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Suggest Treatment For Chronic Tonsillitis

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Posted on Tue, 18 Feb 2014
Question: Hi - For about 6 months I noticed my LEFT tonsil is swollen - I have tried to take a picture but I couldn't (didn't work well) . the tonsil seems to stick out a bit and is about 50% bigger than my right Tonsil. it almost looks like I have extra cheek tissue on it . when I feel it with my finger that "extra tissue" it looks like a little circular bump I can squish all the way back in like it almost inverts. the Tonsil itself does feel bigger still than my left about 50% . When I get sick the one on the left hurts more than the one on the right- the tissue is the same color as the rest of the mucousal tissue. no white spots. I DID have an ENT looked at my throat - as he took some kind of pappilomma off of my Uvula in the back of my mouth - he never mentioned anything about my left Tonsil. I am 27 non smoker and NO tobacco use. I do have lupus. I am worried about Tonnsiler Cancer. . . does this sound concerning ?I get sore throats about once every 4 months - not to the point that it hurts but I can feel it. I don't remember post 6 months ago it being larger- but 6 months ago I started to worry about my health more . I know about 2 years ago I had REALLY bad bronchitis. otherwise until I got lupus after a pregnancy I was pretty darn healthy. I don't have ANY swollen lymph nodes I know the ENT checked those when I was in with Vestibular Neuritis about a month ago, and my CBC and BMP were PERFECT. (I get CBC , BMP checked every 3 months due to lupus) Please advice-
doctor
Answered by Dr. Sumit Bhatti (56 minutes later)
Brief Answer: There is no cause for worry. Detailed Answer: Hi, Thank you for your query. 1. There is normally a difference in the appearance of the tonsils. This difference is also evident during tonsillectomy, a procedure that I have performed on thousands of patients over the last two decades. 2. The tonsils are composed of spongy lymphoid tissue and hence may appear larger, even double the sze of the other and be compressed on pressure. 3. You seem to have a chronic tonsillitis. If there are more than 5-6 attacks of tonsillitis per year over 2-3 years, tonsillectomy may be considered. 4. Tonsil cancer is very rare. The papilloma which was removed should have been tested for HPV (Human Papilloma Virus) types 16 and 18. These viral subtypes are linked with Oropharyngeal Cancer. 5. With a regular follow up, Tonsil cancer will not be missed. It is good to hear that you do not smoke or use tobacco. This lessens the risk of Oropharyngeal Cancer. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sumit Bhatti (12 minutes later)
Would the Doctor have told me if I had the subtypes of 16 and 18? The only thing he said was everything looked good when the biopsy report came back - he didn't mention it.
doctor
Answered by Dr. Sumit Bhatti (23 hours later)
Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. It is likely that your doctor got a routine HPE (Histo Pathology Examination) done on the tissue that was removed. 2. The test for viral DNA would have been more expensive. 3. You may get a simple HPV test such as an OraRisk salivary diagnostic test done. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sumit Bhatti (6 hours later)
So are you saying because I did have a Pappiloma - I definatly have HPV?
doctor
Answered by Dr. Sumit Bhatti (6 hours later)
Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. No, there are many harmless types of HPV infection. 2. There are also other viruses such as the EBV (Ebstein Barr Virus) and so on 3. HPV infection has a worldwide prevalence. It is very common. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sumit Bhatti

Otolaryngologist / ENT Specialist

Practicing since :1991

Answered : 2685 Questions

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Suggest Treatment For Chronic Tonsillitis

Brief Answer: There is no cause for worry. Detailed Answer: Hi, Thank you for your query. 1. There is normally a difference in the appearance of the tonsils. This difference is also evident during tonsillectomy, a procedure that I have performed on thousands of patients over the last two decades. 2. The tonsils are composed of spongy lymphoid tissue and hence may appear larger, even double the sze of the other and be compressed on pressure. 3. You seem to have a chronic tonsillitis. If there are more than 5-6 attacks of tonsillitis per year over 2-3 years, tonsillectomy may be considered. 4. Tonsil cancer is very rare. The papilloma which was removed should have been tested for HPV (Human Papilloma Virus) types 16 and 18. These viral subtypes are linked with Oropharyngeal Cancer. 5. With a regular follow up, Tonsil cancer will not be missed. It is good to hear that you do not smoke or use tobacco. This lessens the risk of Oropharyngeal Cancer. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.