Observational studyActa otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale2022
Update of endoscopic classification system of adenoid hypertrophy based on clinical experience on 7621 children.
Observational study in Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Current role of artificial intelligence and machine learning: is their application feasible in pediatric upper airway obstructive disorders?European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Pooled it
- Adelmidrol to fight upper airways inflammation in children: a pilot case control study to safety and efficacy.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Trial
- Different techniques of adenoidectomy and its impact on middle ear pressure: a randomized controlled study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Trial
- Allergic rhinitis is the strongest independent predictor of obstructive sleep apnea severity in preschool children.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Article
- Eustachian Tube Obstruction Grade as an Independent Determinant of Audiological and Quality-of-Life Outcomes in Pediatric Chronic Adenoiditis: A Retrospective Cohort Study.Medicina (Kaunas, Lithuania) · 2026Article
- Inflammatory Endotypes of Chronic Adenoiditis and Their Impact on Persistent Middle Ear Dysfunction: A 2-Year Retrospective Translational Study Integrating Clustering and Machine Learning Approaches.Medicina (Kaunas, Lithuania) · 2026Article
- Clinical evaluation of pediatric olfactory disorders: a review from etiology to management.Frontiers in allergy · 2026Review
- Relationships of childhood allergic rhinitis with tonsil and adenoid sizes.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Article
- Histopathological and Molecular Insights into Chronic Nasopharyngeal and Otic Disorders in Children: Structural and Immune Mechanisms Underlying Disease Chronicity.Life (Basel, Switzerland) · 2025Review
- Age-stratified reference ranges for adenoid hypertrophy in children: a single-center retrospective study.Frontiers in pediatrics · 2025Article
- Cephalometric differences in grades II and IV adenoid hypertrophy: A cross-sectional study.Journal of orthodontic science · 2024Article
- Impact of the COVID-19 pandemic on paediatric otolaryngology: a nationwide study.Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2023Article
- Single-Center-Single-Blinded Clinical Trial to Evaluate the Efficacy of a Nutraceutical Containing Boswellia Serrata, Bromelain, Zinc, Magnesium, Honey, Tyndallized Lactobacillus Acidophilus and Casei to Fight Upper Respiratory Tract Infection and Otitis Media.Healthcare (Basel, Switzerland) · 2022Article
- The impact of adenoid hypertrophy across pediatric age groups on maxillomandibular development and position.Jornal de pediatriaArticle
- From Physiology to Intervention: Endoscopic Adenoid-to-Choanae Ratio Thresholds for Symptomatic Adenoid Hypertrophy in Preschool Children.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialeArticle
- Article
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Nasal endoscopy is likely to be the method of choice to evaluate nasal obstruction and adenoid hypertrophy (AH) in children given its excellent diagnostic accuracy and low risk for the patient. The aim of this study was to update the previous classification of AH to guide physicians in choosing the best therapeutic option. Materials and methods: This is a retrospective observational study including 7621 children (3565 females; mean age 5.92; range: 3-14 years) who were managed for adenoid hypertrophy at our institution between 2003 and 2018. All patients were initially treated with medical therapy and then with surgery if not adequately controlled. We performed a specific analysis based on the presence or absence of comorbidities. Results: In 1845 (24.21%) patients, adenoid obstruction was classified as Grade I when the fiberoptic endoscopy showed adenoid tissue occupying < 25% of choanal space. In 2829 of 7621 (37.12%) patients, the adenoid tissue was scored as Grade II since it was confined to the upper half of nasopharynx, with sufficiently pervious choana and visualisation of tube ostium. In 1611 of 7621 (21.14%) cases, adenoid vegetation occupied about 75% of the nasopharynx with partial involvement of tube ostium and considerable obstruction of choanal openings, and was classified as Grade III. Finally, 1336 of 7621 (17.53%) patients were scored as Grade IV due to complete obstruction with adenoid tissue reaching the lower choanal border without allowing the visualisation of the tube ostium. Based on resolution of symptoms in Grade III obstruction after medical therapy (that was mostly seen in patients without comorbidities), we divided patients in two subclasses: Grade IIIA was not associated with comorbidities, while Grade IIIB was correlated with important comorbidities. Conclusions: These results can be useful to guide medical or surgical therapeutic intervention. In patients with class IIIB AH, surgical treatment offered adequate control not only of nasal symptoms but also of associated comorbidities.
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