---
title: "Brodsky Grading of Tonsillar Enlargement"
description: "ENT notes on Brodsky grading system for assessing tonsillar size."
source: "The ENT Resident"
author: "Dr. Mausumi Das"
canonical_url: "https://www.theentresident.com/ent-notes-lectures/brodsky-grading-tonsils"
categories: ["Pharynx", "Classifications and Gradings in ENT"]
video: "https://www.youtube.com/watch?v=1FcZTKMdby0"
image: "https://media.theentresident.com/og-images/brodsky-grading-tonsils.png"
---

# Brodsky Grading of Tonsillar Enlargement

ENT notes on Brodsky grading system for assessing tonsillar size. Watch the full video lecture on YouTube: https://www.youtube.com/watch?v=1FcZTKMdby0

Brodsky grading helps assess the **degree of oropharyngeal airway obstruction** and is particularly useful in pediatric obstructive sleep apnea (OSA) and surgical decision-making.

---

### 🔍 What is Brodsky's Grading?

> Note: While students sometimes refer to this as the **Brodsky scale**, the correct clinical terminology is the Brodsky grading system.

**Brodsky grading system** classifies the size of the tonsils based on the **percentage of the oropharyngeal airway** they occupy.

Here is the step-by-step breakdown for the clinical grading of tonsils:

#### ✅ Grade 0
- **Tonsils lie completely within the tonsillar fossa**
- Not visible or barely protruding
- Seen typically in patients post-tonsillectomy or with atrophic tonsils

---

#### ✅ Grade 1
- Tonsils occupy **< 25%** of the oropharyngeal width
- **Minimal airway obstruction**
- Mildly enlarged

---

#### ✅ Grade 2
- Tonsils occupy **25–50%** of the oropharyngeal width
- May cause **mild airway obstruction**

---

#### ✅ Grade 3
- Tonsils occupy **50–75%** of the oropharyngeal width
- Associated with **moderate airway obstruction**

---

#### ✅ Grade 4 
- Tonsils occupy **> 75%** of the oropharyngeal width
- Tonsils **touch or nearly touch in the midline**
- Often referred to as **“kissing tonsils”**
- Associated with **severe airway obstruction**

---

### 🩺 Clinical Significance of Brodsky Grading

- Assigning a **Brodsky tonsil grade** helps evaluate the **severity of airway compromise**, especially in:
  - Pediatric **Obstructive Sleep Apnea (OSA)**
  - **Chronic or recurrent tonsillitis**

- Aids decision making for **tonsillectomy**

> Note: This topic is a common viva question in ENT practical examinations, where examiners ask you to outline the Brodsky tonsil grading scale.

---

## About This Note

This free ENT note on Brodsky Grading of Tonsillar Enlargement was written by Dr. Mausumi Das and is paired with a corresponding video lecture.

Canonical page of this note: https://www.theentresident.com/ent-notes-lectures/brodsky-grading-tonsils

When citing or referencing this content, please credit The ENT Resident and link to the canonical page above.

## Related Notes by Category

- Pharynx: https://www.theentresident.com/ent-notes-lectures/category/pharynx.md
- Classifications and Gradings in ENT: https://www.theentresident.com/ent-notes-lectures/category/classifications-and-gradings-in-ent.md

## About The ENT Resident

The ENT Resident is an educational website and resource library created by Dr. Mausumi Das (MS ENT) for ENT residents, ENT postgraduates preparing for exams, and MBBS students.

Dr. Mausumi Das writes the notes, draws the diagrams, and records the lectures herself.

Browse all ENT notes and lectures on The ENT Resident: https://www.theentresident.com/ent-notes-lectures.md

## Medical-use Boundary

The ENT Resident provides educational material for medical learning and revision. It does not provide patient-specific medical advice, diagnosis, or emergency care, and it is not a substitute for evaluation by a qualified healthcare professional.

## More Resources

- Learn about the Premium ENT Notes, preview a complete sample, and find purchase options: https://www.theentresident.com/premium.md
- Premium note for this topic, Brodsky Grading of Tonsillar Enlargement: https://theentresident.gumroad.com/l/tlipp
- Read student testimonials: https://www.theentresident.com/testimonials.md
- Contact The ENT Resident: https://www.theentresident.com/contact.md

---

A complete index of all pages on this site, with descriptions and markdown links can be found here: https://www.theentresident.com/llms.txt