{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:08:17Z","timestamp":1790690897484,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>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\u2014Adenoid\/Nasopharynx Area Ratio\u2014derived from lateral cephalometric radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Eye &amp; ENT Hospital of Fudan University and affiliated orthodontic clinics, Shanghai, China (June 2023\u2010August 2024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2010identified data were analyzed between August and October 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ANAR showed a numerically higher correlation with endoscopic grades than the A\/N ratio (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.649 vs 0.603). For severe obstruction, ANAR cutoff 0.64 yielded sensitivity 70.9% and specificity 82.3% (AUC 0.834; 95% CI, 0.76\u20100.90); the A\/N ratio AUC was 0.793. Inter\u2010rater reliability for ANAR measurement was good (intraclass correlation coefficient [A,1]\u2009=\u20090.924; 95% confidence interval, 0.848\u20100.963; n\u2009=\u200930).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.70273","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T15:32:34Z","timestamp":1782747154000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Evaluation of the Adenoid\/Nasopharynx Area Ratio on Lateral Cephalograms: Correlation With Nasal Endoscopy"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-2249-5864","authenticated-orcid":false,"given":"Jiaming","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of School of Health Science and Engineering University of Shanghai for Science and Technology Shanghai China"},{"name":"Department of Otolaryngology\u2013Head Neck Surgery Eye &amp; ENT Hospital of 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