Comparison of reliability of 5 evaluation methods for intraoral tonsil hypertrophy in awake and anesthetized individuals

doi:10.19438/j.cjoms.2022.05.008

China Journal of Oral and Maxillofacial Surgery ›› 2022, Vol. 20 ›› Issue (5): 461-465.doi: 10.19438/j.cjoms.2022.05.008

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Comparison of reliability of 5 evaluation methods for intraoral tonsil hypertrophy in awake and anesthetized individuals

YAO Kan¹, XIE Yi-lun², YU Wen-wen¹, WEI Si-long¹, XIA Liang¹, ZHENG Tong¹, LU Xiao-feng¹

1. Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology. Shanghai 200011;
2. Department of Stomatology, Renji Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200127, China

Received:2022-03-02 Revised:2022-05-25 Online:2022-09-20 Published:2022-09-20

Abstract

Abstract: PURPOSE: To determine the reliability of the 5 clinical grading scales of tonsillar size in reporting the size of tonsils in awake and anesthetized individuals. METHODS: Awake and anesthetized tonsillar images of 218 patients aged 3 to 14 years with no severe craniofacial abnormalities were retrospectively collected. For each patient, five separate tonsil assessments were conducted by 3 experienced experts. Intraclass correlation coefficients(ICC) and Cronbach's α were used to determine the reliability of tonsil size in awake and anesthetized state. Statistical analysis was performed with R language (version 3.6.3). RESULTS: The reliability was highest for traditional 3-grade scale (ICC, 0.58; Cronbach's α, 0.74), followed by Friedman grading scale (ICC, 0.57; Cronbach's α, 0.73), modified 3-grade scale (ICC, 0.57; Cronbach's α, 0.72), modified 5-grade scale(ICC, 0.42; Cronbach's α, 0.59) and Brodsky grading scale(ICC, 0.30; Cronbach's α, 0.46). CONCLUSIONS: The tonsils tended to be underestimated when the individuals were awake, while the 5 tonsil assessments were able to figure out the real volume of tonsils respectively.

Key words: Obstructive sleep-disordered breathing, Pediatric, Tonsillar hypertrophy, Tonsillar size grading scale

CLC Number:

YAO Kan, XIE Yi-lun, YU Wen-wen, WEI Si-long, XIA Liang, ZHENG Tong, LU Xiao-feng. Comparison of reliability of 5 evaluation methods for intraoral tonsil hypertrophy in awake and anesthetized individuals[J]. China Journal of Oral and Maxillofacial Surgery, 2022, 20(5): 461-465.

References

[1] 孙虹, 张罗. 耳鼻咽喉头颈外科学(第9版)[M]. 北京: 人民卫生出版社, 2018: 267-268.
Sun H, Zhang L.Otolaryngology, head and neck surgery (9th edition)[M]. Beijing: People's Medical Publishing House, 2018: 267-268.
[2] American Academy of Sleep Medicine. International classification of sleep disorders[M]. 3rd Ed. Darien, IL: American Academy of Sleep Medicine, 2014: 68-74.
[3] Bhattacharjee R, Kheirandish-Gozal L, Spruyt K, et al.Adenotonsillectomy outcomes in treatment of obstructive sleep apnea in children: a multicenter retrospective study[J]. Am J Respir Crit Care Med, 2010, 182(5): 676-683.
[4] Dayyat E, Kheirandish-Gozal L, Sans Capdevila O, et al.Obstructive sleep apnea in children: relative contributions of body mass index and adenotonsillar hypertrophy[J]. Chest, 2009, 136(1): 137-144.
[5] Muzumdar H, Arens R.Physiological effects of obstructive sleep apnea syndrome in childhood[J]. Respir Physiol Neurobiol, 2013, 188(3): 370-382.
[6] Chawla J, Waters KA.Snoring in children[J]. J Paediatr Child Health, 2015, 51(9): 847-850.
[7] Hwang SH, Guilleminault C, Park CS, et al.Usefulness of adenotonsillar size for prediction of severity of obstructive sleep apnea and flow limitation[J]. Otolaryngol Head Neck Surg, 2013, 149(2): 326-334.
[8] Marcus CL, Brooks LJ, Draper KA, et al.Diagnosis and management of childhood obstructive sleep apnea syndrome[J]. Pediatrics, 2012, 130(3): e714-e755.
[9] Brodsky L.Modern assessment of tonsils and adenoids[J]. Pediatr Clin North Am, 1989, 36(6): 1551-1569.
[10] Friedman M, Tanyeri H, La Rosa M, et al.Clinical predictors of obstructive sleep apnea[J]. Laryngoscope, 1999, 109(12): 1901-1907.
[11] Kumar DS, Valenzuela D, Kozak FK, et al.The reliability of clinical tonsil size grading in children[J]. JAMA Otolaryngol Head Neck Surg, 2014, 140(11): 1034-1037.
[12] Ng SK, Lee DL, Li AM, et al.Reproducibility of clinical grading of tonsillar size[J]. Arch Otolaryngol Head Neck Surg, 2010, 136(2): 159-162.
[13] Albarakati S, Kula K, Ghoneima A.The reliability and reproducibility of cephalometric measurements: a comparison of conventional and digital methods[J]. Dentomaxillofac Radiol, 2012, 41(1): 11-17.
[14] Akcay A, Kara CO, Dagdeviren E, et al.Variation in tonsil size in 4- to 17-year-old schoolchildren[J]. J Otolaryngology, 2006, 35(4): 270-274.
[15] Dutta A, Zisserman A.The VIA annotation software for images, audio and video[C]. Proceedings of the 27th ACM International Conference on Multimedia. New York, NY, USA: ACM, 2019.
[16] The R Development Core Team. R: a language and environment for statistical computing[M]. Vienna, Austria: R Foundation for Statistical Computing, 2020.
[17] Koo TK, Li MY.A guideline of selecting and reporting intraclass correlation coefficients for reliability research[J]. J Chiropractic Med, 2016, 15(2): 155-163.
[18] Tavakol M, Dennick R.Making sense of Cronbach's alpha[J]. Int J Med Educ, 2011, 2(1): 53-55.
[19] Bland JM, Altman DG.Statistics notes: Cronbach's alpha[J]. BMJ, 1997, 314(7080): 572.
[20] 沈翎, 林宗通, 许杨杨, 等. 儿童OSAHS与腺样体和扁桃体大小的关系探讨[J]. 临床耳鼻咽喉头颈外科杂志, 2014, 28(6): 381-385.
Shen L, Lin ZT, Xu YY, et al.The relationship between obstructive sleep apnea hypopnea syndrome and adenoid size as well as tonsil size in children[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2014, 28(6): 381-385.
[21] Nolan J, Brietzke SE.Systematic review of pediatric tonsil size and polysomnogram-measured obstructive sleep apnea severity[J]. Otolaryngol Head Neck Surg, 2011, 144(6): 844-850.
[22] Brietzke SE, Gallagher D.The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis[J]. Otolaryngol Head Neck Surg, 2006, 134(6): 979-984.
[23] Marcus CL, Moore RH, Rosen CL, et al.A randomized trial of adenotonsillectomy for childhood sleep apnea[J]. New Eng J Med, 2013, 368(25): 2366-2376.

Comparison of reliability of 5 evaluation methods for intraoral tonsil hypertrophy in awake and anesthetized individuals

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