Costello et al described an anatomical grading system for lingual tonsil. This can help to standardize the clinical description. The authors are from Singleton Hospital in Swansea, UK.
Patient selection: lingual tonsil
Parameters:
(1) amount of visible lymphoid tissue
(2) valleculae
(3) median gloss-epiglottic fold
Lymphoid Tissue
Valleculae
Median Glosso-Epiglottic Fold
Grade
minimal
free of lymphoid tissue
unhindered view
1
prominent
partially filled with lymphoid tissue
partially obscured
2
florid
completely filled
completely obscured
3
where:
• In Grade 1 lingual tonsil the submucosal blood vessels should be visible.
• A Grade 0 could be added if no lymphoid tissue seen.
• In Grade 3 lingual tonsil the lymphoid tissue may encroach upon the epiglottis.
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