Usage of Epworth Sleepiness Scale, Modified Mallampati Scoring and Brodsky Grading in Adults with Hypertrophic Palatine Tonsils and Sleep Disordered Breathing

Abstract

Objective: We aimed to determine the correlation of Modified Mallampati scoring and Brodsky tonsillar grading as indicative factor for sleep disordered breathing by using an Epworth sleepiness scale in patients with hypertrophic tonsils.Methodology: Data for this prospective cross-sectional analytical study was collected at an ENT Department of PNS Shifa Hospital, Karachi between January to July 2021. Non-probability consecutive sampling technique was used. After taking informed consent, a subject evaluation proforma was filled which involved detailed personal history of the selected subjects with hypertrophic tonsils and sleep disordered breathing. Epworth sleepiness scale was assessed, Physical examination of subjects involved grading of tonsils and examination of the tongue was done. Data was entered and analyzed on SPSS 23.0 software.Results: The present study enrolled (n=54) adult subjects with mean age calculated to be 25.72 ± 7.9 SD. Pre-operative Epworth scores were significantly lower in subjects with Brodsky grade I and II as compared to higher grades which is in accordance with increasing severity of obstruction as tonsil grading advanced. Furthermore, statistically significant association was seen between Epworth scoring and Mallampati grading.Conclusion: The results of the current study generated significant recommendations for the evaluation of the anatomy of pharynx, use of Epworth questionnaire, Mallampati and Brodsky classification might be a rapid, non-invasive screening tool for advance identification and timely intervention for subjects at risk of sleep disordered breathing.