Should You Remove Enlarged Tonsils? Risks and Benefits

One tonsil is larger than the other?

Hello, doctor.
I have had enlarged tonsils since childhood, but I haven't experienced any significant issues over the years.
My left tonsil has always been slightly larger, and every time I see a doctor, they mention that it is too large and suggest surgery to remove it.
Today, due to long-term nasal allergy issues, I visited an ENT specialist.
The doctor examined my throat and rated my tonsils on a scale of 0 to 4, stating that my left tonsil is at a level 4, while the right is at a level 2.
The doctor recommended surgery to remove them to check for any tumors or related issues.
Since I do not have any pain, discomfort, or inflammation, I consulted with a relative who is a doctor, and they mentioned that having large tonsils does not necessarily mean they need to be removed if they are not causing any problems.
I would like to ask your opinion on whether you think I should proceed with the surgery.
What are the potential effects of having my tonsils removed?

Miss Lin, 30~39 year old female. Ask Date: 2020/07/17

Dr. Zheng Jueyi reply Otolaryngology

Hello, if there are no recurrent acute tonsillitis, tonsil stones, or symptoms of snoring, tonsil hypertrophy can be monitored through self-observation.
If any of the above symptoms occur, surgical removal is recommended.
Generally, there are no significant long-term complications after the procedure.
Wishing you safety and health.
Sincerely, Dr.
Jue-Yi Cheng, Director of the Department of Otolaryngology, Taoyuan Hospital, Ministry of Health and Welfare.

Reply Date: 2020/07/17

More Info

When considering whether to remove enlarged tonsils, it's essential to weigh the potential risks and benefits carefully. Enlarged tonsils, or tonsillar hypertrophy, can be a common condition, especially in children, but they can also persist into adulthood. In your case, it seems that your left tonsil is significantly larger than the right, which has raised concerns from your ENT specialist.

Reasons for Tonsillectomy
1. Obstruction: Enlarged tonsils can obstruct the airway, leading to sleep apnea, which is characterized by interrupted breathing during sleep. This can result in poor sleep quality, daytime fatigue, and other health issues.

2. Recurrent Infections: If you experience frequent tonsillitis or throat infections, removal of the tonsils may reduce the frequency of these episodes.

3. Difficulty Swallowing or Breathing: If the size of the tonsils is causing difficulty in swallowing or breathing, surgery may be recommended.

4. Suspicion of Malignancy: As your doctor mentioned, if there is any suspicion of tumors or other abnormalities, a tonsillectomy may be necessary for diagnosis and treatment.

Risks of Tonsillectomy
1. Surgical Risks: As with any surgery, there are risks involved, including bleeding, infection, and reactions to anesthesia.
2. Postoperative Pain: Tonsillectomy can be quite painful, especially in the first few days after surgery. Pain management is crucial during recovery.

3. Changes in Immune Function: Tonsils are part of the immune system, and their removal may have some impact on immune function, although this is generally minimal in healthy individuals.

4. Potential for Complications: While rare, complications such as dehydration, changes in voice, or issues with swallowing can occur.

Benefits of Keeping the Tonsils
1. Immune Function: Tonsils play a role in the immune system, helping to fight infections. Removing them may slightly affect your body's ability to respond to certain pathogens.

2. No Symptoms: If you are not experiencing any symptoms such as pain, difficulty breathing, or recurrent infections, it may be reasonable to monitor the situation rather than proceed with surgery.

3. Quality of Life: If your enlarged tonsils do not interfere with your daily activities or quality of life, you might choose to avoid surgery.

Conclusion
Ultimately, the decision to remove enlarged tonsils should be made in consultation with your healthcare provider, considering your specific circumstances. If your tonsils are not causing any significant issues and there are no signs of malignancy, it may be appropriate to adopt a watchful waiting approach. However, if your ENT specialist has recommended surgery due to the size of your tonsils and potential complications, it is essential to discuss all your concerns and options thoroughly with them.

If you decide to proceed with the surgery, ensure you understand the postoperative care and recovery process. If you opt to keep your tonsils, regular monitoring and communication with your healthcare provider will be crucial to manage any future issues that may arise.

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