Related Experiment Video
Updated: Feb 17, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Association of palatine tonsil size and obstructive sleep apnea in adults
Sebastian M Jara1, Edward M Weaver1,2
1Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, Washington, U.S.A.
Objective:
The relationship between palatine tonsil (PT) size and obstructive sleep apnea (OSA) has not been well established in adults. The purpose of this study was to test the association between PT grade, PT volume, and OSA severity in U.S. adult patients.
Study Design:
Cross-sectional study of all patients (age ≥ 18 years) who underwent pharyngeal surgery for OSA that included palatine tonsillectomy with tonsil volume measurement from January 2011 to June 2016.
Methods:
Medical records were reviewed for PT grade (measured on clinical exam by the Brodsky tonsil grading scale), PT volume (measured intraoperatively by water displacement), and apnea-hypopnea index (AHI). Associations were evaluated with multivariate linear regression adjusting for age, sex, body mass index (BMI), smoking status, lingual tonsil volume (AHI models only), and multilevel surgery aside from lingual tonsillectomy (PT volume vs. AHI model only).
Results:
The cohort (N = 83) was middle-aged (mean age 43 ± 12 years), predominantly male (61%), obese (mean BMI 33 ± 7 kg/m2 ), and had severe OSA (mean AHI 32 ± 28). After adjustment for confounders, PT grade was strongly associated with PT volume (beta = 1.8, 95% confidence interval [CI]: [1.0, 2.6], P < 0.001) and with AHI (beta = 13.5, 95% CI: [3.5, 23.6], P = 0.01); PT volume was not associated with AHI (beta = -0.2, 95% CI: [-2.2, 1.9], P = 0.89).
Conclusion:
In contrast to past studies, subjective PT grade (vs. objective PT volume) was more strongly associated with AHI. These data suggest the space that the tonsils occupy within the oropharyngeal airway, instead of their actual measured volume, may be more predictive of OSA severity in a cohort of U.S. adult patients.
Level Of Evidence:
2c. Laryngoscope, 128:1002-1006, 2018.
Related Concept Videos
Sleep Apnea
The condition is more prevalent among...
Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
Chronic Pharyngitis
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
Other Pulmonary Disorders
Physical Assessment of the Respiratory Tract I: Health History
Subjective Data
Subjective data provides vital information about the patient's health history and symptoms. This data is typically collected through interviews in which patients describe their experiences, symptoms, and concerns.
Health history and...
Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...

