Comparative Evaluation of Adenoids and Airway Space in 12 to 14-Year-Old Children With Different Growth Patterns Using Cephalometric Methods Commonly Used by ENT Specialists

Abstract

Introduction: Altered airway and growth are interrelated; hence, a study was planned to develop a diagnostic protocol that may help in diagnosing difficult airway by utilizing routine radiographic assessment. Material and Methods: Lateral cephalograms of 60 children aged 12 to 14 years who were grouped based on the growth pattern into 3 groups with 20 cases each (Group 1—normodivergent cases; Group 2—hypodivergent cases; Group 3—hyperdivergent cases) were observed. The diagnostic protocol included 3 diagnostic methods (Handelman–Osborne area method, Maw et al method, and Holmberg et al method) routinely used by ENT surgeons for altered airway evaluation, and their diagnostic efficacy was correlated with McNamara’s airway analysis. Results: Highest specificity and diagnostic accuracy were found with Holmberg et al method followed by Maw et al method. Poor specificity was observed with Handelman–Osborne area method. Conclusion: The new diagnostic protocol which includes commonly used cephalometric methods by ENT surgeons can be helpful for orthodontists in early evaluation of altered airways, so that preventive and interceptive procedures can be carried out to normalize the altered craniofacial growth. Among the methods used in this diagnostic protocol, Holmberg et al and Maw et al methods had better sensitivity and specificity.

The Link Between Adenoids and Nasopharyngeal Carcinoma

“…Lateral nasopharyngeal X-ray, ultrasonography, and magnetic resonance imaging (MRI) of the nasopharynx are grouped as imaging techniques. Other imaging techniques such as computed tomography (CT) and cone beam tomography have also been reported [108]. These procedures come with high costs, the need for ENT specialists and cutting-edge expensive equipments.…”

“…Other methods have been formulated in recent years [119][120][121]. Among these, Choudhari and Shrivastav in a recent study, found the methods proposed by Holmberg and Linder-Aronson and Maw et al to have better diagnostic accuracy due to their high sensitivity and specificity [108]. Adenoidnasopharyngeal (A/N) ratio has also been used to assess adenoid size in several AH studies [23,53,[122][123][124][125], proposed earlier by Fujioka et al [126].…”