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

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. Fiftyone 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.