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79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

30.04. - 04.05.2008, Bonn

How is exhaustion due to chronic tonsillitis reflected in the Epworth and Stanford Sleepiness Scales?

Meeting Abstract

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  • corresponding author Bernhard Roth - ENT-Departement, University of Hamburg, Hamburg, Germany
  • Katja Vogeler - Bundeswehrkrankenhaus Hamburg, Hamburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 79th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Bonn, 30.04.-04.05.2008. Düsseldorf, Köln: German Medical Science; 2008. Doc08hno94

The electronic version of this article is the complete one and can be found online at:

Published: July 8, 2008

© 2008 Roth et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: The Epworth Sleepiness Scale (ESS) and Stanford Sleepiness Scale (SSS) are commonly used methods to determine the degree of daytime sleepiness on a standardised scale for sleep-related respiratory disorders (SRRD) and other sleep disorders. Chronic tonsillitis is also accompanied by a typical feeling of exhaustion. So far, however, there have been no findings as to which impact chronic tonsillitis has on the EES and SSS results.

Method: 15 randomly selected patients who underwent tonsillectomy (TE) due to chronic tonsillitis were interviewed with EES and SSS questionnaires one day prior to the TE and 2 weeks after surgery. SRRD was excluded with polygraphy. The patients' case histories and examinations did not indicate any other inflammatory disease.

Findings: Prior to surgery the EES value showed a significant increase (mean value: 13). Only 2 weeks after the TE the daytime sleepiness value had dropped considerably (mean value: 5). Prior to the TE most of the patients stated that they were "awake, but relaxed; responsive but not fully alert"; 2 weeks after surgery most of the patients responded that they were "active, vital, alert, or wide awake".

Conclusion: Chronic tonsillitis is accompanied by a significantly increased tendency to fall asleep (measured with the ESS scale) and increased daytime sleepiness (measured with the SSS scale). These results are not only vitally important when interpreting the EES and SSS results with differential diagnosis, but also when evaluating surgical success, for instance, of an Uvulavelatopharyngoplastie with TE with the help of ESS and SSS questionnaires.