Question: I have a unilaterally enlarged tonsil. I first noticed this a couple of months ago and went to an ENT who told me not to worry about it and that not all tonsils are the same size. Last week I went to a different ENT for a reflux related issue and he noticed the unilaterally enlarged tonsil and recommended surgery to biopsy and rule out cancer (squamous cell, lymphoma, etc.).

I certainly don't want to have this tonsillectomy surgery unless it is necessary but absolutely don't want to avoid the surgery then find out later that it is cancer. I am looking for a third opinion on this matter.

Does this look suspicious to you? It doesn't hurt. The Dr. checked my neck for swollen lymph nodes and said he didn't feel any, but I do worry about Lymphoma as my Grandfather had it. I can feel some lymph nodes in my neck but they feel the same on the other side. I also know that I have HPV but am not sure which type I have.

I have a very deviated septum and my good nostril is my right nostril (can't really breathe out of the other). My enlarged tonsil is my right tonsil. Could that be the cause of the unilateral enlargement?

I am very torn as to what I should do regarding this surgery as my wife is pregnant so I don't want to take any chances but also don't want to put both of us through a very painful/stressful surgery if it isn't necessary. Any advice?

Thank you so much for your reply. A few follow up questions:

1) you said opposite sode turbinates hypertrophy. Did you mean the same side? My good nostril is the right and the swollen nostril is the right... So they are on the same side. Assuming that's what you meant?

2) I am definitely dealing with LPR type reflux, especially in the mornings where I have to blow my nose and cough up mucus. I also snore. What you sre saying makes sense but due to my reflux of acid/pepsin shouldnt my other tonsil be at least a but swollen? Because one is so small and the other so big that makes me worry a lot, especially sth this ENT saying to biopsy.

3) How common / often do you see unilateral tonsil enlargement like this? When do you / don't you recommend surgery?

4) Does mine look suspicious in any way for squamous or lymphoma? I am strongly considering canceling the surgery but my wife is pregnant so i am very concerned about risking something.

5) My tonsil has been like this for at least 6 weeks possibly a lot longer as I hadnt looked before that. If I follow your protocol and it does not decrease in size after a certain amount of time would I then need surgery? How quickly should that treatment help? If my LPR reflux continues despite treatment would that keep the enlargement?

Sorry for so many questions but this is a big decision! Thanks!!!