Objective: The objective of this study was to assess the adenoid size of each pediatric age group in our media and to compare the subjective visual assessment with a confronted measurement, the Fujioka's adenoidal-nasopharyngeal (AN) ratio. These data would allow the composition of a map, a guide for pediatricians useful in predicting the degree of upper airway obstruction, the role of adenoids in the etiology of serious otitis media and/or in selecting patients for adenoidectomy.
Patients and methods: We studied 1,033 radiographs of the nasopharynx taken in the emergency room of children between 5 months and 15 years of age that did not have any otorhinolaryngological (ENT) pathology. These individuals had no history of ear, nose or throat disease and the ENT evaluation was done in order to discard any ENT pathology. The subjective review and the AN ratios were calculated by experienced observers, tabulated and statistically analyzed.
Results: Only 692 infants and children passed the careful selection. The differences in mean values among the ages were statistically significant (p < 0.001). The mean AN ratio reached its highest value (0.575) at 5 years of age. The AN ratio as an indicator of adenoid size was comparable to the visually estimated classifications of adenoid size (p < 0.0001). In addition, 85% of the radiographs selected were in the group normal to slightly enlarged (AN = 0.48).
Conclusions: The distribution of the mean AN ratios for age groups in healthy children shows a line which we could use as a standard, or guideline, to compare the AN ratio of any infant or child with any pathology related to the adenoids.