title: [Videofluoroscopic evaluation of adenoid hypertrophy and velopharyngeal closure during speech].
abstract: BACKGROUND
  Adenoid hypertrophy is a common cause of upper airway obstruction in children. Traditionally, adenoid size has been evaluated using a conventional lateral skull film. Flexible endoscopy is now the gold standard for the evaluation of the upper airway. In small children, this study is not always adequately tolerated.
  
  
  OBJECTIVE
  Determine specificity and sensitivity of videofluoroscopy for evaluating adenoid size and velopharyngeal closure during speech, as compared with lateral skull film, using videonasopharyngoscopy as gold standard.
  
  
  METHODS
  Prospective study analyzing 70 patients with clinical data of upper airway obstruction, ages 5-10 years old. Videofluoroscopy, videonasopharyngoscopy, and lateral skull film were performed in all cases. Patients were divided into children with and without adenoid hypertrophy. Specificity, sensitivity, and predictive values were calculated. Also, data concerning comfort during the three procedures were obtained.
  
  
  RESULTS
  Videofluoroscopy showed sensitivity of 100% and specificity of 93%. Lateral skull film showed sensitivity of 70% and specificity of 52%. A Spearman correlation coefficient demonstrated a significant correlation (p < 0.05) between videofluoroscopy and videonasopharyngoscopy. A non-significant correlation was found between lateral skull film and videonasopharyngoscopy. Parents or legal guardians considered the lateral skull film as a comfortable procedure. Seventy-one percent of the parents considered videofluoroscopy as a comfortable procedure and 29% reported “mild discomfort”. Ten percent evaluated videonasopharyngoscopy as “extremely uncomfortable”. The rest reported “minor” and “moderate” discomforts.
  
  
  CONCLUSIONS
  Videofluoroscopy seems a reliable method without serious complications for evaluating adenoid hypertrophy and velopharyngeal closure in children,besides being a well-tolerated procedure.
authors.affiliation: Departamento de Otorrinolaringología, Hospital General Dr. Manuel Gea González, México, D.F. amysunza@terra.com.mx
authors.forename: Antonio
authors.initials: A
authors.lastname: Ysunza
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Pamplona
authors.forename: Juan M
authors.initials: JM
authors.lastname: Ortega
authors.forename: Héctor
authors.initials: H
authors.lastname: Prado
mesh_terms: D000234:Adenoids / Q000473:pathology*; D000402:Airway Obstruction / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D006984:Hypertrophy / Q000503:physiopathology; D007828:Laryngoscopy / Q000379:methods*; D010699:Phonation / Q000502:physiology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D055158:Velopharyngeal Sphincter / Q000503:physiopathology*