Assessment Of Adenoid Size Using Flexible Nasoendoscopy And Lateral Neck Radiography And Its Relation To Clinical Symptoms

Background: Enlarged adenoids commonly occur in pediatric patients and require medical attention. Various diagnostic methods have been proposed to assess adenoid enlargement, but there is no consensus on the optimal approach.Aim: : measure the reproducibility of flexible nasoendoscopy, comparing the adenoid size using both lateral neck radiography and flexible nasoendoscopy, and correlate both modalities in relation to clinical symptoms.Patients and Methods: The study involved 66 children. Their age ranged from 3 to 14 years, with a mean of 7.68 ± 2.26. All patients had flexible nasopharyngoscopy by two physicians and lateral neck radiograph to measure the adenoid size. Then, results were compared and correlated to the clinical symptoms. Results: Moderate agreement between endoscopy rater A and radiological evaluator (weighted kappa = 0.516, p < 0.001) was observed for adenoid size, with 39.4% grade III and 34.8% grade IV agreement. However, 25.8% cases had discrepancies, favoring endoscopist A's grade IV. Fair agreement between endoscopy rater B and radiological evaluator (weighted kappa = 0.283, p = 0.018) showed 42.4% grade III and 22.7% grade IV agreement, with 12.1% and 22.7% disagreements.Conclusion: Our study concludes that both flexible nasopharyngoscopy and lateral neck radiography are complementary techniques for evaluating adenoid size and its correlation with symptoms.