X-rays in the evaluation of adenoid hypertrophy: It's role in the endoscopic ERA

Objectives: To evaluate the reliability of X-rays in the diagnosis of adenoid hypertrophy and to validate this with flexible nasopharyngoscopy which is the existing gold standard. Method: Lateral radiograph of the neck and a flexible nasopharyngeal endoscopy was done to evaluate adenoid enlargement in children aged 3-12 years who were included in a 8 week randomized double-blind placebo controlled study for the effect of beclomethasone in adenoid hypertrophy. These were graded independently by both the co-investigor and investigator. X-ray and nasal endoscopy for reevaluation of adenoid size was done at the completion of the study. Variables of both the procedures were scored at the beginning and end of the study. The agreement between the two groups was assessed using weighted kappa statistic. Results: There were 26 patients in the study, 17 of them had complete correlation between the X-ray and endoscopy findings. The agreement between these findings was statistically significant (p<.01) with the weighted kappa 0.51. Conclusion: This study shows that lateral X-rays of the neck, besides being a noninvasive procedure, still remains a very reliable and valid diagnostic test in the evaluation of hypertrophied adenoids.