Comparison between cavum x-ray and nasal videoendoscopy in the diagnosis of adenoid hypertrophy in pediatric patients
DOI:
https://doi.org/10.34019/1982-8047.2022.v48.37693Keywords:
Nasopharynx, Adenoids, Radiography, Endoscopy, Diagnostic ImagingAbstract
Introduction: The adenoid hypertrophy can cause several health impacts: changes in craniofacial development, sleep disorders, impaired weight gain and even nocturnal enuresis. The diagnosis of this disease has undergone several changes over time and the gold standard is nasal videoendoscopy, however with difficult access in the public health system. Objective: To measure the diagnostic accuracy of lateral cranial radiography (LCR) in the diagnosis of pharyngeal tonsillar hypertrophy compared to nasal videoendoscopy in pediatric patients. Material and methods: We evaluated 35 patients aged between 5 and 14 years old seen at the Pediatric Otorhinolaryngology outpatient clinic evaluated for the possibility of adenoid hyperplasia, being submitted to nasal videoendoscopy and classified second Brodsky scale for hyperplasia being also performed cavum radiography whose classification for adenoid size was considered the nasopharyngeal adenoid ratio (NAR). Results: The lowest nasopharyngeal adenoid NAR was 0.38 and the highest was 0.95. In turn, Brodsky's percentage classification showed maximum and minimum values of 99% and 25% respectively. The sample showed a Pearson correlation of 0.72 between the NAR and Brodsky's percentile classification variables, thus presenting a strong positive relationship. Conclusions: Nasal videoendoscopy is a medium complexity exam, which requires specific equipment and the presence of a specialist to perform. The LRC on the other hand is a non-invasive and financially more accessible propaedeutic technique in primary care. This study showed that LRC is a viable and safe alternative to nasal videoendoscopy, since it shows good correlation and accuracy.
Downloads
References
Sih T, Castro JC, Pinho M. Anel linfático de Waldeyer: histologia e imunologia. In: Pignatari SSN, Anselmo-Lima WT. Tratado de Otorrinolaringologia. 3. ed. Rio de Janeiro: Elsevier; 2018, p. 456-62.
Franco RAJ, Rosenfeld RM, Rao M. First place: resident clinical science award 1999: quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000; 123(1):9-16. https://doi.org/10.1067/mhn.2000.105254.
Almeida MM, Wandalsen GF, Solé D. Growth and mouth breathers. J Pediatr. 2019; 95(1):66-71. https://doi.org/10.1016/j.jpedp.2019.02.003.
Torre C, Guilleminault C. Establishment of nasal breathing should be the ultimate goal to secure adequate craniofacial and airway development in children. J Pediatr. 2018; 94(2):101-3. https://doi.org/10.1016/j.jped.2017.08.002.
Ribeiro ACP, Candido TC, Nascimento PHA, Rodrigues PF, Guércio WB. Crescimento pôndero-estatural de crianças e adolescentes submetidos à adenoamigdalectomia. Sci Med. 2021; 31:1-11.http://dx.doi.org/10.15448/1980-6108.2021.1.39746.
Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol. 1987; 13:149.https://doi.org/10.1016/0165-5876(87)90091-7.
Grasel SS, Francesco RC, Bech RMO, Almeida ER. Faringotonsilites e hipertrofia das tonsilas palatinas e faríngea. In: Pignatari SSN, Anselmo-Lima WT. Tratado de Otorrinolaringologia. 3. ed. Rio de Janeiro: Elsevier; 2018, p. 464-73.
Feres MFN, Hermann JS, Cappellette M, Pignatari SSN. Lateral X-ray view of the skull for the diagnosis of adenoid hypertrophy: a systematic review. Int J Pediatr Otorhinolaryngol. 2011; 75(1):1-11. https://doi.org/10.1016/j.ijporl.2010.11.002.
Ritzel RA, Berwing LC, Silva AMT, Corrêa ECR, Serpa EO. Correlação entre a nasofibrofaringoscopia e a cefalometria no diagnóstico de hiperplasia de tonsilas faríngeas. Int Arch Otorhinolaryngol. 2012; 16(2):209-16. https://doi.org/10.7162/S1809-97772012000200009.
Caylakli F, Hizal E, Yilmaz I, Yilmazer C. Correlation between adenoid-nasopharynx ratio and endoscopic examination of adenoid hypertrophy: a blind, prospective clinical study. Int J Pediatr Otorhinolaryngol. 2009;73(11):1532-5.https://doi.org/10.1016/j.ijporl.2009.07.018.
