Asymmetric Tonsil Size
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| In the photo above, it is seen that the right tonsil is larger and more medially located in the patient with tonsil asymmetry. It has been observed that there are deep crypt pits on the surfaces of the tonsils and at the same time, tonsil stones occur from time to time in the patient. It was determined that the tonsil asymmetry in the patient had been present for about 25 years (according to the patient's own story), and there was no change in the tonsil dimensions during the follow-up of the patient. |
Why Can Tonsils Be Asymmetrical?
In patients with tonsil asymmetry, the problem is usually structural. The problem here is not only the size difference between the tonsils, but also the different locations of the tonsils. In some patients, although rarely, one tonsil may become larger than the other. However, in this case, as physicians, it is necessary to investigate whether there is an underlying neoplastic problem in case of increasing tonsil asymmetry. In other words, the asymmetric growth of the tonsils over time and the subsequent emergence of tonsil asymmetry cause physicians to suspect tonsil neoplasms. In a tonsil asymmetry that has been present since birth, if there is no change in the shape of the tonsils over time, there is usually no cause for concern.
Asymptomatic Tonsil Asymmetry
The situation where the tonsils are different in shape and size without causing any symptoms (asymptomatic tonsil asymmetry) is a situation that many otolaryngologists face. No part of our body is fully symmetrical with the other. However, in the case of asymmetric tonsillar enlargement over time, if a tonsillar enlargement without fever, sore throat, malaise with symptoms of tonsillitis is present in the patient, tonsillectomy may be required for diagnosis and differential diagnosis. Symptoms such as weight loss, ear pain, and fatigue in tonsil cancers usually occur in the late period. For example, in tonsillar lymphoma, only unilateral tonsil enlargement may be the first symptom, and other symptoms, enlargement of the lymph nodes in the neck, may also be seen in the later period. When there is unilateral tonsillitis, asymmetrical enlargement of the tonsils may occur, however, fever, redness of the tonsils, sore throat and weakness, regression of existing complaints within a few days, and the reinstatement of tonsil size show that the existing disease consists of a simple infection. In other words, in case of asymptomatic and asymmetric tonsil enlargement, it would be best to consult an otolaryngologist.
In Which Situation Is Tonsil Asymmetry A Sign of a Dangerous Disease?
Below, I would like to briefly summarize the situations that should be considered in case of tonsil asymmetry or asymmetric tonsil enlargement:
- In addition to the symptoms of infection such as sore throat, fever, weakness and malaise, the enlarged tonsil is seen as red during the examination, the enlarged and reddened tonsil gradually returns to its former state and color in the follow-up of the patient, and the patient's complaints disappear, in the diagnosis "simple tonsillitis infection". brings to mind
- If the patient has symptoms such as a gradual enlargement of a tonsil, decrease in appetite, earache, necrosis on the surface of the tonsils, regular enlargement of a tonsil size in the follow-up of the patient, prominence of lymph nodes in the neck, neoplastic, such as tonsil cancer, without fever, fatigue and sore throat. a disease can be considered in the preliminary diagnosis. In this case, tonsillectomy operation can be planned for diagnosis and treatment.
Is Treatment Necessary in Tonsil Asymmetry?
As I mentioned briefly above, if the patient has redness, pain in the asymmetric or large tonsil area, and if the patient has signs of infection, medical treatment and follow-up can be planned. Sometimes only due to viral infection, a reddened tonsil may not be accompanied by high fever, but infection symptoms that have been present for a few days can be noticed in the patient's anamnesis. In some patients, a throat culture may be planned prior to medical treatment.
Care should be taken in patients with progressively increasing asymmetry of the tonsils or asymmetrical changes in the shape of the tonsils and without symptoms in the initial period. Some patients may present with only earache and weight loss, and other symptoms of tonsillar cankers may go unnoticed. You can view the photos by clicking on the tonsil cancer link in the similar links below. In other words, it is appropriate for an otolaryngologist to evaluate the patient in asymptomatic and increasing tonsil asymmetry.
