Endoscopic Evaluation of Adenoids: Reproducibility Analysis of Current Methods

OBJECTIVES: To investigate intra- and interexaminers' reproducibility of usual adenoid hypertrophy assessment methods, according to nasofiberendoscopic examination. METHODS: Forty children of both sexes, ages ranging between 4 and 14 years, presenting with nasal obstruction and oral breathing suspected to be caused by adenoid hypertrophy, were enrolled in this study. Patients were evaluated by nasofiberendoscopy, and records were referred to and evaluated by two experienced otolaryngologists. Examiners analysed the records according to different evaluation methods; i.e., estimated, and measured percentage of choanal occlusion; as well as subjective and objective classificatory systems of adenoid hypertrophy. RESULTS: Data disclosed excellent intraexaminer reproducibility for both estimated and measured choanal occlusion. analysis revealed lower reproducibility rates of estimated in relation to measured choanal occlusion. Measured choanal occlusion also demonstrated less agreement among evaluations made through the right and left sides of the nasal cavity. Alternatively, intra- and interexaminers reliability analysis revealed higher agreement for subjective than objective classificatory system. Besides, subjective method demonstrated higher agreement than the objective classificatory system, when opposite sides were compared. CONCLUSION: Our results suggest that measured is superior to estimated percentage of choanal occlusion, particularly if employed bilaterally, diminishing the lack of agreement between sides. When adenoid categorization is used instead, the authors recommend subjective rather than objective classificatory system of adenoid hypertrophy.

Rinite alérgica - como diagnosticar e tratar / Allergic rhinitis

A rinite alérgica é uma doença crônica cujos sintomas variam quanto à frequência e à severidade. Está presente em crianças e adultos, geralmente diminuindo a qualidade de vida. O diagnóstico depende de uma história clínica detalhada, exame físico minucioso e exames complementares. O tratamento é complexo, uma vez que, além de medidas educativas, exige controle do ambiente, medicamentos diversos e, em alguns casos, imunoterapia específica e cirurgia. Esta revisão pretende abordar, de forma prática, como diagnosticar, classificar e tratar a rinite alérgica.