Adenotonsillar hypertrophy: Does it correlate with obstructive symptoms in children?

• Published in: International journal of pediatric otorhinolaryngology 2010-11, Vol.74 (11), p.1316-1319
• Main Authors: Toros, Sema Zer, Noşeri, Hülya, Ertugay, Çiğdem Kalaycık, Külekçi, Semra, Habeşoğlu, Tülay Erden, Kılıçoğlu, Gamze, Yılmaz, Gökalp, Egeli, Erol
• Format: Article
• Language: English
• Subjects: Adenoidectomy; Adenoids - pathology; Adenoids - surgery; Adenotonsillar hypertrophy; Airway Obstruction - diagnostic imaging; Airway Obstruction - etiology; Child; Child, Preschool; Decision Making; Humans; Hypertrophy - diagnostic imaging; Infant; Otolaryngology; Palatine Tonsil - pathology; Pediatrics; Radiography; Severity of Illness Index; Upper airway obstruction
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2010.08.012

Abstract Objective The goal of this study is to determine the correlation of clinical symptoms of UAO (upper airway obstruction) with radiographic evaluation of adenoidal obstruction and tonsil size in children with adenotonsillar hypertrophy and to evaluate the usefullness of lateral neck radiography. Study design Prospective study. Setting Haydarpaşa Numune Research and Education Hospital, Istanbul, Turkey. Subjects and methods This study analyses 95 children with one or more of the symptoms of UAO. Clinical symptoms were assessed by a standardized questionnaire evaluating the severity of symptoms. All patients underwent otolaryngologic examination and their tonsil sizes were graded. 74 of 95 patients underwent digital lateral soft tissue radiographs. Assessment of nasopharyngeal obstruction in radiographs was done according to four different methods. Results We did not find statistically siginificant correlation between symptom scores and radiologic measurements according to Johanneson ( r = 0.072, p = 0.544, p > 0.05) and Crepeau ( r = 0.034, p = 0.773, p > 0.05). The correlations between OSA score and Cohen and Konak's method and AN ratio were weak and not statistically siginificant ( p = 0.133, r = 0.176; p = 0.290, r = 0.125 respectively; p > 0.05). But, we found a statistically siginificant correlation between the tonsil grade and symptom scores ( r = 0.216, p = 0.036, p < 0.05). Conclusion Our results have demonstrated that radiologic measurements of the nasopharyngeal obstruction do not correlate with clinical symptoms of UAO, but clinical assessment of tonsil size does.