The following five methods have been used for the diagnosis of adenoid up to the present:
i) Symptoms characteristic of adenoid (adenoid face, rhinolalia, etc.)
ii) Rhinoscopia anterior
iii) Rhinoscopia posterior
iv) Digital examination
V) Roentogenological examination
Already in 1874, WILHELM MEYER described these methods except the roentog enological one;but they are far from satisfactory in reliability. Relying merely on symptoms is a too indirect method for the diagnosis. Rhinoscopia anterior is not applicable to all patients and is not reliable enough. Rhinoscopia posterior, though the most reliable, is not easy to use for children. Digital examination has a disadvantage that it gives discomfort to the patient. A method of roentogenological examination using low voltage has been recently developed, so it will be hereafter extensively used, though the method is not in general use now.
The author has found a new simple method for the diagnosis of adenoid, of which the procedure is as follows: A coton-wound applicator is put into the nasal cavity along the floor until it touches the back wall of the pharynx. Then its tip is raised by using the thick of the thumb. The applicator will arch, if there is an abnormal growth in the way. The applicator will have to be to a certain extent withdrawn in order to raise its tip farther up. Thus the length of the applicator's regression will indicate the size of the adenoid.
According to the length of the regression the size of the adenoid can be graded as follows:
Grade Size of the adenoid
No regression of the applicator 0 no adenoid
Less than 5 mm regression 1 small
Less than 10 mm regression 2 medium
More than 10 mm regression 3 large
The foregoing has been supported by examining twenty cases of adenoid with rhinoscopia posterior and roentogenological method as well as by the results of operation.
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