Persistent Swelling of Right Tonsil: When to Worry?

The right tonsil is more swollen?

A month ago, I noticed that the right side of my tonsil was swollen, and I experienced pain in my throat on the right side when swallowing saliva.
I visited a doctor who said it was just inflammation and prescribed anti-inflammatory medication.
After finishing the medication, my throat pain resolved, but the right tonsil has not completely reduced in size, although it is no longer painful.
Could there be any issues with this?

77, 10~19 year old female. Ask Date: 2018/02/08

Dr. Ji Zhaoyun reply Otolaryngology

Hello, regarding your question about the tonsils, it is possible for them to be of different sizes on each side, but medical evaluation is necessary.
An otolaryngologist (ENT specialist) should determine whether this is simply a size difference or swelling, as there can be several underlying causes, including: 1) Enlarged tonsils affecting breathing or conditions such as obstructive sleep apnea; 2) The presence of a malignant tumor; 3) Recurrent tonsillitis, which is internationally recognized as a) more than 7 episodes of tonsillitis within one year; b) more than 5 episodes per year for two consecutive years; c) more than 3 episodes per year for three consecutive years.
If any of these criteria are met, tonsillectomy may be recommended.
If it is merely an infection, general care advice includes rinsing your mouth after eating to help clear out any tonsil stones (located in the tonsillar crypts) and avoiding colds.
If you do catch a cold, seeking medical attention promptly can help reduce the chances of tonsillitis.
It is still advisable to consult an ENT specialist to rule out the aforementioned conditions.
Wishing you health and safety.
Sincerely, Dr.
Chi Chao-Yun, Head of ENT Department, Taichung Hospital, Ministry of Health and Welfare.

Reply Date: 2018/02/08

More Info

When it comes to persistent swelling of the tonsils, particularly if it has lasted for a month, it is important to pay attention to the symptoms and seek further medical evaluation if necessary. In your case, you mentioned that you noticed swelling in your right tonsil, experienced pain while swallowing, and were prescribed anti-inflammatory medication by your doctor, which alleviated the pain but did not completely resolve the swelling.
Tonsil swelling can occur for various reasons, including infections (viral or bacterial), allergies, or other underlying conditions. The fact that your pain has subsided is a positive sign, but the persistent swelling raises some questions. Here are a few considerations:
1. Infection: The initial swelling and pain could have been due to an infection, such as tonsillitis. If the infection was viral, it might take longer for the swelling to resolve. Bacterial infections, on the other hand, may require antibiotics, and if the swelling persists despite treatment, it could indicate that the infection was not fully resolved or that there is another underlying issue.

2. Chronic Tonsillitis: Sometimes, individuals can experience chronic tonsillitis, where the tonsils remain swollen and inflamed over a long period. This condition can lead to recurrent infections and discomfort.

3. Abscess Formation: In some cases, an abscess can form around the tonsils, known as a peritonsillar abscess. This condition can cause significant swelling and may require drainage or surgical intervention. Symptoms may include severe pain, difficulty swallowing, and a "hot potato" voice.

4. Other Conditions: Persistent swelling could also be a sign of other conditions, such as allergies, tumors, or even lymphatic issues. While these are less common, they should not be overlooked, especially if the swelling continues without improvement.

5. Monitoring Symptoms: It is crucial to monitor any additional symptoms that may arise, such as fever, difficulty breathing, changes in voice, or any new pain. If you experience any of these symptoms, it is essential to seek medical attention promptly.

Given that your tonsil swelling has not resolved after a month, it would be advisable to follow up with your healthcare provider. They may recommend further evaluation, which could include a physical examination, imaging studies, or even a referral to an ear, nose, and throat (ENT) specialist for a more thorough assessment.

In summary, while the absence of pain is a good sign, persistent swelling of the tonsil warrants further investigation to rule out any serious underlying conditions. It is always better to err on the side of caution when it comes to health concerns, especially those that persist over time.

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