How Should Follow-Up Be Done in Asymptomatic Tonsil Asymmetry?
If your tonsils are asymmetrical and you have just noticed, you can consult an otolaryngologist if you have signs of infection. If you find that your tonsils are quite asymmetrical without any complaints, an important question is "how long has it been like this?" it is. If you've been this way for a long time, you don't have to worry. You can take a photo with your mobile phone for tracking purposes, turning on the flash and focusing your tonsils. You can repeat this photo every 6 months or 1 year and if there is no difference in size, it's fine. In case of increasing asymmetrical asymptomatic tonsil enlargement, you should consult an otolaryngologist without delay.If your tonsils are asymmetrical and you have just noticed, you can consult an otolaryngologist if you have signs of infection. If you find that your tonsils are quite asymmetrical without any complaints, an important question is "how long has it been like this?" it is. If you've been this way for a long time, you don't have to worry. You can take a photo with your mobile phone for tracking purposes, turning on the flash and focusing your tonsils. You can repeat this photo every 6 months or 1 year and if there is no difference in size, it's fine. In case of increasing asymmetrical asymptomatic tonsil enlargement, you should consult an otolaryngologist without delay.
In Tonsil Asymmetry, How Do The Symptoms Occur If There Is Tumor Tissue In The Tonsil?
When there is a tumoral mass in the tonsil, only unilateral tonsil enlargement may be the only symptom in the initial period. Over time, when the tumoral tissue spreads locally or peripherally, weight loss, bleeding from the tonsils, earache, bad breath, enlarged lymph nodes in the neck, decreased appetite and fatigue may occur. Normally, infection symptoms such as sore throat, redness of the tonsils and fever are not usually seen in the initial period of tonsil cancers.
Unilateral Chronic Tonsil Inflammation
In some patients, tonsil infections may occur only unilaterally. In this case, patients may apply to clinics with symptoms such as unilateral sore throat, pain in the ear while swallowing, hyperemia in the unilateral tonsils, and fever. Patients may have typical signs of infection. In bacterial tonsil infections, fever may be in the foreground; In viral tonsillitis, fever may increase less and muscle pain may be seen. In some patients, unilateral chronic tonsillitis can be seen without fever. Although the size of the tonsils increases when there is an infection; Over time, a decrease in tonsil size and increased surface changes can be seen on the tonsil surfaces. Medical treatment and throat culture may be necessary.
Tonsil Surgery Techniques
Various techniques and devices are used during tonsil surgery. Except for the techniques with high mucosal damage such as cautery, electrocautery, radiofrequency applications, old techniques such as cold knife, dissection ans method, scalpel or scissors with a high risk of bleeding, modern methods that use thermal welding and plasma technology to reduce bloodless and heat damage considerably, Techniques such as laser that are bloodless but have high heat damage can be used. You can watch 4 thermal welding tonsillectomy videos below.
Thermal welding tonsillectomy video 1
Thermal welding tonsillectomy video 2
Thermal welding tonsillectomy video 3
Thermal welding tonsillectomy video 4
In Which Situation Is Tonsil Biopsy Required In Patients With Tonsil Asymmetry?
If the size of the tonsils gradually increases unilaterally, if there is no other symptom other than the increase in size, it is ideal for the patient to apply to an otolaryngologist for examination. If signs of infection are also present, it is appropriate to recommend oral feeding and support foods, use local anti-inflammatory drugs and oral antipyretics. In case of fever lasting longer than 2 days, it is appropriate to consult a physician and use antibiotics if necessary. Asymptomatic and asymmetric tonsil enlargement can be a sign of some neoplastic diseases (lymphoma, tonsil tumor, tumoral metastasis) that should be taken seriously.
Similar links >> Tonsils and Adenoids / Tonsil Cancer - Causes, Symptoms, Diagnosis and Treatment
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon
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Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
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