{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:29:32Z","timestamp":1790314172294,"version":"4.1.0"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T00:00:00Z","timestamp":1422316800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Comparisons among studies involving the tongue base are limited by lack of a universal system for grading lingual tonsils. The authors propose a new standardized clinical grading system for lingual tonsil hypertrophy (LTH). Validation was assessed via an interexaminer agreement study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Kappa interrater agreement study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary academic center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Subjects and Methods<\/jats:title>\n                    <jats:p>Video assessment: The proposed grading system consists of a 0\u2010to\u20104 scale: 0 = complete absence of lymphoid tissue; 1 = lymphoid tissue scattered over tongue base; 2 = lymphoid tissue covering entirety of tongue base with limited vertical thickness; 3 = significantly raised lymphoid tissue covering entirety of the tongue base, approximately 5 to 10\u00a0mm in thickness; 4 = lymphoid tissue rising above the tip of the epiglottis, \u22651\u00a0cm in thickness. The vertical height of the tonsils is a clinical approximate. A teaching video demonstrated identification of this grading system. Fourteen trained otolaryngologists graded 20 video clips of the tongue base, recorded during flexible laryngoscopy. Live assessment: A second study was performed by 2 examiners directly examining the tongue base of 23 patients using flexible laryngoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Video assessment: The overall Fleiss kappa statistic was 0.775 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 0001). This denotes substantial agreement. Live assessment: The overall kappa for nominal data was 0.8665 (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;. 0001). This denotes near perfect agreement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The substantial interexaminer correlation demonstrated during video assessment and perfect interexaminer correlation in live assessment indicate that the proposed grading system may be a valuable and useful tool in creating a common language to describe lingual tonsils.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0194599815568970","type":"journal-article","created":{"date-parts":[[2015,1,27]],"date-time":"2015-01-27T23:46:38Z","timestamp":1422402398000},"page":"667-672","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":57,"title":["A Standardized Lingual Tonsil Grading System"],"prefix":"10.1002","volume":"152","author":[{"given":"Michael","family":"Friedman","sequence":"first","affiliation":[{"name":"Rush University Medical Center Chicago Illinois USA"},{"name":"Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreeya","family":"Yalamanchali","sequence":"additional","affiliation":[{"name":"Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center Chicago Illinois USA"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of Kansas Medical Center Kansas City Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gleb","family":"Gorelick","sequence":"additional","affiliation":[{"name":"Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ninos J.","family":"Joseph","sequence":"additional","affiliation":[{"name":"Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle S.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Advanced Center for Specialty Care Advocate Illinois Masonic Medical Center Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,1,27]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2000.98362"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.05.012"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940711601103"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200112000-00012"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.12.036"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.3263"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.02.040"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.12.023"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/h0031619"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.127.4.369"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599815568970","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599815568970","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599815568970","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:58:22Z","timestamp":1760957902000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599815568970"}},"subtitle":["Interexaminer Agreement"],"short-title":[],"issued":{"date-parts":[[2015,1,27]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1177\/0194599815568970"],"URL":"https:\/\/doi.org\/10.1177\/0194599815568970","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,27]]},"assertion":[{"value":"2014-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-01-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-01-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}