{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:41:05Z","timestamp":1792813265869,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether parent\u2010captured oropharyngeal videos obtained using a handheld telemedicine device can assess tonsil size in children with sleep\u2010disordered breathing compared with in\u2010person clinical examination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective diagnostic accuracy study at a single tertiary pediatric referral center. A consecutive sample of 169 children scheduled for tonsillectomy, adenoidectomy, or adenotonsillectomy was enrolled. Parents obtained oropharyngeal videos using a handheld telemedicine device (TytoCare). Three blinded pediatric otolaryngologists independently graded tonsil size using the Brodsky scale. Interrater agreement, diagnostic performance relative to in\u2010person examination, and video usability were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 169 children (median age 4.4\u2009years, IQR 3.3\u20137.6), 53% underwent adenotonsillectomy and 46% adenoidectomy alone. Interrater agreement for tonsil size grading was strong (Kendall's\n                      <jats:italic>W<\/jats:italic>\n                      \u2009=\u20090.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) and remained substantial when grades were dichotomized as 0\u20132 versus 3\u20134 (Fleiss\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.65, 95% CI: 0.58\u20130.73). Using the in\u2010person examination as the reference standard, sensitivity was 70%, specificity was 86%, positive predictive value was 84%, and negative predictive value was 73%. Twenty\u2010one videos (12%) were unusable by all evaluators and 54 (32%) by at least one evaluator, with higher rates in younger children.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Parent\u2010captured oropharyngeal videos may provide a feasible method for remote tonsil size assessment in selected children with sleep\u2010disordered breathing. Strong interrater agreement and generally favorable parental attitudes support further evaluation of this approach, while additional validation is needed before routine reliance on video\u2010based assessment for surgical decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>2.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.71014","type":"journal-article","created":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:11:12Z","timestamp":1792811472000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Video\u2010Based Assessment of Tonsil Size in Children With Sleep\u2010Disordered Breathing"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3601-1724","authenticated-orcid":false,"given":"Nir","family":"Livneh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaara","family":"Wazana","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idan","family":"Peled","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eldar","family":"Carmel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4970-8750","authenticated-orcid":false,"given":"Chilaf","family":"Peled","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0491-9068","authenticated-orcid":false,"given":"Ory","family":"Madgar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Sheba Medical Center  Ramat Gan Israel"},{"name":"Gray Faculty of Medical &amp; Health Sciences Tel Aviv University  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03168648\/METRICS"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/COA.13768"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2011.08.003"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/JEP.13044"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/2473974X211072791"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAOTO.2020.1972"},{"issue":"1","key":"e_1_2_9_8_1","first-page":"26","article-title":"Otolaryngology Consultations by Real\u2010Time Telemedicine","volume":"71","author":"Ullah R.","year":"2002","journal-title":"Ulster Medical Journal"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/WJPS\u20102022\u2010000440"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2012\u20101671"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011165.PUB2"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2016\u20103491"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAPEDIATRICS.2015.2016"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAOTO.2020.0869"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAOTO.2022.1330"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0031\u20103955(16)36806\u20107"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2024.104304"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1258\/135763305775124821"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/JAMAOTO.2020.5223"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.71014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.71014","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.71014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:11:15Z","timestamp":1792811475000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.71014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,23]]},"references-count":18,"alternative-id":["10.1002\/lary.71014"],"URL":"https:\/\/doi.org\/10.1002\/lary.71014","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,23]]},"assertion":[{"value":"2026-06-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"lary.71014"}}