Tonsillectomy and biopsy for asymptomatic asymmetric tonsillar enlargement: are we right?

The aim of this study was to evaluate the incidence of malignancy in patients with clinically asymmetrical tonsils and who are otherwise asymptomatic.

Retrospective review of our experience based on case note review, carried out in a district general hospital setting during a period of two years.

142 patients who had undergone tonsillectomy and biosy were included in the study. Histological studies of all these patients obtained and correlated with the clinical findings.

None of the patients with asymmetric enlargement of tonsils but are otherwise asymptomatic had shown histological evidence of malignancy. However all the 3 patients with associated suspicious symptoms in the presence of asymmetric tonsils were diagnosed as having tonsillar malignancy.

Tonsillar asymmetry in the absence of other associated risk factors may not indicate malignancy and a period of watchful waiting is considered appropriate prior to any surgical intervention.