title: Radiographic adenoid evaluation--suggestion of referral parameters.
abstract: OBJECTIVE
  this study aimed to evaluate the usefulness of current radiographic measurements, which were originally conceived to evaluate adenoid hypertrophy, as potential referral parameters.
  
  
  METHODS
  children aged from 4 to 14 years, of both genders, who presented nasal obstruction complaints, were subjected to cavum radiography. Radiographic examinations (n = 120) were evaluated according to categorical and quantitative parameters, and data were compared to gold-standard videonasopharyngoscopic examination, regarding accuracy (sensitivity, negative predictive value, specificity, and positive predictive value).
  
  
  RESULTS
  radiographic grading systems presented low sensitivity for the identification of patients with two-thirds choanal space obstruction. However, some of these parameters presented relatively high specificity rates when three-quarters adenoid obstruction was the threshold of interest. Amongst the quantitative variables, a mathematical model was found to be more suitable for identifying patients with more than two-thirds obstruction.
  
  
  CONCLUSIONS
  this model was shown to be potentially useful as a screening tool to include patients with, at least, two-thirds adenoid obstruction. Moreover, one of the categorical parameters was demonstrated to be relatively more useful, as well as a potentially safer assessment tool to exclude patients with less than three-quarters obstruction, to be indicated for adenoidectomy.
authors: Faculdade de Odontologia, Universidade São Francisco (USF), Bragança Paulista, SP, Brazil. Electronic address: mn_feres@uol.com.br.
authors: Murilo F N
authors: MF
authors: Feres
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Juliana S
authors: JS
authors: Hermann
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Ana C
authors: AC
authors: Sallum
authors: Department of Otorhinolaryngology, Head and Neck Surgery, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors: Shirley S N
authors: SS
authors: Pignatari
mesh_terms: D000234:Adenoids / Q000000981:diagnostic imaging*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D009305:Nasopharynx / Q000000981:diagnostic imaging; D011859:Radiography; D012680:Sensitivity and Specificity
keywords: Adenoidectomia; Adenoidectomy; Diagnosis; Diagnóstico; Mouth breathing; Respiração bucal