Quantitative assessment of uvula dimensions, airway space, and pharyngeal bursa in children with and without adenoid hypertrophy

This study aimed to investigate the association between adenoid hypertrophy (AH) and upper airway morphology in pediatric patients, with a specific focus on uvula dimensions, pharyngeal bursa characteristics, and nasopharyngeal airway space using sagittal and axial magnetic resonance imaging (MRI). In this retrospective cross-sectional study, MRI scans of 104 pediatric patients aged 1–18 years were analyzed. Uvula height and width, pharyngeal bursa height and width, and the nasopharyngeal airway distance (from the posterior nasal spine to the posterior pharyngeal wall) were measured using calibrated DICOM software. Patients were grouped based on the presence of AH, and anatomical measurements were compared accordingly. Correlations with age and sex were also assessed. Statistical analysis included t-tests, ANOVA, chi-square tests, and Pearson correlation. Children with AH had significantly reduced nasopharyngeal airway space compared to those without AH (mean: 12.05 mm vs. 16.71 mm, p<0.001). No significant differences were observed in uvula or bursa dimensions across groups. A strong correlation was found between uvula height and width (r=0.66), and both increased significantly with age. Males showed greater pharyngeal bursa height than females (p=0.001), while bursa width did not differ significantly by sex. MRI is a valuable non-invasive tool for evaluating pediatric airway anatomy. While AH is associated with airway narrowing, it does not appear to affect uvula or bursa characteristics. Pediatric dentists should consider comprehensive airway assessments, as early detection of obstruction can impact craniofacial development and treatment planning.