Patel A, et al. - Given that adenoid hypertrophy assessment can be done using various methods including flexible endoscopy and intraoperative mirror exam, researchers contrasted the impact of adenoid size on the accuracy of these techniques. Participants in the study were patients younger than 18 years old who had adenoidectomy at Boston Medical Center from October 2012 to December 2018 and had documented preoperative and intraoperative adenoid sizes. Utilizing Chi-square analysis and t-tests, patients who had less obstruction (75% or less obstruction) and more obstruction (> 75%) were compared. Of the 276 patients who underwent adenoidectomy between October 2012 and December 2018, 84 patients had adenoid size assessed by flexible endoscopy as well as intraoperative. The mean preoperative adenoid obstruction size of 72% was significantly higher in patients with less obstruction than the mean intraoperative adenoid obstruction size of 63%. However, the mean preoperative adenoid size of 86% in patients with more obstruction was not significantly different from the mean intraoperative adenoid size of 90%.Flexible endoscopy can overestimate the adenoid size in patients with less obstructive hypertrophy compared with intraoperative assessment.