medigraphic.com
Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2012, Number 2

<< Back Next >>

Rev Esp Med Quir 2012; 17 (2)

Flexible nasofibrolaryngoscopy as diagnostic tool in patients with chronic adenoiditis

Durán OM, Pineda CF, Delgado CMM

Language: Spanish
References: 22
Page: 81-86
PDF size: 478.28 Kb.


ABSTRACT

Background: Adenoid hypertrophy is a common cause of nasal obstruction in the pediatric population. Adenoid evaluation in children can be difficult and historically clinical evaluation has been used as an ideal method, corroborating this suspicion with a lateral x-ray of the skull. With the introduction of the flexible nasopharyngoscopy, a large number of children have been evaluated without exposing them to radiation.
Objective: To compare the efficacy of flexible nasopharyngoscopy vs lateral skull radiography in diagnosis of adenoiditis.
Material and methods: We performed a retrospective, observational, open and cross study in a tertiary care center.
Results: We assessed 179 pediatric patients, aged between 2 and 14 years old, divided into three groups, making equivalence with that reported in the study of lateral radiography of skull and the study of flexible nasopharyngoscopy. The highest incidence corresponded to the range of 4-8 years old, with 96 cases. The most common symptoms were: oral breathing in 89% and rhinolalia in 82%. Statistical analysis was conducted with exact test of Fisher finding a p ‹ 0.002 with a confidence interval of 95%. Using 2 by 2 contingency tables a sensitivity of 95% and 65% for nasopharyingoscopy and lateral skull x-ray, respectively was found.
Conclusion: Nasofibrolaryngoscopy has a higher reliability in diagnostic corroboration of adenoid hypertrophy than on lateral skull radiography; it shortens the time of therapeutic conclusion demonstrating in that moment the objective obstructions of adenoid tissue.


REFERENCES

  1. Bechara Y, Ghorayeb MD. Tonsils and adenoids. Otolaryngol Head Neck Surg 2007;464:2614.

  2. Carr MM, Poje C, Ehring D, Brodsky L. Incidence of reflux in young children undergoing adenoidectomy. Laryngoscope 2001;111:2170-2172.

  3. Caylakli F, Hizal E, Yilmaz I. Correlation between adenoidnasopharynx ratio and endoscopic examination of adenoid hypertrophy: A blind, prospective clinical study. Int J Ped Otorhinolaryngol 2009;73:1532-1535.

  4. Donnelly LF, Casper KA, Chen B. Correlation on cine MR imaging of size of adenoid and palatine tonsils with degree of upper airway motion in asymptomatic sedated children. AJR Am J Roentgenol 2002;179:503-508.

  5. Duran von Arx JM. Ustrell Torrent. Ortodoncia Clínica 2003;6:138-140.

  6. Guilleminault C, Li K, Quo S, Inouye R. A prospective study on the surgical outcomes of children with sleep-disordered breathing. Sleep 2004;27:95-100.

  7. Kubba H, Bingham BJ. Can nasal endoscopy be used to predict residual symptoms alter adenoidectomy for nasal obstruction? Int J Pediatr Otorhinolaryngol 2001;58:223-228.

  8. Herrera MR. Frecuencia de respiración oral en niños con maloclusión. Revista Odontológica Mexicana 2009;13:91-98.

  9. Havas T, Lowinger D. Obstructive adenoide tissue: an indication for powered shaver adenoidectomy. Arch Otolaryngol Head Neck Surg 2002;128:789-791.

  10. Jack L, Paradise MD. Tonsillectomy and adenotonsillectomy for recurrent throat infection in moderately affected children. Pediatrics 2002;110:313-314.

  11. Lertsburapa K, Schroeder J, Sullivan C. Assessment of adenoid size: A comparison of lateral radiographic measurements, radiologist assessment, and nasal endoscopy. Int J Pediatr Otorhinolaryngol 2010;74:1281-1282.

  12. Karlidag T, Demirdag K, Kaygusuz M, Ozden M, et al. Resistant bacteria in the adenoide tissues of children with otitis media with efusion. Int J Pediatr Otorhinolaryngol 2002;64:35-40.

  13. Hernández FO. Nueva pantalla vestibular. Su influencia en el tratamiento de las desarmonías dentomaxilofaciales. Rev Cubana Ortod 1996;11:115-121.

  14. Mercado V. Evaluación de la obstrucción adenoidea en niños: telerradiografía cefalométrica versus fibroscopia. Revista Otorrinolaringológica Cirugía Cabeza Cuello 2005;65:15-22.

  15. Paradise BS, Bernanrd DK, Colbon, J.E. Assessment of adenoidal obstruction in clildren: clinical signs versus roentgenographic findings. Pediatrics 1998;101:979-986.

  16. Steward M. Pediatric outcomes research: development of an outcomes instrument for tonsil and adenoide disease. Laryngoscope 2000;110:12-15.

  17. Willamson R, Huang R, Shapiro N. Adenotonsillar histopathology after organ transplantation. Otolaryngol Head Neck Surg 2001;125:231-241.

  18. Graham J. Pediatric ENT. London: Springer, 2007.

  19. Mitchell R. Pediatric otolaryngology for the clinician. New York: Humana Press, 2009.

  20. Josephson G. Complications in pediatric otolaryngology. Boca Raton, FL: Taylor & Francis, 2005.

  21. Balley BJ, Calhoun KH. Atlas of head and neck surgeryotolaryngology. Philadelphia: Lippincott-Raven, 1996.

  22. Cummings CW. Otolaryngology head and neck surgery. 4th ed. St. Louis: Mosby, 2005.




2020     |     www.medigraphic.com