Tonsil Size Grading Scale and Tongue Position Grading System

Clinical Grading of Tonsillar Size and Tongue Position

Tonsillar Size Scoring System

Tonsillar hypertrophy grading scale / Image source: sleepmedicineboardreview

Tonsils can be scored according to their size. Especially in patients with sleep apnea syndrome, disease severity increases as tonsil scores increase. The tonsil size scoring system, which is described in the photograph and defined at scores ranging from zero to four, is used in patients with sleep apnea and for pre-anesthetic evaluation. Tonsillectomy in patients with very big (hypertrophic) tonsils has important health benefits.

Tonsil Size Grading

As the tonsil size increases, sleep apnea may become more severe!

As the size of the tonsils increases, the cross-sectional area of the upper airway decreases, so symptoms of sleep apnea may occur or the number of existing sleep apnea attacks may increase. Abnormal increase in sleep apnea symptoms may occur, especially in patients with airway obstruction at the tongue base area.

The Friedman Tongue Position (FTP) Grading System

Friedman Tongue Position (FTP) Scoring System / Image source: Pocket Dentistry - Surgical treatment for sleep-related breathing disorders

According to the Friedman Tongue Position (FTP) Scoring System, the patient opens their mouth without removing the tongue and evaluates the soft palate, uvula and tonsils with the tongue. Depending on the appearance of the soft palate, the patient is given a score of 1-4.

In the photographs, it is seen that the air vents are arranged from big to small. In other words, in patients with both tonsil and tongue position scores, the number of apneas may be high and the risk of sleep apnea may be higher in terms of health. The most objective diagnostic and assessment tool in sleep apnea is sleep test. There are also assessment tools such as "Epworth Sleepiness Scale (ESS)" and sleep endoscopy. It is difficult to describe such a detailed and complex disease in a few sentences and to define it with a few scoring systems.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Mobile phone: +90 533 6550199
Fax: +90 212 542 74 47