Objective

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.

Review methods

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).

Results

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.

Conclusion

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.

中文翻译：

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腺样体的大小与鼻塞有什么关系？系统评价

客观的

腺样体切除术是儿科耳鼻喉科实践中最常见的外科手术之一。临床指南（如西班牙或美国）建议当腺样体增大与鼻塞相关时进行腺样体切除术。鼻内窥镜检查和头颅造影是估计腺样体大小的适当方法。但是，它们不测量鼻腔通畅性。本系统评价旨在通过鼻测压探索腺样体大小与鼻腔通气之间的关系。

复习方法

YO-IFOS 鼻科学研究组的 3 位作者成员独立分析了数据源（Pubmed、Cochrane 图书馆、EMBASE、SciELO），以通过任何方法（内窥镜检查、头颅造影）评估鼻压力和/或鼻腔气流和腺样体大小的论文，直接检查）。

结果

共有 10 项研究，共有 969 名参与者符合纳入标准。5 位作者通过内窥镜检查了腺样体的大小。4 位作者通过侧脑图探索了腺样体。最后，另外 2 位作者探索了研究切除组织的腺样体大小。五项研究探讨了鼻测压法中腺样体大小与鼻阻力之间的相关性，范围从 0.20 到 0.84。最后，5 项研究使用了鼻减充血剂。发现更高的灵敏度和特异性，接受者操作特征曲线的曲线下面积更高，并且在鼻充血下鼻测压与腺样体大小的相关性更高。

结论

迄今为止，对腺样体肥大尚无理想的诊断方法。因此，使用所有当前可用工具的组合似乎是谨慎的，因为它们提供补充信息，而不是补充信息。现有证据表明，鼻测压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，并揭示鼻塞的其他可能原因，主要是鼻甲肥大。