Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026
Adenoid Hypertrophy: Correlation between Clinical and Radiological Findings
*Haque MA,1 Asad MK,2 Mahmud M,3 Islam MR,4 Islam MM,5 Akanda MH,6 Reza SS7
Abstract
Background: Adenoids, part of Waldeyer’s ring, play a key role in immune defense. Adenoid hypertrophy (AH) is a common pediatric condition that can cause otitis media, sleep apnoea, cognitive and craniofacial complications if untreated. As the nasopharynx is not directly visible, AH is commonly assessed using clinical and radiological methods.
Objective: To determine the correlation between clinical assessment and grading of AH with radiographic findings in children diagnosed with AH.
Methods: This observational, cross-sectional study was conducted in the Department of Otolaryngology – Head & Neck Surgery, Chittagong Medical College Hospital, Chattogram, Bangladesh, from June 2022 to August 2023. Fifty pediatric patients with adenoid hypertrophy were selected consecutively using purposive sampling. Clinical scoring of mouth breathing/dyspnoea, sleep apnoea, and snoring was categorized as mild, moderate, or severe and compared with lateral nasopharyngeal radiographs assessed by Fujioka and Cohen methods. Data were analyzed in SPSS v26, with results expressed as mean ± SD, frequency, and percentage, and associations tested using ANOVA (P < 0.05).
Results: Among 50 children with adenoid hypertrophy (mean age 5.94 ± 0.72 years; 78% male), common clinical features were mouth breathing/dyspnoea (62%), snoring (58%), and apnoea (76%). Fujioka ANR ratios were mild 10%, moderate 58%, severe 32%, correlating with clinical severity (P = 0.0017; ROC cut-off 0.61: 76% sensitivity, 79% specificity). Cohen AC:SP ratios were mild 14%, moderate 62%, severe 24%, also correlating with clinical grading (P = 0.0261; ROC cut-off 0.66: 68% sensitivity, 57% specificity). Fujioka method showed higher reliability than Cohen.
Conclusion: Lateral radiographs of the nasopharynx are reliable and valid for evaluating children with AH in accordance with their clinical symptoms or grading. A strong correlation between clinical scores and radiological findings was observed. The Fujioka method demonstrated better accuracy than the Cohen method in terms of diagnostic validity and reliability.
[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):75-86]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.11
Keywords: Adenoid Hypertrophy, Clinical Assessment, Radiological Evaluation.Dr.
- *Dr. Md. Aminul Haque, Junior Consultant (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh. aminul49rmc@gmail.com.
- Professor Dr. Md. Khalid Asad, Department of ENT, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
- Dr. Muddassir Mahmud, Assistant Professor (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
- Dr. Muhammad Rafiqul Islam, Assistant Professor (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
- Dr. Md. Mizanul Islam, Assistant Registrar (ENT), Department of ENT, Shaheed Syed Nazrul Islam Medical College Hospital, Kishoreganj, Bangladesh
- Dr. Md. Mobarak Hosen Akanda, Registrar (ENT), Department of ENT, Mymensingh Medical College Hospital, Mymensingh, Bangladesh
- Dr. SM Shohan Reza, Registrar (ENT), Department of ENT, Universal Medical College & Hospital, Dhaka, Bangladesh
*For correspondence