In Reply Thank you for providing us the opportunity to respond to the letter from Drs Friedman and Hwang, in reference to our recent publication.1 We appreciate their interest in this work. We recognize their concern that this study was performed in a pediatric population and therefore conclusions should have been limited to this population. Specifically, based on our work, the Brodsky scale2 would seem to be the most reliable tonsil grading scale for future clinical and research work involving children. The question of whether an alternative scale, such as the Friedman scale,3 would be more reliable in adults was not directly addressed in our study.