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Development and Evaluation of the Adenoid/Nasopharynx Area Ratio on Lateral Cephalograms: Correlation With Nasal Endoscopy.
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4 authors.
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Abstract
Objective: The clinical assessment of adenoid hypertrophy presents 2 practical challenges: (1) the need for an objective, reproducible estimate of nasopharyngeal obstruction in children when cooperation is limited and (2) the need for a reliable radiographic metric to support interdisciplinary assessment and communication between dental/orthodontic providers and otolaryngologists. To address these challenges, this study aimed to evaluate the diagnostic performance of a novel radiographic index-Adenoid/Nasopharynx Area Ratio-derived from lateral cephalometric radiographs. Study Design: Retrospective cohort study. Setting: Eye & ENT Hospital of Fudan University and affiliated orthodontic clinics, Shanghai, China (June 2023-August 2024). Methods: Consecutive children aged 2 to 14 years flagged for suspected adenoid hypertrophy during routine dental examinations were screened; eligible participants were enrolled after prespecified exclusions. De-identified data were analyzed between August and October 2024. Results: ANAR showed a numerically higher correlation with endoscopic grades than the A/N ratio ( Conclusion: Adenoid/Nasopharynx Area Ratio is a practical, reproducible planimetric index derived from lateral cephalograms that may support opportunistic upper airway assessment when imaging is already obtained for dental/orthodontic care. Nasal endoscopy remains the reference standard; ANAR is complementary, and additional radiographs solely for adenoid evaluation are not recommended.
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