Pierce B, et al. - Using polysomnography and/or quality of life outcomes, researchers systematically reviewed the biomedical literature for data comparing subjective preoperative tonsil (and adenoid) size (0- to > 4-point scale) with adenotonsillectomy outcomes. From June 1, 2018, through November 1, 2018, a PubMed and Embase search was carried out to identify articles comparing preoperative subjective tonsil and adenoid size with surgical outcomes. Twenty-three of the 27 studies concluded that there was no connection between the preoperative tonsil and adenoid size and successful surgical outcome, while four studies found that an association existed. The results indicate that tonsil size alone should not be used in pediatric patients as a key component of clinical decision-making for adenotonsillectomy as it is not a reliable indicator of surgical success.