Caylakli Fatma, Hizal Evren, Yilmaz Ismail, Yilmazer Cuneyt
Baskent University Faculty of Medicine, Department of Otorhinolaryngology Head and Neck Surgery, Ankara, Turkey.
Int J Pediatr Otorhinolaryngol. 2009 Nov;73(11):1532-5. doi: 10.1016/j.ijporl.2009.07.018. Epub 2009 Sep 3.
To determine the reliability of adenoid-nasopharynx (A/N) ratio that is calculated on lateral cephalometric graphies for measuring the adenoid tissue size.
85 patients that had been examined in our clinic with a prediagnosis of adenoid hypertrophy between June 2007 and March 2008 were included in the study. Local ethics committee approved the study protocol. Patients who had a previous adenoidectomy history and anatomic anomaly or acute infection in nose, palate or nasopharynx were excluded. Endoscopic nasal examination was done in all patients in addition to the routine ear nose throat examination. Lateral cephalometric graphs were obtained from all patients. Digital images obtained during endoscopic examination were evaluated on computer and obstruction ratios of adenoid tissue to choanal opening were calculated. Each cephalometric graph was evaluated by a blinded author. A/N ratio was calculated by dividing the distance from the outermost point of convexity of adenoid shadow to basiocciput to the distance between sphenobasiocciput and posterior end of hard palate (Fujioka Method). A/N ratio of each patient was then compared with the obstruction ratio obtained in nasal endoscopy. Pearson correlation test was used for statistical analysis and a p-value of <0.05 was accepted as significant.
There were 52 male and 33 female patients between the ages of 2 and 12 years (mean age, 5.0+/-2.2; median, 4.5). In nasal endoscopy, adenoid tissue was determined to obstruct the choanal opening as 88.5+/-12.0% (range, 51-99%) in an average. Mean adenoid nasopharynx ratio was found to be 0.87+/-0.1. There was a statistical significant correlation between A/N ratio and nasal endoscopic examination findings (r=0.511; p<0.0001).
A/N ratio is an easily applicable, noninvasive method that can correctly measure the size of the adenoid tissue in patients who are suspected to have adenoid hypertrophy.
确定在头颅侧位片上计算的腺样体-鼻咽部（A/N）比值用于测量腺样体组织大小的可靠性。
本研究纳入了2007年6月至2008年3月期间在我院门诊预诊断为腺样体肥大的85例患者。当地伦理委员会批准了研究方案。排除既往有腺样体切除术史以及鼻、腭或鼻咽部存在解剖异常或急性感染的患者。除了常规的耳鼻喉检查外，所有患者均进行了鼻内镜检查。获取了所有患者的头颅侧位片。在内镜检查过程中获得的数字图像在计算机上进行评估，并计算腺样体组织与后鼻孔开口的阻塞率。每张头颅侧位片由一位不知情的作者进行评估。A/N比值通过将腺样体阴影最凸点到枕骨基底部的距离除以蝶枕骨与硬腭后端之间的距离来计算（藤冈法）。然后将每位患者的A/N比值与鼻内镜检查获得的阻塞率进行比较。采用Pearson相关检验进行统计分析，p值<0.05被认为具有统计学意义。
共有52例男性和33例女性患者，年龄在2至12岁之间（平均年龄，5.0±2.2岁；中位数，4.5岁）。在鼻内镜检查中，腺样体组织平均阻塞后鼻孔开口88.5±12.0%（范围，51 - 99%）。发现平均腺样体-鼻咽部比值为0.87±0.1。A/N比值与鼻内镜检查结果之间存在统计学显著相关性（r = 0.511；p < 0.0001）。
A/N比值是一种易于应用的非侵入性方法，可正确测量疑似腺样体肥大患者的腺样体组织大小。
