Correlation between the Size of Adenoid and the Preoperative and Postoperative Symptoms after Tonsillectomy and Adenoidectomy

ABSTRACT

BACKGROUND AND OBJECTIVES: For the documentation of nasopharyngeal adenoid tissue, various methods, including radiological, aerodynamic diagnostic modalities, have been utilized but were not practically efficient. The previous evaluation method of radiology was used to measure the shortest A-P diameter of nasopharyngeal air space (NPD min) in the preoperative skull lateral view or adenoidal-nasopharyngeal ratio (A/N ratio) related to the subjective symptoms. The authors attempted to compare the correlation between the narrowest, upper third, middle third, low third A-P diameter of nasopharyngeal air space, A/N ratio in the pre & postoperative skull lateral view and pre & postoperative subjective symptoms. MATERIALS AND METHODS: We evaluated the data from 100 children (61 males, 39 females age range 2-14 years, mean 8.2 years), who received adenoidectomy and tonsillectomy from a single surgeon (senior author) from January 2004 to August 2004. RESULTS: There was no significance in the correlation between A/N ratio in the pre & postoperative skull lateral view and the most pre & postoperative subjective symptoms. However, the degree of postoperative nasal obstruction and cough were significantly related to the postoperative narrowest A-P diameter of nasopharyngeal air space, regardless of the location. The upper third, middle third and low third AP diameter of nasopharyngeal air space were also significantly related to the degree of postoperative cough. CONCLUSION: It is necessary to resolve the narrowest A-P diameter of nasopharyngeal air space on the skull lateral view for the improvement of the subjective symptom such as nasal obstruction and cough due to adenoid hypertrophy.