Evaluation of lateral cephalometric radiography as a mean of diagnosing adenoids hypertrophy

Marcelo de CASTELLUCCI E BARBOSA, Luégya Amorim Henriques KNOP, Marcus Miranda LESSA, Telma Martins de ARAUJO

Introduction: One of the most usual causes of mouth breathing is adenoids hypertrophy with reduction of the nasopharyngeal space. The most precise diagnostic methods are magnetic resonance and nasal endoscopy, because they make possible a three dimension image of the nasopharynx. However, in Dentistry, cephalometric radiography is the method used in the majority of cases. That is why it is so important the evaluation of the efficacy of this diagnostic method. Aim: The aim of this paper is to determine the efficacy of the lateral cephalometric radiography in diagnosing adenoids hypertrophy, comparing this method to the nasal endoscopy. Methods: Thirty patients (7 to 12 years), with no history of otolaryngological surgery, were evaluated. All of them were submitted to a nasal endoscopy and a lateral cephalometric radiography. In the endoscopic exams it was registered the percentage of nasopharyngeal obstruction and in the radiographic exams it was registered the minor nasopharyngeal dimension. Results: The results of the exams showed a strong correlation with each other (r = – 0.793, p-value < 0.01). After that, reliability tests to the radiographic diagnose were performed, assuming that 75% (endoscopic exams) and 5mm (radiographic exams) were the limit values to the determination of the diagnose of severe adenoids hypertrophy. The radiographic exam showed a sensibility of 75%, specifi city of 86.3%, positive predictive value of 66.7%, negative predictive value of 90.4% and an exactness of 83.3%. Therefore, lateral cephalometric radiography is an effi cient method of adenoids hypertrophy diagnose. It was proved by the strong correlation of its results with the results of the nasal endoscopy, that is considered a method of excellence for diagnosing this condition.

Keywords: Adenoids hypertrophy. Nasal endoscopy. Cephalometric radiography.

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