FIBERENDOSCOPIC ASSESSMENT OF RHINOPHARYNGEAL OBSTRUCTION DUE TO ADENOIDAL HYPERTROPHY

Key words: Nasal obstruction, Adenoidal hypertrophy, Rhinopharyngeal fiberendoscopy

Transnasal fiberendoscopy of the nasopharinx is the easiest and most effective way to assess adenoidal hypertrophy in children. On this basis, the Authors proposed a 4-stage classification to guide the case management: the first two stages are characterized by moderate or discrete adenoidal hypertrophy, and adenoidectomy is not necessary; in 4th stage obstruction adenoidectomy is mandatory. The most important therapeutic problems are present in 3rd grade obstruction, characterized by hypertrophic adenoids taking up about 3/4 of the rhinopharynx. In this group, which includes the largest number of hypertrophic adenoids, the therapeutic strategy must take into account the existance of obstructed breathing and of frequent complications such as recurrent otites, sinusites, sleep apnea etc. The Authors conclude that when transnasal fiberendoscopy shows important though incomplete obstruction, the decision about treatment must be based on complementary investigations to assess the presence and severity of complications.