European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 8, pp 2305–2310 | Cite as

Objective versus subjective measurements of palatine tonsil size in adult patients with obstructive sleep apnea/hypopnea syndrome

  • Chi-Chih Lai
  • Michael Friedman
  • Hsin-Ching LinEmail author
  • Pa-Chun Wang
  • Cheng-Ming Hsu
  • Sreeya Yalamanchali
  • Meng-Chih Lin
  • Yung-Che Chen


The objective of this study was to evaluate the relationship between subjective and objective tonsil size measurements in adult patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) and compare the tonsil size measurements with the severity of disease. Fifty-one adult patients (46 males and 5 females) who failed continuous positive airway pressure therapy and underwent OSAHS surgery were recruited. Physical examinations, subjective tonsil size grading preoperatively, and objective tonsil measurements including size (length, width, and height), weight and volume immediately after surgery were recorded. The results showed significant positive correlations between subjective tonsil size grading and all the parameters of the objective tonsil measurements (p < 0.05). When comparing the subjective and objective tonsil measurements with the polysomnographic parameters, the subjective grading was significantly correlated with snoring index (p < 0.05) but showed only borderline correlation with apnea/hypopnea index. However, the objective tonsil measurements were significantly correlated with both snoring index and apnea/hypopnea index (both p < 0.05). Although the subjective tonsil size grading reflected the objective tonsil measurements, the objective tonsil measurements were more meaningful in predicting the severity of OSAHS.


Palatine tonsil Snoring Obstructive sleep apnea/hypopnea syndrome Tonsillectomy 



The authors thank Drs. Mao-Chang Su and Chien-Hung Chin for their assistance in manuscript preparation. This study was supported by grants CMRPG8A0041 awarded by the Chang Gung Memorial Hospital, Taiwan.

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Chi-Chih Lai
    • 1
  • Michael Friedman
    • 2
    • 3
  • Hsin-Ching Lin
    • 1
    • 4
    • 7
    Email author
  • Pa-Chun Wang
    • 5
  • Cheng-Ming Hsu
    • 1
  • Sreeya Yalamanchali
    • 3
  • Meng-Chih Lin
    • 4
    • 6
  • Yung-Che Chen
    • 4
    • 6
  1. 1.Division of Laryngology, Department of OtolaryngologyKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan
  2. 2.Department of Otolaryngology, Head and Neck SurgeryRush University Medical CenterChicagoUSA
  3. 3.Department of Otolaryngology, Advanced Center for Specialty CareAdvocate Illinois Masonic Medical CenterChicagoUSA
  4. 4.Sleep CenterKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan
  5. 5.Department of OtolaryngologyCathay General HospitalTaipeiTaiwan
  6. 6.Division of Pulmonary and Critical Care Medicine, Department of Internal MedicineKaohsiung Chang Gung Memorial Hospital and Chang Gung University College of MedicineKaohsiungTaiwan
  7. 7.Department of Otolaryngology, Sleep CenterKaohsiung Chang Gung Memorial HospitalKaohsiungTaiwan

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