An enlarged tonsil may indicate infection or irritation due to factors such as smoke or polluted air[3]. The swelling of the tonsils and adenoids can have various causes, including exposure to viruses, bacteria, fungal and parasitic infections, as well as cigarette smoke[1]. In some cases, individuals naturally possess larger tonsils[3]. While not always symptomatic, severe enlargement can partially obstruct the throat and interfere with breathing. Additional indicators of an enlarged tonsil include difficulty in nasal breathing, mouth-breathing patterns, noisy respiration during sleep (i.e., snoring), obstructive sleep apnea syndrome (OSAS), restless sleeping habits leading to daytime fatigue/sleepiness symptoms; frequent runny nose conditions; repeated ear/sinus infections; eating difficulties in young children; and halitosis [3].
What are tonsils and what are their functions?
Tonsils are a crucial component of the body's immune system, serving as an initial line of defense against inhaled or ingested pathogens. These lymphoid tissue aggregates, located near the entrance of both the respiratory and digestive tracts, play a pivotal role in our immunity by preventing germs from entering through the mouth or nose. Additionally, tonsils contain high concentrations of white blood cells that effectively eliminate harmful microorganisms. The various types of tonsils include palatine tonsils (tonsilla palatina), adenoids (pharyngeal tonsil or tonsilla pharyngealis), lingual tonsil (tonsilla lingualis), and tubal tonsils[9].
Additional symptoms with an enlarged tonsil
Other things that can make your tonsils swell and look larger include allergies, exposure to irritants such as secondhand smoke and pollution in the air, and gastroesophageal reflux[3].
Diagnostics with an enlarged tonsil
To diagnose an enlarged tonsil, the physician initially inquires about the presenting symptoms. Subsequently, a thorough examination of the throat is conducted to assess both the size of the tonsils and any accompanying airway constriction. Additionally, evaluation of the child's ears may be performed to ascertain whether there is splenomegaly (a potential indicator of mononucleosis, which can cause inflammation of the tonsils). In some cases, a throat swab may also be administered to test for streptococcal bacteria.
Treatment of an enlarged tonsil
Enlarged tonsils may not necessarily warrant intervention. However, if they are abnormally large and causing symptoms, treatment becomes imperative. Treatment modalities encompass the use of antibiotics, surgical removal or a combination of both. Surgical intervention for enlarged tonsils is deemed necessary when their size impedes airflow (obstructive sleep apnea), leads to chronic mouth breathing or dental complications, or when infections become recurrent and severe in nature. While tonsillitis (infection of the tonsils) commonly affects preschool children through mid-teens, it can also manifest in adults. Infections that do not respond adequately to therapy or occur frequently (at least five times per year over consecutive years) are categorized as chronic and require surgical attention only if they are bacterial in origin and have become recurrent or persistent[10].
Citations:
[1] https://www.childrenshospital.org/conditions/enlarged-tonsils-and-adenoids
[2] https://www.mayoclinic.org/diseases-conditions/tonsillitis/diagnosis-treatment/drc-20378483
[3] https://www.healthline.com/health/tonsillar-hypertrophy
[4] https://www.theatlantic.com/health/archive/2014/08/almonds-demon-nuts/379244/
[5] https://www.ncbi.nlm.nih.gov/books/NBK279406/
[6] https://www.mayoclinic.org/diseases-conditions/tonsillitis/symptoms-causes/syc-20378479
[7] https://www.ncbi.nlm.nih.gov/books/NBK536881/
[8] http://www.sacvalleyorchards.com/almonds/insects-mites/possible-causes-of-gummy-nuts/
[9] https://www.ncbi.nlm.nih.gov/books/NBK539792/
[10] https://www.entkidsadults.com/ear-nose-throat/947-2/
[11] https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/tonsillitis
[12] https://www.npr.org/sections/codeswitch/2013/09/16/219402847/-almond-shaped-eyes-remarkably-exotic-yet-too-foreign
[13] https://my.clevelandclinic.org/health/body/23459-tonsils
[14] https://www.healthline.com/health/swollen-tonsils
[15] https://www.npr.org/sections/thesalt/2015/05/19/407760579/what-does-raw-mean-when-it-comes-to-almonds-you-might-be-surprised
[16] https://www.news-medical.net/health/Functions-of-Tonsils.aspx
[17] https://www.nationwidechildrens.org/conditions/enlarged-tonsils
[18] https://www.medicalnewstoday.com/articles/269468
[19] https://www.pristyncare.com/blog/functions-of-tonsils-pc0135/
[20] https://www.merckmanuals.com/home/children-s-health-issues/ear-nose-and-throat-disorders-in-children/enlarged-tonsils-and-adenoids-in-children
[21] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229803/
[22] https://www.livescience.com/62447-tonsils.html
[23] https://premierucchicago.com/posts/10-reasons-why-your-tonsils-may-be-swollen/
[24] https://www.ncbi.nlm.nih.gov/medgen/870336
[25] https://www.britannica.com/science/tonsil
[26] https://www.prevention.com/health/a28772189/swollen-tonsils/
[27] https://www.thermofisher.com/allergy/us/en/allergen-fact-sheets.html?allergen=almond
[28] https://www.healthline.com/health/tonsils-and-adenoids
[29] https://www.aafp.org/pubs/afp/issues/2010/0915/p669.html
[30] https://patient.info/news-and-features/what-do-tonsils-do
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