Arefin’s Oral Endoscopic Grading of Adenoid Hypertrophy: A New Perspective

ENT Specialist & Hybrid ENT Surgeon, Consultant Popular Medical College Hospital, Bangladesh

*Corresponding author: Mostafa Kamal Arefin, MBBS, MCPS, FCPS, FICS (USA), FACS (USA), DLSB, ENT Specialist & Hybrid ENT Surgeon, Consultant Popular Medical College Hospital, Bangladesh, Phone: +8801671748866; Email: [email protected]

Received Date: February 24, 2026

Published Date: April 29, 2026

Citation: Arefin MK. (2026). Arefin’s Oral Endoscopic Grading of Adenoid Hypertrophy: A New Perspective. Mathews J Otolaryngol. 5(1):15.

Copyrights: Arefin MK. © (2026).

ABSTRACT

Background: Endoscopic evaluation is essential for grading adenoid hypertrophy. Most existing systems are based on nasal endoscopic views (0° telescope) assessing choanal obstruction. However, in children or patients with narrow nasal cavities, oral endoscopic visualization with a 70° or 90° telescope can provide an alternative, clearer view. Objective: To propose a new oral endoscopic grading system of adenoid hypertrophy that is simple, visual, and correlates with the degree of choanal obstruction. Methods: Based on intraoral 70° or 90° endoscopic assessment of adenoids through the mouth, a four-grade system was developed according to the visible extent of obstruction of choana and torus tubarius. The grading can be applied both under topical or general anesthesia. Results: Arefin’s Oral Endoscopic Grading (AOEG) system demonstrates consistent visualization of the adenoid mass, torus tubarius, and choanal opening without nasal manipulation. It is reproducible and correlates well with the established nasoendoscopic percentage-based systems. Conclusion: Arefin’s Oral Endoscopic Grading offers a practical and patient-friendly approach, especially for pediatric or uncooperative patients, and may serve as a complementary or alternative classification method for research and surgical planning.

Keywords: Oral, Endoscopic, Grading, Adenoid.