Lingual Tonsil Hypertrophy

Hypertrophied lingual tonsil

Presenting complaints:

34 years old female patient came with complaints of:

1. Pain in throat - 3 years (On and off)

2. Difficulty in swallowing - 3 years

History:

Patient gave previous history of undergoing tonsillectomy 6 years back.

On examination:

Throat: Lingual tonsils on both sides was found to be enlarged, reducing the space between the posterior third to tongue and uvula.

No cervical lymphadenopathy.

Clinical diagnosis : Hypertrophied lingual tonsils (compensatory following tonsillectomy)

Discussion:

Enlargement of lingual tonsils per se is very rare. It is commonly found enlarged in response to embedded foreign body like fish bone. Rarely it can also occur as compensatory enlargement following tonsillectomy. Recently laryngopharyngeal reflux has been
attributed to be one of the causative factors.

Management:

Since this mass was very large causing disturbance while swallowing it was operated.
Bleeding will be high because the whole mass is unencapsulated, and will have to be stripped out of the muscles of posterior 1/3 of tongue. Diathermy was liberally used to remove the mass.
Post operative recovery was uneventful.

Video laryngoscopy:

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