What is the cause of hypertrophia in asymmetric tonsils?

Asymmetric tonsillar hypertrophy is a condition, confirmed by physical examination, that can be found in every age group. The aim of this study was to compare each tonsil through macroscopic and microscopic assessment of specimens and reveal the reasons that cause one tonsil to grow more than the other.

The study was carried out with 93 patients who wereindicated for tonsillectomy in the authors' Clinic. Of these 93 patients, seven cases who had clinically asymmetric but pathologically symmetric tonsils were excluded from the study. The presence of microscopicintraepithelial abscess, Helicobacter pylori with Giemsa stain, Coccobacillus, fungus, Actinomyces with Pas-Grocott stain, dysplasia or hyperplasia, malignancy and reactive changes in the epithelium were evaluated.

The study was conducted with 86 patients aged between two and 35, of whom 32 were women (37.2%) and 54 were men (62.8%). The mean age of cases was 8.37 ± 5.95. The mean difference between two tonsils ranged from 1 to 12 mm, mean 3.67 ± 2.56 mm. When the findings were examined, the presence of H. pylori, Coccobacillus, fungus and Actinomyces, reactive changes in the epithelium, pattern of hyperplasia, intraepithelial abscess and macroscopic presence of pus did not reveal any statistically significant changes.

The reasons behind asymmetric tonsil hypertrophies and how they are related to malignancies have not yet been clarified. There is no statistically significant difference between the evaluated parameters in the present study. This study has brought a new point of view to the subject by comparing different-sized tonsils in the same person, thus paving the way for future studies with a broader scope.