Adenoidal hypertrophy and allergic rhinitis: Is there an inverse relationship?

Background: Nasal obstruction is a very common symptom in children. The main causes are allergic rhinitis (AR) and adenoidal hypertrophy (AH); the possible correlation between AR and AH has been investigated by few studies, mainly conducted using radiographic craniometry. This study aimed at investigating this topic by nasal endoscopy. Methods: There were 205 children (134 boys; mean age, 6.7 years age range, 4-12 years) studied. Clinical visit, nasal endoscopy, and skin-prick test were performed in all patients. Anterior nasal obstruction was graded using the Friedmann's classification. Adenoid size was graded using the Parikh's classification. Perception of symptoms by children was also assessed using the visual analog scale. Results: Ninety-two children (44.9%) had complete nasal obstruction and 28 children (13.7%) had choanae invasion. There was a negative significant correlation (r=-0.41; p <0.001) between nose obstruction severity and volume of adenoids. Decreased probability of greater adenoid volume was associated with increased severity of nose obstruction (odds ratio [OR] = 0.13) and in patients with allergy compared with nonallergic patients (OR = 0.31). Conclusion: This real-life study shows that large adenoids may be associated with absence of allergy, whereas large turbinates may be associated with small adenoids.