The clinical significance of adenoid-choanae area ratio in children with adenoid hypertrophy

Int J Pediatr Otorhinolaryngol. 2005 Feb;69(2):235-9. doi: 10.1016/j.ijporl.2004.09.007. Epub 2004 Nov 18.

Abstract

Objective: We designed a method to compare the adenoid-choanae area ratio (A/C ratio) measured in children with symptoms of adenoid hypertrophy with those from children without any symptoms related to adenoid hypertrophy.

Methods: A prospective analysis of A/C ratio of 42 patients undergoing adenoidectomy and tonsillectomy from January 2000 to September 2003 in a medical center was compared with 28 patients receiving treatment other than the above-mentioned procedures in the same period. We used 0 degrees telescope to take pictures of the nasopharynx under general anesthesia preoperatively. The pictures were transformed digitally. The A/C ratio was calculated by the program we developed after these pictures were processed by the Photoshop 6.0 (Adobe, USA) software.

Results: The A/C ratio in adenoid hypertrophy group (0.863+/-0.0983) is significantly higher (p<0.001) than that of control group (0.445+/-0.1431). Mouth breathing, nasal obstruction and snoring were found to be more severe in children with high A/C ratio (p<0.001).

Conclusions: The A/C ratio provided the two-dimensional information of the nasopharyngeal airway. The A/C area ratio is significantly higher in the group of symptomatic adenoid hypertrophy when compared with symptomatic-free group. For practical purposes, the adenoid with an A/C ratio more than 2/3 is considered a pathological enlargement.

MeSH terms

  • Adenoids / pathology*
  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Hypertrophy / complications
  • Hypertrophy / diagnosis
  • Image Processing, Computer-Assisted
  • Male
  • Mouth Breathing / etiology
  • Multivariate Analysis
  • Nasal Obstruction / etiology
  • Nasopharynx / pathology*
  • Palatine Tonsil / pathology
  • Photography
  • Prospective Studies
  • Snoring / etiology
  • Tonsillitis / pathology*