Introduction Adenoid hypertrophy (AH) is a prevalent otolaryngological condition that primarily affects children aged 3–10 years and may adversely impact their growth and development. The choice of treatment largely hinges on the severity of hypertrophy. Currently, the main diagnostic modalities for AH include nasal endoscopy, lateral nasopharyngeal radiography, CT and MRI. In recent years, ultrasonography has emerged as a novel diagnostic tool for AH. This review aims to comprehensively evaluate the diagnostic performance of ultrasonography for detecting AH in children. Methods and analysis We will conduct a systematic literature search in five databases—PubMed, MEDLINE, Embase, the Cochrane Library and CNKI—to identify studies evaluating the use of ultrasonography for the diagnosis of paediatric AH. The search period will span from database inception to 31 March 2025. Only studies published in Chinese or English will be considered. All retrieved records will be independently screened by two reviewers at the title and abstract level to identify eligible studies. Data extraction will also be independently performed by two reviewers. The methodological quality of the included studies will be evaluated using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. To synthesise diagnostic accuracy, pooled estimates of sensitivity, specificity and likelihood ratios will be obtained through a bivariate random-effects approach in combination with the hierarchical summary receiver operating characteristic model. When notable heterogeneity is detected, subgroup analyses and meta-regression will be conducted to examine whether estimates of diagnostic accuracy differ according to country, ultrasound probe type or operator experience. Ethics and dissemination As this review is based exclusively on previously published studies, ethical approval is not required. The findings will be disseminated through publication in peer-reviewed journals and presentations at academic conferences. Study registration PROSPERO, CRD420251080754.
Chen et al. (2026) studied this question.