Comparison Between Adenoid-Nasopharynx Ratio and Endoscopic Examination of Adenoid Hypertrophy: A Systematic Review and Meta-Analysis

Otitis media is a major health issue that usually results from adenoid hypertrophy. Diagnosis is based on symptoms, such as mouth breathing, and imaging studies, including lateral neck radiography (LNR). The adenoid-nasopharyngeal ratio (ANR) is one of the most important and widely used criteria in LNR studies. It helps estimate the real size of adenoid gland measurements. The present systematic review aimed to detect the accuracy of adenoid hypertrophy diagnosis by LNR and compare the same with the endoscopic method. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Diagnostic Test Accuracy (PRISMA-DTA) guideline, a scoping evaluation of the articles was performed. The electronic databases considered were PubMed, Scopus, Web of Science, and Embase, from January 2004 to November 2024. The inclusion and exclusion criteria were applied. A total of 20 articles were studied in detail, 13 full-text articles were further excluded, and finally, seven articles were found appropriate to be included in this review. The outcome of this systematic review has led to the conclusion that endoscopic examination, when employed for measurement of adenoid hypertrophy, has shown extremely positive and promising results as compared to cephalometric and head-neck radiographs.