The adenoidal-nasopharyngeal ratio (AN ratio)

Elwany, Samy

doi:10.1017/s0022215100102269

Cited by 61 publications

(4 citation statements)

References 15 publications

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“…There have been many different methods described for evaluating radiographs of the nasopharynx and the interpretation of whether the adenoid is significantly enlarged has varied from author to author (Elwany, 1987). The four most widely used methods of measuring adenodial size on radiographs ( Fig.…”

Section: Introductionmentioning

confidence: 99%

Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings

Wormald¹,

Prescott²

1992

J. Laryngol. Otol.

134

127

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Methods of evaluating adenoidal size pre-operatively are controversial. Symptoms and clinical evaluation have been both advocated and condemned. Depending on the methodology, measurement of the radiological adenoidal shadow has been difficult to correlate with the clinical patency of the nasopharyngeal airway and to the actual size of the removed adenoid.Four different methods were used to measure the adenoidal size on 74 radiographs. The methods were evaluated against the degree to which the adenoids obstructed the nasopharynx on flexible endoscopy of the postnasal space. Obstructive symptomatology was also evaluated against the degree of obstruction.The radiological method that best correlated to the endoscopic findings was that of Cohen and Konak (1985). However, obstructive symptomatology had the overall highest correlation to endoscopic findings.

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Section: Introductionmentioning

confidence: 99%

Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings

Wormald¹,

Prescott²

1992

J. Laryngol. Otol.

134

127

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“…In children, At/Nd has excellent specificity (95%) and positive predictive value (94%), but low sensitivity (41%) and negative predictive value (39%) [ 28 ]. At/Nd has also been shown to correlate well with clinical symptoms and weight of surgically removed adenoids [ 29 ]. The second parameter consisted of the ratio between the thickness of the adenoids and the width of the nasopharynx (both measured along the line connecting the posterior nasal spine with Basion).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of adenoid hypertrophy among 12-year-old children and its association with craniofacial characteristics: a cross-sectional study

Tse,

Savoldi,

et al. 2023

Prog Orthod.

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Background Identifying the prevalence of adenoid hypertrophy (AH) and craniofacial factors associated with this condition requires studies with random sampling from the general population, and multiple criteria can be used for assessing AH on lateral cephalometric radiograph (LCR). The present analysis represents the first report performed according to these requirements in a large cross-sectional sample of children. Methods LCRs of 517 12-year-old children (286 males, 231 females) randomly selected from the general population were retrospectively retrieved. AH was defined using three criteria (At/Nd, Ad-Ba/PNS-Ba, 1-Npaa/Npa), and twelve craniofacial variables were measured (SNA, SNB, ANB, Wits, Cd-Gn, MnP^SN, MxP^MnP, TPFH/TAFH, OPT^SN, C2ps-C4pi^SN, H-CV, H-FH). Skeletal characteristics were compared between children with and without AH using Mann–Whitney U test. Binary logistic regression (adjusted for sex and skeletal growth) was used to independently quantify the association between craniofacial factors and AH. Results The prevalence of children with AH was 17.6% (according to At/Nd), 19.0% (according to Ad-Ba/PNS-Ba), and 13.9% (according to 1-Npaa/Npa). Children with AH presented greater antero-posterior jaw discrepancy (larger ANB, smaller SNB), greater mandibular divergence (larger MnP^SN), forward head posture (larger OPT^SN and C2ps-C4pi^SN), and anteriorly positioned hyoid bone (larger H-CV). Larger SNA (OR = 1.39–1.48), while smaller SNB (OR = 0.77–0.88) and Wits (OR = 0.85–0.87), were associated with greater likelihood of having AH, independently from the assessment method used. Conclusions The prevalence of children with AH ranged from 13.9 to 19.0% based on LCR. Greater antero-posterior maxillo–mandibular discrepancy and mandibular retrusion were independently associated with higher likelihood of having AH.

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“…The ANR is significantly associated with age [ 64 ] and AHI [ 19 ]. Clinically, an ANR ≥ 0.73 may be considered indicative of pathological enlargement of the adenoids [ 65 ]. Accordingly, our results strengthened the utility of the ANR to screen severe OSA in children with snoring.…”

Section: Discussionmentioning

confidence: 99%

Screening Severe Obstructive Sleep Apnea in Children with Snoring

et al. 2021

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Efficient screening for severe obstructive sleep apnea (OSA) is important for children with snoring before time-consuming standard polysomnography. This retrospective cross-sectional study aimed to compare clinical variables, home snoring sound analysis, and home sleep pulse oximetry on their predictive performance in screening severe OSA among children who habitually snored. Study 1 included 9 (23%) girls and 30 (77%) boys (median age of 9 years). Using univariate logistic regression models, 3% oxygen desaturation index (ODI3) ≥ 6.0 events/h, adenoidal-nasopharyngeal ratio (ANR) ≥ 0.78, tonsil size = 4, and snoring sound energy of 801–1000 Hz ≥ 22.0 dB significantly predicted severe OSA in descending order of odds ratio. Multivariate analysis showed that ODI3 ≥ 6.0 events/h independently predicted severe pediatric OSA. Among several predictive models, the combination of ODI3, tonsil size, and ANR more optimally screened for severe OSA with a sensitivity of 91% and a specificity of 94%. In Study 2 (27 (27%) girls and 73 (73%) boys; median age, 7 years), this model was externally validated to predict severe OSA with an accuracy of 76%. Our results suggested that home sleep pulse oximetry, combined with ANR, can screen for severe OSA more optimally than ANR and tonsil size among children with snoring.

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The adenoidal-nasopharyngeal ratio (AN ratio)

Cited by 61 publications

References 15 publications

Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings

Adenoids: comparison of radiological assessment methods with clinical and endoscopic findings

Prevalence of adenoid hypertrophy among 12-year-old children and its association with craniofacial characteristics: a cross-sectional study

Screening Severe Obstructive Sleep Apnea in Children with Snoring

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