significance of adenoid-choanae area ratio in children with adenoid hypertrophy.
OBJECTIVE
We designed a method to compare the adenoid-choanae area ratio (A/C ratio) measured in children with symptoms of adenoid hypertrophy with those from children without any symptoms related to adenoid hypertrophy.


METHODS
A prospective analysis of A/C ratio of 42 patients undergoing adenoidectomy and tonsillectomy from January 2000 to September 2003 in a medical center was compared with 28 patients receiving treatment other than the above-mentioned procedures in the same period. We used 0 degrees telescope to take pictures of the nasopharynx under general anesthesia preoperatively. The pictures were transformed digitally. The A/C ratio was calculated by the program we developed after these pictures were processed by the Photoshop 6.0 (Adobe, USA) software.


RESULTS
The A/C ratio in adenoid hypertrophy group (0.863+/-0.0983) is significantly higher (p<0.001) than that of control group (0.445+/-0.1431). Mouth breathing, nasal obstruction and snoring were found to be more severe in children with high A/C ratio (p<0.001).


CONCLUSIONS
The A/C ratio provided the two-dimensional information of the nasopharyngeal airway. The A/C area ratio is significantly higher in the group of symptomatic adenoid hypertrophy when compared with symptomatic-free group. For practical purposes, the adenoid with an A/C ratio more than 2/3 is considered a pathological enlargement.
Chien
Chih-Yen
CY
Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, 123, Ta-Pei Road, Niao-Song Hsiang, Kaohsiung County 833, Taiwan.
Chen
An-Min
AM
Hwang
Chung-Feng
CF
Su
Chih-Ying
CY
D000234:Adenoids / Q000473:pathology*; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000150:complications / Q000175:diagnosis; D007091:Image Processing, Computer-Assisted; D008297:Male; D009058:Mouth Breathing / Q000209:etiology; D015999:Multivariate Analysis; D015508:Nasal Obstruction / Q000209:etiology; D009305:Nasopharynx / Q000473:pathology*; D014066:Palatine Tonsil / Q000473:pathology; D010781:Photography; D011446:Prospective Studies; D012913:Snoring / Q000209:etiology; D014069:Tonsillitis / Q000473:pathology*