{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T19:31:40Z","timestamp":1778009500909,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2016,12,23]],"date-time":"2016-12-23T00:00:00Z","timestamp":1482451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine whether the degree of lateral pharyngeal wall (LPW) obstruction on pediatric drug\u2010induced sleep endoscopy (DISE) correlates with preprocedure tonsillar hypertrophy score on physical examination, and to determine if clinically small tonsils are obstructive.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of 154 patients who underwent DISE at a single pediatric tertiary care center over a 4\u2010year period. Inclusion criteria were documentation of Brodsky tonsil score on preoperative physical examination. Exclusion criteria were previous tonsillectomy, adenoidectomy, or adenotonsillectomy. Lateral pharyngeal wall obstruction was graded for each patient from 0 (no obstruction) to 3 (severe obstruction) using a validated pediatric DISE scoring system known as the Chan\u2010Parikh scoring system (C\u2010P). Data were analyzed using multivariate linear regression controlling for age at time of DISE and presence of comorbid conditions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred fifteen patients met criteria for analysis. Median age at DISE was 5.1 years. A moderate positive correlation was calculated between Brodsky score and DISE score, Spearman correlation coefficient 0.55, <jats:italic>P<\/jats:italic> = &lt; 0.001. Linear regression modeling determined that for every 1\u2010point increase in tonsil score, there was a 0.7\u2010point increase in C\u2010P LPW score (95% confidence interval [0.45, 0.92]). Sensitivity analysis did not detect a difference in correlation between children with comorbid conditions and children who were otherwise in good health. Of the 65 children with a pre\u2010DISE Brodsky tonsil score of 1, 39 (60%) had a LPW score of 0 (no obstruction); nine (14%) had a score of 1 (&lt; 50% obstruction); 11 (17%) had a score of 2 (&gt; 50% obstruction); and six (9%) had a score of 3 (100% obstruction).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a positive correlation between Brodsky Score and DISE LPW score. The majority of children with sleep\u2010disordered breathing with a Brodsky score of 1 did not demonstrate LPW obstruction. These children may benefit from DISE for identification of alternative sites of upper airway obstruction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 127:1943\u20131949, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26447","type":"journal-article","created":{"date-parts":[[2016,12,24]],"date-time":"2016-12-24T18:55:35Z","timestamp":1482605735000},"page":"1943-1949","source":"Crossref","is-referenced-by-count":29,"title":["Clinically small tonsils are typically not obstructive in children during drug\u2010induced sleep endoscopy"],"prefix":"10.1002","volume":"127","author":[{"given":"Craig","family":"Miller","sequence":"first","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Seattle Washington U.S.A"},{"name":"Seattle Children's Hospital Seattle Washington U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia L.","family":"Purcell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Seattle Washington U.S.A"},{"name":"Seattle Children's Hospital Seattle Washington U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Dahl","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Indiana University School of Medicine Indianapolis Indiana U.S.A"},{"name":"Riley Hospital for Children Indianapolis Indiana U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaalan","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Seattle Washington U.S.A"},{"name":"Seattle Children's Hospital Seattle Washington U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Horn","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Seattle Washington U.S.A"},{"name":"Seattle Children's Hospital Seattle Washington U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maida L.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Division of Pulmonary and Sleep Medicine the University of Washington School of Medicine Seattle Washington U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery the University of California, San Francisco San Francisco California U.S.A"},{"name":"Benioff Children's Hospital San Francisco California U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay R.","family":"Parikh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology: Head and Neck Surgery Seattle Washington U.S.A"},{"name":"Seattle Children's Hospital Seattle Washington 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