Tonsils Grading Scale: What You Need to Know

November 15, 2021 by No Comments

Inflammation of the tonsils that is naturally caused by a viral or bacterial infection is called tonsillitis. Some symptoms include swollen tonsils, sore throat, fever, and pain when swallowing. This article will reflect all about the tonsils grading scale.

Swollen tonsils can have a huge impact on a patient’s health. This viral infection can severely influence children’s overall health. A child’s growth can severely be impacted by the increase in the size of tonsils. Therefore, doctors keep a check on a patient’s tonsils to monitor their size.

They also use a grading scale to administer any other issues in the throat. This article will help you understand what that grading scale is and how it works. Stick through, and continue reading.

What is a Tonsil Grading Scale?

It is a grading scale used by the ENT medics to monitor the change in the size of tonsils. It is also used to grade the tonsils along with determining any changes in their sizes. Moreover, snoring and You can timely treat obstructive sleep apnea (OSA) with the help of the tonsils grading scale.

Standardized Grading of Tonsil Scale

Tonsils grading scale

Globally, different grading scales are used by ENT specialists. However, the most reliable and widely used grading scale is that of Friedman and Brodsky. Friedman and Brodsky’s grading scales offer a range of 1-4 and 0-4, respectively. 


Brodsky was the first person to discover a grading scale for tonsil size. This scale gets named after him. His purpose was to develop an instrument that could check the degree of extension in tonsil size. This scale ranges from 0-4, where 4 is the largest enlargement size.

Use of Grading Scale

Size0: This means that the tonsils don’t exist

Size1: This means tonsils are hardly visible. It’s a normal size of the tonsils, indicating the extension to the pillars.

Size2: This means that the tongue tissues are not beyond the pillars, indicating the extension to the pillars. Again, it’s the normal size of the tonsils. 

Size3: This means that tonsils have now extended beyond the pillars.

Size4: Here, tonsils would take up more than 75% of the air passageway. It shows that tonsils have stretched to the midline of the oropharyngeal way. It also indicates that tonsils are almost touching each other.


Friedman developed an improved version of the Brodsky grading scale, which have done based on the palate’s outlook. Here grading scale measured the size of the upper airway, which was later called palate grading. The scale of this grading system ranges from 1-4, 4 being the largest size. 

Use of Grading Scale

Size1: This means that tonsils are easily visible along with uvula and the pillars

Size2: This means that tonsils are barely visible while the uvula has easily visualized

Size3: This means that you can visualize the patient’s palate. However, you can’t see uvula.

Size4: This means that only the hard palate can be seen

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