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Symptoms and courseThe palatine tonsils are an oval-shaped formation of lymphoid tissue located symmetrically on either side of the throat between the palatine arches. The tonsils are part of the immune system and the body's first important barrier against the entry of germs into the lower respiratory tract.
Pirquet Scale - Symptoms and course
Every infection of the upper respiratory tract is accompanied by a reactive, temporary enlargement of the lymphatic system and frequent recurrence of infections stimulates the tonsils to permanent hypertrophy causing breathing, speech or swallowing disorders.
The size of the tonsils is assessed in comparison with the transverse dimension of the middle pharynx using the Pirquet scale.
There are five grades of the scale:
- Small tonsils hiding between the arches.
- Adenoids reaching up to the height of the palatopharyngeal arches.
- Tonsils slightly exceeding the line of the palatopharyngeal arches.
- The tonsils occupy at least half the width of the oral part of the pharynx.
- The palatine tonsils meet each other at the posterior wall of the pharynx.
Using a conventional scale allows the size of the palatine tonsils to be objectively assessed. However, it is not size alone that determines the need for complete removal (tonsillectomy) or partial undercutting of the tonsils (tonsillotomy). An absolute indication for surgery is the presence of obstructive apnoea during sleep, and a relative indication is hypertrophy that makes speech or swallowing difficult.
