HSC Section 3 - Trauma, Critical Care and Sleep Medicine

Palatal Procedures for Obstructive Sleep Apnea

Fig. 1. ( A ) The Friedman palate position is based on visualization of the oral cavity. Palate grade I has visualization of the entire uvula and tonsils. Grade II has visualization of the uvula but not the tonsils. Grade III shows visualization of the soft palate, and grade IV reveals only the hard palate. ( B ) Tonsil size is graded from 0 to 4. Size 0 tonsils are surgically removed. Size 1 tonsils are tonsils hidden within the pillars. Size 2 tonsils are extending to the pillars. Size 3 tonsils are beyond the pillars but not the midline. Size 4 tonsils are touching in the midline. ( From Friedman M, Ibrahim H, Bass L. Clinical staging for sleep disordered breathing. Otolaryngol Head Neck Surg 2002;127:14–5; with permission.)

201