title: Method of the diagnosis of adenoid hypertrophy for physicians: adenoid-nasopharynx ratio.
abstract: OBJECTIVE
  We aimed to describe the feasibility of a prediction of adenoid hypertrophy by pediatricians for diagnostic accuracy of nasopharyngeal x-ray in a pediatric unit.
  
  
  METHODS
  Forty-six patients with a history of probable adenoid hypertrophy between January 2013 and August 2013 were included in the study. Participants were excluded from the study if they had previous adenoidectomy; anatomic anomaly in the nose, palate, or nasopharynx; and acute infection. Nasal endoscopy was performed and evaluated adenoid size (choanal obstruction ratio) in all patients by an otorhinolaryngologist who was blinded to the information of other data. Lateral nasopharyngeal x-ray graphs of all patients were evaluated by pediatricians with adenoid-nasopharynx (A-N) ratio, who were blinded to the information of other data. The A-N ratio was calculated by Fujioka method. The A-N ratio of each patient was compared with the choanal obstruction ratio that was determined in the nasal endoscopic examination. Spearman correlation test was used for statistical analysis, and P < 0.05 was described as significant.
  
  
  RESULTS
  Forty-six patients were included in this study. The study sample consisted of 25 male (54.3%) and 21 female (45.7%) patients. The mean age of the patients was 6.17 years (range, 2-14 y). In the nasal endoscopic examination, the mean (SD) choanal obstruction ratio was 64.6% (19.5%) (range, 12.5%-90%). Mean (SD) A-N ratio was found to be 16.7 (14.4). The A-N ratio correlated with nasal endoscopic examination findings (r = 0.334, P = 0.023) CONCLUSIONS: The A-N ratio was found to be a useful, tolerable, and confident diagnostic method in pediatric patients for adenoid hypertrophy. Pediatricians can confidently use this method for decision after follow-up or operation.
authors.affiliation: From the *Dr. Sami Ulus Children Hospital; Departments of †Otorhinolaryngology and ‡Pediatrics, Kecioren Training and Research Hospital, Ankara, Turkey.
authors.forename: Mehtap
authors.initials: M
authors.lastname: Acar
authors.forename: Ekrem Said
authors.initials: ES
authors.lastname: Kankilic
authors.forename: Ali Osman
authors.initials: AO
authors.lastname: Koksal
authors.forename: Aslihan Arasli
authors.initials: AA
authors.lastname: Yilmaz
authors.forename: Deniz
authors.initials: D
authors.lastname: Kocaoz
mesh_terms: D000233:Adenoidectomy; D000234:Adenoids / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging; D008297:Male; D009305:Nasopharynx / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D009929:Organ Size; D011859:Radiography