title: Variation in tonsil size in 4- to 17-year-old schoolchildren.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the variation in tonsil size and prevalence of asymmetric tonsils in 4- to 17-year-old schoolchildren and the relationships between tonsillar hypertrophy and frequent tonsillitis, frequent fever, and sleep-related symptoms observed by parents.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Six daycare centres, four primary schools, and four high schools.
  
  
  METHODS
  Questionnaire and physical examination.
  
  
  METHODS
  The size of the tonsils was evaluated and scored on a 4-point scale. The interrelationships between tonsillar hypertrophy and other studied symptoms were examined.
  
  
  RESULTS
  In the study, the parents of 1784 children, consisting of 803 (45%) boys and 981 (55%) girls, completed the questionnaires. The prevalence rates of snoring, habitual snoring, observed apnea, and habitual observed apnea were 24.6%, 4.1%, 3.8%, and 0.9%, respectively. The results of tonsil scoring were grade 1, 62.7%; grade 2, 28.4%; grade 3, 3.3%; and grade 4, 0.1%. The prevalence rate of grade 1 tonsils was increasing, whereas the prevalence rates of grade 2 and 3 tonsils were decreasing with increasing age. Tonsil size peaked in 4- to 8-year-old children. The prevalence rates of tonsillar hypertrophy and asymmetric tonsils were 3.4% and 1.7%, respectively. Tonsillar hypertrophy was found to be significantly associated with male gender, a history of frequent tonsillitis, a history of frequent fever, often or always snoring, and often or always observed apnea.
  
  
  CONCLUSIONS
  A tonsil size curve was developed in 4- to 17-year-old schoolchildren. Children aged 4- to 8 years with oropharyngeal symptoms and particularly male gender should undergo consultation with otorhinolaryngology and pediatric pulmonology physicians for the evalution of adenotonsillar tissue.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Pamukkale University, Denizli, Turkey. aahmetakcay@hotmail.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Akcay
authors.forename: Cüneyt Orhan
authors.initials: CO
authors.lastname: Kara
authors.forename: Erol
authors.initials: E
authors.lastname: Dagdeviren
authors.forename: Mehmet
authors.initials: M
authors.lastname: Zencir
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000453:epidemiology / Q000473:pathology; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology*; D015995:Prevalence; D012891:Sleep Apnea Syndromes / Q000453:epidemiology / Q000473:pathology; D012913:Snoring / Q000453:epidemiology / Q000473:pathology; D011795:Surveys and Questionnaires; D014069:Tonsillitis / Q000453:epidemiology / Q000473:pathology; D014421:Turkey / Q000453:epidemiology