Tonsil Issues: When to Seek Further Medical Advice - Otolaryngology

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Tonsillar oral issues?


Hello Dr.
Tseng,
It has been a week since my last inquiry (#148970), and I have finished the medication.
My throat and the area around my tonsils have not improved.
The area circled in black in the image feels swollen, and there seems to be a raised, soft, granular mass.
I used a cotton swab to check it, and it feels soft rather than hard.
The area marked in red still feels like there is something inside.
I am unsure if I should see a doctor again since I am currently abroad, and the doctor only prescribed antibiotics and anti-inflammatory medication.
I would like to know if there is a possibility that I might have a tumor or some lesions.
The area is not very painful, just slightly uncomfortable, but I am worried about the swelling.

As for the discomfort in my left oral cavity, it has been ongoing for over seven months without improvement, making it hard for me to feel reassured that there is no issue.
At the end of May, I had a CT scan of my head and neck with contrast, which showed no abnormalities.
In June, I also underwent a head MRI in neurology, which also showed no issues.
Is the area in the image considered part of the tonsils? If it remains red for an extended period, does it increase the risk of cancer? Recently, I have also noticed an unusual taste in my saliva or bad breath, and I can't quite distinguish between the two.

I hope you can provide some insight based on the photo.
I feel quite embarrassed to keep bothering you, but I am very grateful for your help.
Thank you.

[Link to image]

Ms. Chen, 40~49 year old female. Ask Date: 2019/08/14

Dr. Zheng Jueyi reply Otolaryngology


Hello: Upon initial examination, the tonsils appear normal.
If there are no obvious ulcers or pain, you may observe them for now.
If you have concerns, you can seek medical evaluation for confirmation.
Wishing you safety and health.
Sincerely, Dr.
Cheng Jue-Yi, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2019/08/14

More Info


When it comes to tonsil issues, especially when there are persistent symptoms such as swelling, discomfort, or unusual growths, it is crucial to seek further medical advice. Your concerns about the enlarged area around your tonsils, especially given the presence of soft, raised spots and a lingering feeling of discomfort, warrant a thorough evaluation by a healthcare professional.

Tonsils are part of the lymphatic system and play a role in the immune response. They can become inflamed or infected, leading to conditions such as tonsillitis. Common symptoms of tonsillitis include sore throat, difficulty swallowing, and swollen tonsils. However, when symptoms persist despite treatment with antibiotics, as you mentioned, it raises the question of whether there might be an underlying issue that needs to be addressed.

Based on your description, the fact that you have already completed a course of antibiotics without improvement suggests that the issue may not be purely infectious. The presence of soft, raised areas could indicate several possibilities, including chronic inflammation, the formation of tonsil stones (which can occur when debris becomes trapped in the tonsils), or, in rare cases, more serious conditions such as tumors or malignancies.

While it is understandable to feel anxious about the possibility of a tumor or cancer, it is essential to remember that many tonsil-related issues are benign. However, given the duration of your symptoms—particularly the discomfort on the left side of your mouth that has persisted for over seven months—it is advisable to pursue further medical evaluation. A healthcare provider may recommend additional imaging studies, such as a repeat CT scan or an ultrasound, to assess the area more closely. They may also consider a referral to an ear, nose, and throat (ENT) specialist for a more comprehensive examination.

Regarding your concerns about the potential for cancer, chronic irritation or inflammation of the tonsils can lead to changes in the tissue, but this does not necessarily mean that cancer will develop. However, persistent symptoms, especially those that do not respond to treatment, should not be ignored. Early detection is key in managing any potential malignancy, so it is better to err on the side of caution.

In terms of the bad taste or odor in your mouth, this could be related to several factors, including poor oral hygiene, the presence of tonsil stones, or even gastroesophageal reflux disease (GERD). Addressing these issues with your healthcare provider can help improve your overall oral health and alleviate some of your concerns.

In summary, it is important to follow up with a healthcare professional, especially given the persistence of your symptoms and the lack of improvement after antibiotic treatment. Do not hesitate to seek a second opinion or request further testing to ensure that any potential issues are identified and managed appropriately. Your health and peace of mind are paramount, and addressing these concerns proactively is the best approach.

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