MORPHOLOGICAL AND ULTRASONOGRAPHIC ASSOCIATION OF TONSIL GRADING WITH OBJECTIVE TONSIL SIZE IN ADULTS

Abstract

There is inadequate data with respect to ultrasonographic assessment of tonsil size with subjective assessment of it through grading by extent of airway occlusion. We sought to determine the association between tonsil volume by ultrasound and Brodsky tonsillar grading. This cross sectional study involved 54 patients fulfilling the inclusion criteria from August 2019 to March 2020 observed at ENT department, PNS Shifa hospital Karachi. The age group ranged from 18 to 60 years, mean age ± SD was 25.72 years ± 7.9. Detailed history and examination were taken from enrolled participants which also included tonsillar and tongue grading. These patients had history of snoring, weight gain, sleep disturbance that was affecting life style of patients and work performance. Further questions regarding addiction and medical history were also noted. USG mea’surements were taken using 13.6 Megahertz probe. On analysis through SPSS 23.0 version we found significant association of USG volume with Brodsky tonsillar grading mean for right and left tonsil volume ± SD were 1.22 ± 0.8 ml 1.16 ± 0.64 ml respectively (p-value < 0.001). Age and gender appeared to be an independent factor that could affect consistency between clinical grading and USG volume. Positive relation was obtained between neck circumference and subjective grading for right and left tonsil (p-value 0.002, 0.014) respectively. USG volume was found to be associated with BMI, ESS and MS (p-value ≤ 0.001) for all variables. Association of MS with ESS (p-value 0.013), BMI (p-value 0.003) and nasal obstruction (p-value 0.006) was found to be significant. Snoring was found to be related with increased BMI (p-value 0.001). Children and adults were affected by tonsillitis which was the most common condition in our setup. Hence USG is practically easy, non- invasive and safest tool for the measurement of objective tonsillar volume