Effectiveness of Evaluation of Adenoid Hypertrophy in Children by Flexible Nasopharyngoscopy Examination (FNE), Proposed Schema of Frequency of Examination: Cohort Study
Abstract
1. Introduction
2. Materials and Methods
2.1. Research Participants
2.2. Inclusion and Exclusion Criteria
2.3. Study Methods
2.4. Endoscopy
2.5. Surgery
2.6. Statistical Analysis
2.7. Ethics
3. Results
3.1. Association of A/C Ratio with Operative Adenoid Size
3.1.1. Patients’ Characteristics
3.1.2. Diagnostic Value of A/C Ratio
3.2. Volatility of the A/C Ratio over Time
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | All Patients | Female | Male | p Value | |
---|---|---|---|---|---|
n | 108 | 43 | 65 | ||
Gender | female | 43 (39.8%) | 43 (39.8%) | - | |
male | 65 (60.2%) | 65 (60.2%) | |||
Age (years) | mean ± SD | 5.2 ± 1.8 | 5.4 ± 1.9 | 5.0 ± 1.7 | 0.267 |
median (Q25–Q75) | 5.0 (4.0–6.0) | 5.0 (4.0–6.0) | 4.5 (4.0–5.5) | ||
Adenoid size (A/C ratio *, %) | mean ± SD | 77.5 ± 13.2 | 78.8 ± 13.4 | 76.6 ± 13.2 | 0.396 |
median (Q25–Q75) | 80.0 (75.0–85.0) | 80.0 (75.0–90.0) | 80.0 (70.0–85.0) | ||
40 | 1 (0.9%) | 1 (2.3%) | 0 (0.0%) | 0.505 | |
50 | 10 (9.3%) | 2 (4.7%) | 8 (12.3%) | ||
60 | 9 (8.3%) | 4 (9.3%) | 5 (7.7%) | ||
65 | 3 (2.8%) | 1 (2.3%) | 2 (3.1%) | ||
70 | 3 (2.8%) | 1 (2.3%) | 2 (3.1%) | ||
75 | 13 (12.0%) | 7 (16.3%) | 6 (9.2%) | ||
80 | 23 (21.3%) | 7 (16.3%) | 16 (24.6%) | ||
85 | 22 (20.4%) | 7 (16.3%) | 15 (23.1%) | ||
90 | 16 (14.8%) | 8 (18.6%) | 8 (12.3%) | ||
95 | 8 (7.4%) | 5 (11.6%) | 3 (4.6%) | ||
Adenoid size (A/C ratio on Bolesławska scale, %) | 35–65 (B II) | 23 (21.3%) | 8 (18.6%) | 15 (23.1%) | 0.587 |
>65 (B III) | 85 (78.7%) | 35 (81.4%) | 50 (76.9%) | ||
Operative adenoid size, 3 categories | small | 21 (19.4%) | 8 (18.6%) | 13 (20.0%) | 0.857 |
medium | 12 (11.1%) | 6 (14.0%) | 6 (9.2%) | ||
large | 75 (69.4%) | 29 (67.4%) | 46 (70.8%) | ||
Operative adenoid size, 2 categories | not large | 33 (30.6%) | 14 (32.6%) | 19 (29.2%) | 0.713 |
large | 75 (69.4%) | 29 (67.4%) | 46 (70.8%) | ||
Consistency between A/C ratio in Bolesławska scale and operative adenoid size ** | true | 96 (88.9%) | 37 (86.0%) | 59 (90.8%) | 0.536 |
false | 12 (11.1%) | 6 (14.0%) | 6 (9.2%) |
Characteristics | Operative Adenoid Size, 3 Categories | p Value 1 | p Value 2 | ||
---|---|---|---|---|---|
Small | Medium | Large | |||
n | 21 | 12 | 75 | ||
Gender | |||||
female | 8 (38.1%) | 6 (50.0%) | 29 (38.7%) | 0.857 | 0.713 |
male | 13 (61.9%) | 6 (50.0%) | 46 (61.3%) | ||
Age (years) | |||||
mean ± SD | 5.0 ± 1.5 | 4.7 ± 1.3 | 5.3 ± 1.9 | 0.559 | 0.336 |
median (Q25–Q75) | 4.5 (4.0–6.5) | 4.3 (4.0–5.8) | 5.0 (4.0–6.0) | ||
Adenoid size (A/C ratio, %) | |||||
mean ± SD | 59.5 ± 13.6 | 69.6 ± 10.1 | 83.8 ± 6.8 | <0.001 3 | <0.001 |
median (Q25–Q75) | 50.0 (50.0–65.0) | 67.5 (60.0–77.5) | 85.0 (80.0–90.0) | ||
Adenoid size (A/C ratio on Bolesławska scale, %) | |||||
35–65 (B II) | 16 (76.2%) | 6 (50.0%) | 1 (1.3%) | <0.001 | <0.001 |
>65 (B III) | 5 (23.8%) | 6 (50.0%) | 74 (98.7%) | ||
Consistency between A/C ratio on Bolesławska scale and operative adenoid size | |||||
true | 16 (76.2%) | 6 (50.0%) | 74 (98.7%) | <0.001 | <0.001 |
false | 5 (23.8%) | 6 (50.0%) | 1 (1.3%) |
A/C Ratio | ||
---|---|---|
AUC | 0.894 | |
95% CI | 0.818–0.969 | |
