Comparison between Awake Endoscopy and Computed Tomography to Define Lingual Tonsil Hypertrophy. (November 2017)

• Record Type: Journal Article
• Authors: Tang, Jessica A.; Gorelick, Gleb; Friedman, Michael
• Is Part Of: Otolaryngology--head and neck surgery. Volume 157:Number 5(2017)
• Page Start: 898
• Page End: 902
• Publication Date: 2017-11
• Subjects: lingual tonsil hypertrophy -- obstructive sleep apnea -- awake endoscopy -- computed tomography -- lingual tonsil tissue thickness -- Friedman staging; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599817731731
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: To analyze correlations between endoscopic lingual tonsil grade (LTG) by the Friedman Lingual Tonsil Hypertrophy grading system and computed tomography (CT) measurements of lingual tonsil thickness (LTT). Study Design: Retrospective chart review. Setting: Single-center database, September 2016 to April 2017. Subjects and Methods: Patients who received CT covering base of tongue and endoscopic LTG were included. LTT was measured on axial and sagittal CT. LTT measurements were compared against endoscopic LTG. One-way analysis of variance with Tukey's post hoc adjustment for multiple comparisons was performed. Results: Seventy-five charts were included for a total of 150 LTT measurements. Axial CT measurements of LTG 1 and LTG 2 were each significantly different from LTG 3 ( P < .001 for both), and LTG 1 and LTG 2 also differed significantly ( P = .010). Mean sagittal CT measurements were significantly different between LTG 1 and LTG 3 ( P < .001) and between LTG 2 and LTG 3 ( P = .002) but not between LTG 1 and LTG 2 ( P = .186). Those without lingual tonsil hypertrophy had a mean axial CT thickness of 6.45 ± 1.39 mm and mean sagittal CT thickness of 6.58 ± 1.53 mm, which was significantly different from both the mean axial CT thickness of 8.48 ± 1.52 mm and the mean sagittal CT thickness of 8.07 ± 1.16 mm in the LTG 3 group ( P < .001 for both). Threshold analysis showed a potential cutoff of approximately 7.5 mm on axial and sagittal CT for defining clinically significant lingual tonsil hypertrophy. Conclusion: Awake endoscopy grading of lingual tonsil hypertrophy is a subjective measurement that seems to correlate with objective CT measurements. LTT measurements of LTG 1 and LTG 2 on awake endoscopy differed significantly from LTG 3.