Radiographic examination
The size of the adenoid was assessed using a nasopharyngeal lateral radiograph. The degree of airway obstruction was evaluated according to the A/N ratio. A :the vertical distance between the most convex point of the inferior adenoid and the extracranial tangent of the occipital slope. N:the vertical distance between the intersection of the reverse extension of the vertical line with the posterior end of the hard palate or the superior edge of the anterior middle of the soft palate and the extracranial tangent of the occipital slope is. An A/N ratio ≤ 0.60 indicates normal, an A/N ratio from 0.61~0.70 indicates mild hypertrophy, an A/N ratio from 0.71~0.80 indicates moderate hypertrophy, and A/N ratio ≥ 0.80 indicates severe hypertrophy[13,14].
This study has used reporting in implementation research of nurturing care interventions designed to promote early childhood development(ECD) as the reporting guideline