Tonsillar Hypertrophy (Palatine Tonsil Size) Brodsky/Friedman Grading Scales
Tonsillar hypertrophy is commonly graded with the Brodsky tonsil scale and the Friedman tonsil size (anatomic location relative to pillars). [1][2]
Brodsky Tonsil Grading Scale (0–4)
- Grade 0: Tonsils within the tonsillar fossa. [1]
- Grade 1: Tonsils just outside the tonsillar fossa and occupy ≤25% of the oropharyngeal width. [1]
- Grade 2: Tonsils occupy 26%–50% of the oropharyngeal width. [1]
- Grade 3: Tonsils occupy 51%–75% of the oropharyngeal width. [1]
- Grade 4: Tonsils occupy >75% of the oropharyngeal width. [1]
Friedman Tonsil Size (Location Relative to Tonsillar Pillars) (0–4)
- Size 0: Absence of tonsillar tissue. [2]
- Size 1: Within the pillars. [2]
- Size 2: Extended to the pillars. [2]
- Size 3: Extended past the pillars. [2]
- Size 4: Extended to the midline. [2]
Key Clinical Distinction Between Scales
- Brodsky grading is based on the percentage of oropharyngeal width obstructed by the tonsils. [1]
- Friedman grading is based on the anatomic position of the tonsils relative to the tonsillar pillars and the midline. [2]
Notes on Naming in Clinical Literature
- Friedman tonsil grading is frequently described as a 0-to-4 scale for tonsil size based on extent relative to pillars and midline. [2][3]
- Brodsky tonsil grading is frequently described as 0–4 based on oropharyngeal width occupied by the tonsils. [1][4]