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Tonsillectomy for one enlarged tonsil ?

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Hi. I went to see an ENT consultant today after my GP referred me urgently, on account of my having one enlarged tonsil and, periodically, the sensation of a lump in my throat (the swollen tonsil has been present for approx 12-18 months, and I first noticed the lump symptom about 4 months ago). The swollen tonsil also has several crypts. After examining me, the ENT consultant I saw today said that he doesn't think I have anything to worry about, because I don't have any swollen lymph nodes in my neck and no other symptoms. However, he then offered me a tonsillectomy! He said this was basically for my benefit rather than his and that it depends how much the swollen tonsil is bothering me. I said that if he thinks it's nothing to worry about, then obviously I don't want an operation. He's asked me to go back and see him in 2 months time. I've been left very confused by all this!! Would you recommend a tonsillectomy in these circumstances or not?

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replied August 13th, 2010
Ear, Nose and Throat Disorders Answer A15238
Hi, welcome to the ehealth forum and I am glad to help you.
You seem concerned about tonsillectomy. Tonsillectomy may be indicated when the patient:
1.Experiences recurrent infections of acute tonsillitis. The number requiring tonsillectomy varies with the severity of the episodes. One case, even severe, is generally not enough for most surgeons to decide tonsillectomy is necessary. According to the current guidelines (2000) of the American Academy of Otolaryngology & Head and Neck Surgery (AAO-HNS), tonsillectomy is indicated if a patient contracts "Three or more attacks of sore throat per year despite adequate medical therapy”.
2.Has chronic tonsillitis, consisting of persistent, moderate-to-severe throat pain.
3.Has multiple bouts of peritonsillar abscess.
4.Has sleep apnea.
5.Has difficulty eating or swallowing due to enlarged tonsils (very unusual reason for tonsillectomy)
6.Produces tonsilloliths (tonsil stones) in the back of their mouth.
7.Has abnormally large tonsils with crypts.
As far as your case is concerned indication number 7 may solve your confusion and accordingly you might benefit from tonsillectomy.
Hope this helps. Take care.
Note: This post is not to emphasise final diagnosis as the same cannot be made online and is aimed just to provide medical information and no treatment suggested above be taken without face to face consultation with health care professional.

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