title: Endoscopic evaluation of adenoids: reproducibility analysis of current methods.
abstract: OBJECTIVE
  To investigate intra- and interexaminers' reproducibility of usual adenoid hypertrophy assessment methods, according to nasofiberendoscopic examination.
  
  
  METHODS
  Forty children of both sexes, ages ranging between 4 and 14 years, presenting with nasal obstruction and oral breathing suspected to be caused by adenoid hypertrophy, were enrolled in this study. Patients were evaluated by nasofiberendoscopy, and records were referred to and evaluated by two experienced otolaryngologists. Examiners analysed the records according to different evaluation methods; i.e., estimated, and measured percentage of choanal occlusion; as well as subjective and objective classificatory systems of adenoid hypertrophy.
  
  
  RESULTS
  Data disclosed excellent intraexaminer reproducibility for both estimated and measured choanal occlusion. analysis revealed lower reproducibility rates of estimated in relation to measured choanal occlusion. Measured choanal occlusion also demonstrated less agreement among evaluations made through the right and left sides of the nasal cavity. Alternatively, intra- and interexaminers reliability analysis revealed higher agreement for subjective than objective classificatory system. Besides, subjective method demonstrated higher agreement than the objective classificatory system, when opposite sides were compared.
  
  
  CONCLUSIONS
  Our results suggest that measured is superior to estimated percentage of choanal occlusion, particularly if employed bilaterally, diminishing the lack of agreement between sides. When adenoid categorization is used instead, the authors recommend subjective rather than objective classificatory system of adenoid hypertrophy.
authors.affiliation: Post-graduate Program on Otolaryngology, Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Murilo Fernando Neuppmann
authors.initials: MF
authors.lastname: Feres
authors.forename: Juliana Sato
authors.initials: JS
authors.lastname: Hermann
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Sallum
authors.forename: Shirley Shizue Nagata
authors.initials: SS
authors.lastname: Pignatari
keywords: Adenoids; Diagnostic techniques; Endoscopy