Calvo-Henriquez Christian, Branco Ana María, Lechien Jerome R, Maria-Saibene Alberto, DeMarchi Maria Victoria, Valencia-Blanco Beatriz, Boronat-Catalá Borja, Rangel-Chávez Jesús, Martin-Martin Carlos
Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology. Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
College of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain.
Int J Pediatr Otorhinolaryngol. 2021 Dec;151:110895. doi: 10.1016/j.ijporl.2021.110895. Epub 2021 Sep 7.
adenoidectomy is one of the most common surgical procedure in pediatric otolaryngology practice. Clinical guidelines (such as the Spanish or American) suggest adenoidectomy when the enlargement of the adenoids is associated with nasal obstruction. Nasal endoscopy and cephalograms are adequate methods to estimate the size of the adenoids. However, they do not measure nasal patency. This systematic review is designed with the objective of exploring the relationship between adenoid size and nasal ventilation through rhinomanometry.
3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing both nasal resistance and/or nasal airflow in rhinomanometry and adenoid size by any method (endoscopy, cephalogram, direct examination).
A total of 10 studies with a total population of 969 participants met the inclusion criteria. 5 authors explored the size of the adenoids through endoscopy. 4 authors explored the adenoids through lateral cephalograms. Finally, a further 2 authors explored adenoid size studying the resected tissue. Five studies explored the correlation between adenoid size and nasal resistance in rhinomanometry, which ranged from 0.20 to 0.84. Finally, 5 studies used nasal decongestant. It was found higher sensitivity and specificity, a higher area under the curve for the receiver operating characteristic curve, and higher correlation with adenoid size for rhinomanometry under nasal decongestion.
Up to now, there is no ideal diagnostic method for adenoid hypertrophy. Therefore, it seems prudent to use a combination of all currently available tools, as they provide complementary, rather than supplementary information. Available evidence suggests that rhinomanometry combined with nasal decongestant could help to elucidate the existence of nasal obstruction in intermediate cases of adenoid hypertrophy, as well as throw light on other possible causes for nasal obstruction, mainly turbinate hypertrophy.
腺样体切除术是小儿耳鼻咽喉科最常见的外科手术之一。临床指南（如西班牙或美国的指南）建议，当腺样体肥大与鼻塞相关时可进行腺样体切除术。鼻内镜检查和头颅侧位片是评估腺样体大小的合适方法。然而，它们无法测量鼻腔通畅度。本系统评价旨在通过鼻阻力测量法探索腺样体大小与鼻腔通气之间的关系。
YO-IFOS鼻科学研究组的3位作者成员独立分析数据源（PubMed、Cochrane图书馆、EMBASE、SciELO），以查找通过任何方法（内镜检查、头颅侧位片、直接检查）评估鼻阻力测量法中的鼻阻力和/或鼻气流以及腺样体大小的论文。
共有10项研究、969名参与者符合纳入标准。5位作者通过内镜检查探究腺样体大小。4位作者通过头颅侧位片探究腺样体。最后，另有2位作者通过研究切除组织来探究腺样体大小。5项研究探究了腺样体大小与鼻阻力测量法中鼻阻力的相关性，范围为0.20至0.84。最后，5项研究使用了鼻减充血剂。结果发现，鼻减充血状态下的鼻阻力测量法具有更高的敏感性和特异性、更高的受试者操作特征曲线下面积以及与腺样体大小更高的相关性。
迄今为止，尚无理想的腺样体肥大诊断方法。因此，使用所有现有工具的组合似乎较为谨慎，因为它们提供的是互补而非补充信息。现有证据表明，鼻阻力测量法结合鼻减充血剂有助于阐明腺样体肥大中间病例中鼻塞的存在情况，以及揭示鼻塞的其他可能原因，主要是鼻甲肥大。
