title: Lateral neck radiography versus direct video rhinoscopy in assessing adenoid size.
abstract: OBJECTIVE
  To evaluate the usefulness of adynamic lateral neck radiographs and dynamic video rhinoscopy in assessing adenoid size and the relationship of these methods to associated symptoms and thus the severity of the disease.
  
  
  METHODS
  Children with suspected adenoid hypertrophy underwent standard lateral neck soft tissue radiographs: the percentage of airway occlusion, adenoid to nasopharynx (AN) ratio, airway to soft palate ratio, and adenoid thickness were assessed by a radiologist. The percentage of airway closure was assessed by direct fibre-optic rhinoscopy in an ear, nose, and throat clinic. Associated clinical symptoms were assessed by parents using a standardized questionnaire, evaluating the severity of symptoms (snoring, sleep apnea, mouth breathing, and otitis media) to give a total symptom score out of 16.
  
  
  RESULTS
  Nonparametric statistical analysis using Spearman's correlation coefficients was performed on 32 patients. There was a weak correlation, which approaches significance, between the percentage of airway occlusion assessed by fibre-optic rhinoscopy and the total symptom score (r = .344, p = .054). However, this correlation becomes significant when the frequency of otitis media is omitted (r = .367, p = .039). There was also a significant correlation between airway occlusion assessed by rhinoscopy and the percentage of airway occlusion as determined by lateral neck radiography (r = .431, p = .014). There was no correlation between any of the measurements taken by lateral soft tissue neck radiography and total symptom score.
  
  
  CONCLUSIONS
  Dynamic video rhinoscopy is more accurate at assessing adenoid hypertrophy, and the percentage of airway occlusion, as estimated by video rhinoscopy, is better correlated to the severity of symptoms than are values obtained by lateral neck radiography.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Montreal Children's Hospital, McGill University, Montreal, Quebec.
authors.forename: Alex
authors.initials: A
authors.lastname: Mlynarek
authors.forename: Marc A
authors.initials: MA
authors.lastname: Tewfik
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Hagr
authors.forename: John J
authors.initials: JJ
authors.lastname: Manoukian
authors.forename: Melvin D
authors.initials: MD
authors.lastname: Schloss
authors.forename: Ted L
authors.initials: TL
authors.lastname: Tewfik
authors.forename: Jeanne
authors.initials: J
authors.lastname: Choi-Rosen
mesh_terms: D000233:Adenoidectomy; D000234:Adenoids / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods*; D005336:Fiber Optic Technology / Q000295:instrumentation; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D007223:Infant; D015508:Nasal Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D009333:Neck; D011859:Radiography; D012720:Severity of Illness Index; D012913:Snoring / Q000175:diagnosis / Q000209:etiology; D011795:Surveys and Questionnaires; D014743:Videotape Recording