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Overgrown palatine tonsils are most often diagnosed in children, less often in adults. Bilateral almond overgrowth usually indicates an infection or allergy. On the other hand, enlarging just one tonsil may suggest much more serious conditions, including cancer. What are the causes and symptoms of an oversized tonsil? What is the treatment? Is it always necessary to excise the tonsils?

Overgrown palatine tonsilsare not a disease in the literal sense of the word, but a manifestation of the activity of the body's immune system. The tonsils are part of this system and they produce antigens that are used to produce antibodies - proteins that protect the body against microorganisms and allergens.

The tonsils are the first barrier that protects the respiratory system against pathogens, thus preventing the spread of germs and the development of diseases. However, if an infection does develop, the tonsils produce more antigens than usual and grow in size, letting you know that they are ready to fight the pathogens. After recovery, the tonsils shrink to their original size.

Overgrown tonsils - causes

The most common cause of bilateral tonsil hypertrophy is repeated inflammation, such as recurrent angina, inflammation of the paranasal sinuses and nasal mucosa. The cause of tonsil hypertrophy can also be allergens - food, inhalant, as well as bacteria that are a strong allergenic factor.

The causes of unilateral tonsil hypertrophy are much more serious.An enlargement of one tonsilcan indicate bacterial infections, tuberculosis, syphilis, fungal infection, and even lymphoma (cancer of the lymphatic system) or a tumor within the tonsils. Unilateral tonsil hypertrophy is often caused by Plautus-Vincent's angina.

Overgrown tonsils - symptoms

After opening the mouth, the tonsils, which are located between the anterior and posterior pharyngeal arches, should be practically invisible, hidden in the arched cavities of the mucosa. If they are overgrown, they often meet in the midline of the throat. In addition, there are:

  • difficulty swallowing;
  • voice timbre changed;
  • slurred speech (also called speechdumpling);
Important

Overgrown tonsils can lead to sleep apnea

Overgrown tonsils also cause difficulty breathing. If left untreated, they can even lead tosleep breathing disorders(SDB), which may contribute to hypoxia, lung changes, and even heart failure (in extreme cases, even cardiac arrest). hearts). SDB manifests itself:

  • non-rhythmic breathing during sleep;
  • loud snoring with episodes of apnea (pauses in breathing during sleep);
  • restless sleep and wake up in the middle of the night;
  • bedwetting for a child;
  • with an accelerated and irregular breathing rhythm;
  • tiredness, drowsiness, headaches during the day;

Overgrown tonsils - diagnosis

The otolaryngologist performs an anterior rhinoscopy (nose endoscopy) and a posterior rhinoscopy with the use of a mirror, which will reveal enlarged tonsils. In addition, it should be determined whether only the palatine tonsils are hypertrophied or also the pharyngeal tonsils.

Overgrown tonsils should be differentiated with nasal congenital defect, nasal polyps, nasopharyngeal cancer, and the presence of a foreign body.

Overgrown tonsils - treatment

When the tonsils are not very hypertrophied, pharmacological treatment can be applied (nasal glucocorticosteroids and immunostimulating therapy). In other cases, one of the following two procedures can be performed:tonsillotomyortonsillectomy.

Tonsillotomyis a procedure aimed at partial removal of overgrown tonsils. The indications for its implementation are symptoms of obstructive sleep apnea syndrome as well as difficulty swallowing and speech disorders.

In turn,tonsilectomyconsists in the complete removal (enucleation) of the palatine tonsils. It is performed in the case of:

  • recurrent inflammation of the palatine tonsils;
  • the necessity to collect the tonsil for examination in the case of suspected neoplastic growth;
  • obstructive sleep apnea;
  • necessity to gain access to the parochial space;

A cleft palate, even surgically repaired, may be a relative contraindication to surgery.

Tonsil removal

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ENT