Digital oral photography for pediatric tonsillar hypertrophy grading

Abstract Background Tonsillar hypertrophy contributes to pediatric disorders, including obstructive sleep apnea. The goal was to determine the utility of digital photographs for pediatric tonsillar grading. Methods Using Brodsky's grading scale, 41 children (3.0–14.6 years) had in-person tonsil grading during a routine pediatric ENT physical examination. Oral photographs were obtained with a standard single-lens reflex digital camera and graded by the same ENT physician and by an independent Pediatrician. Results In-person and photograph gradings were highly correlated, but also differed significantly. Yet photograph gradings did not differ between physicians, suggesting that photographs provide unique, consistent information to different clinicians. Discrepancies between in-person and photograph gradings were not explained by child age. Conclusion Static images may provide experts more time for mental calculations and may therefore provide a superior estimation of tonsil size. Photographs should be considered for remote use, as well as a potentially better alternative to current in vivo estimates.