Background: Enlarged adenoids commonly occur in pediatric patients and require medical attention. Various diagnostic methods have been proposed to assess adenoid enlargement, but there is no consensus on the optimal approach.
Aim: : measure the reproducibility of flexible nasoendoscopy, comparing the adenoid size using both lateral neck radiography and flexible nasoendoscopy, and correlate both modalities in relation to clinical symptoms.
Patients and Methods: The study involved 66 children. Their age ranged from 3 to 14 years, with a mean of 7.68 ± 2.26. All patients had flexible nasopharyngoscopy by two physicians and lateral neck radiograph to measure the adenoid size. Then, results were compared and correlated to the clinical symptoms.
Results: Moderate agreement between endoscopy rater A and radiological evaluator (weighted kappa = 0.516, p < 0.001) was observed for adenoid size, with 39.4% grade III and 34.8% grade IV agreement. However, 25.8% cases had discrepancies, favoring endoscopist A's grade IV. Fair agreement between endoscopy rater B and radiological evaluator (weighted kappa = 0.283, p = 0.018) showed 42.4% grade III and 22.7% grade IV agreement, with 12.1% and 22.7% disagreements.
Conclusion: Our study concludes that both flexible nasopharyngoscopy and lateral neck radiography are complementary techniques for evaluating adenoid size and its correlation with symptoms.