Radiographic evaluation of children with nasopharyngeal obstruction due tothe adenoid

The adenoidal-nasopharyngeal ratio (ANR) was proposed as a convenient and p ractical method to evaluate adenoidal enlargement. We analyzed cephalometri c radiographs of 150 children divided into 6 subgroups according to clinica l assessment (possible adenoidectomy candidates [PACs] and controls) and ag e. Our purpose was to investigate the predictive reliability of different A NRs calculated on the same reference line. Each of the ANRs described in th is study presented statistically significant differences between PACs and c ontrol groups, and highly significant correlations with clinical symptoms o f nasal obstruction. Further, the mean adenoidal depth was significantly la rger in PACs than in normals, and it was found that the adenoidal depth in PACs did not show a significant decrement with age, in contrast to normals. On the other hand, although nasopharyngeal depth was not different between PACs and normals, an age-dependent increment was observed in PACs, in cont rast to normals. Thus, it could be said that the ANR is a more reliable met hod for determining whether adenoidal hyperplasia is clinically significant or not, rather than the size of the adenoid or nasopharynx.