Palatine Tonsil Size and its Correlation with Subjective Tonsil Size in Patients with Sleep-Disordered Breathing

Abstract

OBJECTIVE: To investigate the correlation of subjective tonsil size with real palatine tonsil size and to compare the differences of each parameter according to subjective tonsil size and between children and adults. STUDY DESIGN: Prospective evaluation of subjective tonsil size (0–4+) and real palatine tonsil size, including tonsil height (TH), tonsil width (TW), tonsil thickness (TT), total tonsil volume (TTV), and embedded tonsil volume (ETV) within the tonsillar fossa. SETTING: Tertiary-care rhinologic clinic. SUBJECTS AND METHODS: We measured TH, TW, TT, TTV, and ETV in 277 children and 63 adults with sleep-disordered breathing (SDB). RESULTS: In both children and adults, subjective tonsil size was significantly correlated with TTV, TH, TW, and TT (correlation coefficients 0.199–0.427 for children and 0.462–0.551 for adults). In children, TTV increased in proportion to subjective tonsil size, but about 45 percent and 34 percent of tonsils markedly deviated from the mean value of their TTV in size 2 and 3 groups, respectively. In adults, TTV of subjective tonsil size 3 and 4 groups was significantly larger than that of size 1 and 2 groups. CONCLUSIONS: Real palatine tonsil size correlated with subjective tonsil size in both children and adults with SDB. Although there is a statistical correlation in children between TTV and subjective tonsil size, there is significant discordance in size 2 and 3 groups, thus greatly limiting the value of subjective tonsil size assessment in the majority of children. However, adult subjective tonsil size may reflect real palatine tonsil size and may help predict it preoperatively.