How should adenoidal enlargement be measured? A radiological study based on interobserver agreement.

Clinical assessment of adenoidal size is difficult, and an objective measurement is desirable. To establish the best radiological method, lateral cephalometric radiographs were taken of 38 children three days before their adenoids were removed. Two radiologists each made five measurements related to adenoidal size on ech radiograph, and the correlations between the radiological measurements and between the measurements and the volume of tissue removed at operation were calculated. Linear measurement of the palatal airway at the narrowest point between the outlines of the adenoid and soft palate is the simplest method to use and shows good correlation between observers. It is recommended for clinical use. Measurement of the nasopharyngeal soft tissue area show equally good observer correlation and better correlation with the volume of adenoid removed at operation. This method appears more suitable for longitudinal studies of adenoidal size.