p value | <0.001 | |
Cutoff value (%) | 75.0 | 80.0 |
Sensitivity | 97.3% | 84.0% |
Specificity | 72.7% | 81.8% |
PPV | 89.0% | 91.3% |
NPV | 92.3% | 69.2% |
Characteristics | All Patients | |
---|---|---|
n | 81 | |
Gender | female | 43 (53.1%) |
male | 38 (46.9%) | |
Age at the first visit (years) | mean ± SD | 3.9 ± 1.2 |
median (Q25–Q75) | 3.5 (3.0–4.5) | |
Number of measurements | 3 | 47 (58.0%) |
4 | 16 (19.8%) | |
5 | 15 (18.5%) | |
6 | 2 (2.5%) | |
7 | 1 (1.2%) | |
Period of observation (years) | mean ± SD | 2.4 ± 1.2 |
median (Q25–Q75) | 2.0 (1.5–3.0) | |
1–3 | 63 (77.8%) | |
3.5–5.5 | 18 (22.2%) | |
First visit | mean ± SD | 65.4 ± 13.2 |
median (Q25–Q75) | 65.0 (55.0–75.0) | |
Bolesławska scale | <35 | 1 (1.2%) |
35–65 | 46 (56.8%) | |
>65 | 34 (42.0%) | |
Last visit | mean ± SD | 61.2 ± 16.1 |
median (Q25–Q75) | 60.0 (50.0–75.0) | |
Bolesławska scale | <35 | 4 (4.9%) |
35–65 | 46 (56.8%) | |
>65 | 31 (38.3%) | |
Change; first vs. last visit | decrease | 21 (25.9%) |
no change | 17 (21.0%) | |
increase | 43 (53.1%) | |
≤10 | 54 (66.7%) | |
>10 | 27 (33.3%) | |
≤15 | 61 (75.3%) | |
>15 | 20 (24.7%) | |
Max | mean ± SD | 71.0 ± 12.3 |
median (Q25–Q75) | 70.0 (60.0–80.0) | |
Min | mean ± SD | 56.3 ± 14.6 |
median (Q25–Q75) | 55.0 (50.0–70.0) | |
Range | mean ± SD | 14.7 ± 11.2 |
median (Q25–Q75) | 10.0 (5.0–20.0) | |
≤10 | 42 (51.9%) | |
>10 | 39 (48.1%) | |
≤15 | 56 (69.1%) | |
>15 | 25 (30.9%) | |
Semi-annual continuous measurements, 1 year | n | 38 (46.9%) |
Range | ≤10 | 28 (73.7%) |
>10 | 10 (26.3%) | |
≤15 | 35 (92.1%) | |
>15 | 3 (7.9%) | |
Annual continuous measurements (at least one measurement per year) | n | 57 (70.4%) |
Range | ≤10 | 34 (59.6%) |
>10 | 23 (40.4%) | |
≤15 | 42 (73.7%) | |
>15 | 15 (26.3%) | |
Two-year period | n | 37 (45.7%) |
Range | ≤10 | 21 (56.8%) |
>10 | 16 (43.2%) | |
≤15 | 29 (78.4%) | |
>15 | 8 (21.6%) | |
Three-year period | n | 20 (24.7%) |
Range | ≤10 | 7 (35.0%) |
>10 | 13 (65.0%) | |
≤15 | 11 (55.0%) | |
>15 | 9 (45.0%) |
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Zwierz, A.; Domagalski, K.; Masna, K.; Burduk, P. Effectiveness of Evaluation of Adenoid Hypertrophy in Children by Flexible Nasopharyngoscopy Examination (FNE), Proposed Schema of Frequency of Examination: Cohort Study. Diagnostics 2022, 12, 1734. https://doi.org/10.3390/diagnostics12071734
Zwierz A, Domagalski K, Masna K, Burduk P. Effectiveness of Evaluation of Adenoid Hypertrophy in Children by Flexible Nasopharyngoscopy Examination (FNE), Proposed Schema of Frequency of Examination: Cohort Study. Diagnostics. 2022; 12(7):1734. https://doi.org/10.3390/diagnostics12071734
Chicago/Turabian StyleZwierz, Aleksander, Krzysztof Domagalski, Krystyna Masna, and Paweł Burduk. 2022. "Effectiveness of Evaluation of Adenoid Hypertrophy in Children by Flexible Nasopharyngoscopy Examination (FNE), Proposed Schema of Frequency of Examination: Cohort Study" Diagnostics 12, no. 7: 1734. https://doi.org/10.3390/diagnostics12071734
APA StyleZwierz, A., Domagalski, K., Masna, K., & Burduk, P. (2022). Effectiveness of Evaluation of Adenoid Hypertrophy in Children by Flexible Nasopharyngoscopy Examination (FNE), Proposed Schema of Frequency of Examination: Cohort Study. Diagnostics, 12(7), 1734. https://doi.org/10.3390/diagnostics12071734