Empresa Brasileira de Serviços Hospitalares (BR). Com investimento de R$259 mil, novo serviço de endoscopia é disponibilizado no hospital da Rede Ebserh/MEC em Araguaína (TO). [citado em 2021 maio 05]. 2021. Acesso em: https://www.gov.br/ebserh/pt-br/comunicacao/noticias.
Ministério da Saúde (BR). Sistema de gerenciamento da tabela unificada de procedimentos, medicamentos, opm do SUS: tabela unificada. [citado em 2021 julho 14]. 2022. Acesso em: http://sigtap.datasus.gov.br/tabelaunificada/app/sec/inicio.jsp.
Ribeiro ACP. Enurese primária nos pacientes com obstrução das vias aéreas superiores [Dissertação]. Juiz de Fora: Universidade Federal de Juiz de Fora; 2022.
Chien CY, Chen AM, Hwang CF, Su CY. The clinical significance of adenoid-choana e area ratio in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol. 2005; 69(2):235-9. https://doi.org/10.1016/j.ijporl.2004.09.007.
Lourenço EA, Lopes K, Pontes AJ, Oliveira MH, Umemura A, Vargas AL. Comparison between radiological and nasopharyngolaryngoscopic assessment of adenoid tissue volume in mouth breathing children. Braz J Otorhinolaryngol. 2015; 71(1):23-7. http://dx.doi.org/10.1590/S0034-72992005000100005.
Duan H, Xia L, He W, Lin Y, Lu Z, Lan Q. Accuracy of lateral cephalogram for diagnosis of adenoid hypertrophy and posterior upper airway obstruction: a meta-analysis. Int J Pediatr Otorhinolaryngol. 2019; 119:1-9. https://doi.org/10.1016/j.ijporl.2019.01.011.
Feres MFN, Sousa HIP, Francisco SM, Pignatari SSN.Reliability of radiographic parameters in adenoid evaluation. Brazilian Braz J Otorhinolaryngol. 2012; 78(4):80-90.
Acar M, Kankilic ES, Koksal AO, Yilmaz AA, Kocaoz D. Method of the diagnosis of adenoid hypertrophy for physicians: adenoid-nasopharynx ratio. J Craniofac Surg. 2014; 25(5):438-40. https://doi.org/10.1097/SCS.0000000000000952
Liu H, Feng X, Sun Y, Fan Y, Zhang J. Modified adenoid grading system for evaluating adenoid size in children: a prospective validation study. Eur Arch Otorhinolaryngol. 2021; 278(6):2147-53. https://doi.org/10.1007/s00405-021-06768-8.
Cassanoa P, Gelardib M, Cassanob M, Fiorella ML, Fiorella R. Adenoid tissue rhinopharyngeal obstructiongrading based on fiberendoscopic findings: a novel approach to therapeutic management. Int J Pediatr Otorhinolaryngol. 2003; 67:1303-09. https://doi.org/10.1016/j.ijporl.2003.07.018
Sakano E. Videonasofaringoscopia na avaliação da hipertrofia adenoideana: importância e cuidados no diagnóstico. J Pediatr. 2005; 81(6):425-6.https://doi.org/10.2223/JPED.1413.
Calvo-Henriquez C, Branco AM, Lechien JR. Assessing the effect of adenoidectomy on nasal resistance and airflow: a systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol. 2021;151:110969. https://doi.org/10.1016/j.ijporl.2021.110969.
Calvo-Henriquez C, Branco AM, Lechien JR, Maria-Saibene A, DeMarchi MV, Valencia-Blanco B et al. What is the relationship between the size of the adenoids and nasal obstruction? A systematic review. Int J Pediatr Otorhinolaryngol. 2021; 151:110895. https://doi.org/10.1016/j.ijporl.2021.110895.
Almeida RCC, Artese F, Carvalho FAR,Cunha RD, Almeida MAO. Comparison between cavum and lateral cephalometric radiographs for the evaluation of the nasopharynx and adenoids by otorhinolaryngologists. Dental Press J Orthod. 2011; 16(1):32.https://doi.org/10.1590/S2176-94512011000100006.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 André Costa Pinto Ribeiro, Tarssius Capelo Capelo, Ludimila de Oliveira Cardoso Ouverney, Guilherme Laporti Brandão, Audryo Oliveira Nogueira, Hanny Helena Masson Franck, Wilson BeniniGuércio
This work is licensed under a Creative Commons Attribution 4.0 International License.
Cessão de Primeira Publicação à HU Revista
Os autores mantém todos os direitos autorais sobre a publicação, sem restrições, e concedem à HU Revista o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento irrestrito do trabalho, com reconhecimento da autoria e crédito pela citação de publicação inicial nesta revista, referenciando inclusive seu DOI.
