Evaluation of airway obstruction by adenoid tissue: comparison of measures in the sitting and recumbent.
OBJECTIVE
To measure the airway obstruction caused by adenoid hypertrophy in the sitting and recumbent positions in search of hypothesized differences.


METHODS
Forty eight children between the ages of 2 and 12 years who sought the department of otorhinolaryngology spontaneously complaining of snoring and/or nasal obstruction. Children could be either male or female and belong to any social or racial group. Patients underwent nasal videoendoscopy sitting and lying performed by the same investigator. An image of the posterior nasopharynx was obtained from each nasal cavity of each patient for both positions. The free area of the nasopharynx was measured and compared in both positions. Image analysis was performed by two researchers other than that who carried out the examination.


RESULTS
The nasopharynx free area obtained with seated patient is, on average, 53% bigger than the free area obtained with the patient lying down (confidence interval: 95%; p<0.001). Thus, adenoidal obstruction is larger when the examination is performed with the patient lying down.


CONCLUSIONS
Nasal videoendoscopy to evaluate adenoid hypertrophy with the patient lying down makes testing more reliable, better reproducing the patient's position when sleeping. Such accuracy is essential since it influences the decision for surgical intervention in this important and widespread disease in the pediatric population.
Brasília University Medical School, Brasília, Brazil. hfdoliveira@yahoo.com.br
Henrique Fernandes de
HF
Oliveira
André Luiz Lopes
AL
Sampaio
Carlos Augusto Costa Pires de
CA
Oliveira
Maria Cristina
MC
Teixeira
Lídia Araújo
LA
Miranda
Daniel Araújo
DA
Miranda
D000234:Adenoids / Q000473:pathology*; D000402:Airway Obstruction / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D006984:Hypertrophy; D008297:Male; D009296:Nasal Cavity / Q000473:pathology*; D009305:Nasopharynx / Q000473:pathology*; D056888:Patient Positioning; D012913:Snoring / Q000209:etiology