Evaluation of adenoidal obstruction in children: clinical symptoms compared with roentgenographic assessment

Orji, Foster Tochukwu; Ezeanolue, BC

doi:10.1017/s0022215108001916

Cited by 24 publications

(45 citation statements)

References 19 publications

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“…The SS clinical parameter utilized in our study was validated previously against radiologic assessment and was shown to reliably evaluate the degree of airway obstruction in children with obstructive adenoid vegetations [14]- [16]. It is an easy-to-use tool to assess the impact of airway obstruction on sleep disturbance, physical suffering, and daytime problems of the children as perceived by the caregivers, before and after AT.…”

Section: Discussionmentioning

confidence: 99%

“…'The symptomatology scores' [14] were generated using set of questions designed to grade the severity of the most typical symptoms of adenotonsillar hypertrophy that indicated breathing and sleep disturbances. The following numeric values were assigned to snoring and mouth breathing: 0-absent, 1-occasionally during sleep, 2-regularly during sleep, 3-regularly during sleep and daytime.…”

Section: Study Protocolmentioning

confidence: 99%

“…Radiological evidence of improvement in airway obstruction after AT were assessed by comparing the preoperative and post-operative 'adenoid nasopharyngeal ratio' (AN ratio) measurements derived from lateral soft tissue X-ray of the nasopharynx, as was earlier described [14].…”

Section: Outcome Measuresmentioning

confidence: 99%

“…The 'Symptomatology score' (SS) and other graded clinical assessments have been validated against roentgenographic ratings of upper airway obstruction by adenoid vegetations, and shown to be simple, reliable and easy-to-use tools in evaluating the obstructive impact of adenoid vegetations in children [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Outcome of Adenotonsillectomy for Sleep and Breathing Difficulties in Nigerian Children with Obstructive Adenotonsillar Enlargement

Orji

Ezeanolue

2012

Indian J Otolaryngol Head Neck Surg

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The aim of this study was to examine improvements or otherwise, in sleep disturbance and breathing difficulties after adenotonsillectomy (AT) for chronic upper airway obstruction in children. In a prospective clinical study and tertiary referral center setting, the study population included consecutive children aged 1.5 through 12 years who underwent AT for chronic upper airway obstruction due to adenotonsillar enlargement, without any history of previous AT. The validated ''Symptomatology score'' (SS) parameters were used to grade the symptoms before and after AT. The extent of improvement of the symptoms after surgery were estimated by a standardized response mean (SRM). The study included 59 children, 40 of whom were males (68%). Their ages ranged from 1.5 to 12 years with a mean of 3.3 years and 63% were \4 years. The results showed that tonsillar size was correlated significantly with a high preoperative SS (P B 0.001). The mean preoperative SS for the study population was 7.2, whereas the mean postoperative SS was 1.7. This change was highly significant (P \ 0.001). The symptom domain with the greatest change in mean score was snoring, which improved by 2 points with SRM of 2.2. The changes in total score and in the scores for each symptom domain were highly significant (P \ 0.002). We concluded that adenotonsillectomy is associated with remarkable improvement in breathing difficulties and sleep disturbances in children with obstructive adenotonsillar hypertrophy regardless of the condition whether it is mild or severe.

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Section: Discussionmentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

Section: Outcome Measuresmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcome of Adenotonsillectomy for Sleep and Breathing Difficulties in Nigerian Children with Obstructive Adenotonsillar Enlargement

Orji

Ezeanolue

2012

Indian J Otolaryngol Head Neck Surg

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“…All our children were free of acute infections like acute tonsillitis, adenoiditis and rhinosinusitis. In a study by FT Orji et al 19 , there was significant correlation between AN ratio and age where younger children were observed to have more severe symptoms. Our study also showed maximum number of B type tympanograms in the age group 4-6 years with mean AN ratio of 0.73 showing significant correlation ( P<0.001).…”

Section: Discussionmentioning

confidence: 91%

Adenoidal Nasopharyngeal Ratio and Its Correlation with Tympanometry in Children with Otitis Media with Effusion: A Prospective Clinical Study

Kappadi¹

2017

JMSCR

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The clinical and radiological predictors of pulmonary hypertension in children with adenotonsillar hypertrophy

Orji

Adiele

Umedum

et al. 2016

Eur Arch Otorhinolaryngol

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Unrelieved upper airway obstruction from highly prevalent adenotonsillar hypertrophy (ATH) has the potential of producing structural remodelling of the pulmonary vascular bed with resultant pulmonary hypertension (PH) and cor pulmonale. This cross-sectional study aimed to determine the local prevalence of PH and examine its clinical and radiological pointers among children with ATH. The airway obstruction was evaluated clinically by grading the nocturnal and daytime symptoms of ATH. A Brodsky scale and adenoid-nasopharynx ratio (AN ratio) were used to categorize tonsil and adenoid size, respectively. Mean pulmonary artery pressure (mPAP), was measured noninvasively for each child using Doppler echocardiography and PH was defined by mPAP ≥25 mmHg. Comparison of symptom scores, tonsil and adenoid size and demographic factors was made between children with mPAP ≥25 mmHg and those mPAP <25 mmHg using univariate and multivariate analysis. There was 22.8 % (18/79) prevalence of PH among the 26 children with only adenoid hypertrophy and 53 with ATH. Significant risk factors identified by logistic regression analysis associated with PH were daytime mouth breathing, daytime stertor, and AN ratio >0.75 (P = 0.002, 0.018, and 0.04, respectively), with more than sixfold and fourfold increase risk for daytime mouth breathing and daytime stertor, respectively. Obstructive breathing during sleep was significant only on univariate analysis. Prolonged symptom duration ≥24 months, large tonsils (grades 3 and 4), snoring and mouth breathing during sleep were not significant. This study demonstrated that pulmonary hypertension remains prevalent in children with ATH. Daytime mouth breathing and stertor as well as AN ratio >0.75 are the prime predictors of pulmonary hypertension, with an AN ratio cut-off point of 0.73 on ROC analysis.

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Evaluation of adenoidal obstruction in children: clinical symptoms compared with roentgenographic assessment

Abstract: Clinical rating of adenoidal symptoms in children provides a reasonably reliable assessment of the presence and severity of nasopharyngeal airway obstruction. This technique of assessment is easy to use and is particularly valid when obstruction is either minimal or gross.

Cited by 24 publications

References 19 publications

Outcome of Adenotonsillectomy for Sleep and Breathing Difficulties in Nigerian Children with Obstructive Adenotonsillar Enlargement

Outcome of Adenotonsillectomy for Sleep and Breathing Difficulties in Nigerian Children with Obstructive Adenotonsillar Enlargement

Adenoidal Nasopharyngeal Ratio and Its Correlation with Tympanometry in Children with Otitis Media with Effusion: A Prospective Clinical Study

The clinical and radiological predictors of pulmonary hypertension in children with adenotonsillar hypertrophy

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