Benign Palatine Tonsil Volume Variation Following Bilateral Tonsillectomy in Adults

Background There is a lack of data on normal size discrepancy in benign tonsils. The current school of thought for otolaryngologists is to remove tonsils that look clinically asymmetric on the basis of occult malignancy. However, many of these tonsils turn out to be benign after microscopic evaluation. The data in this article provide a reference range of size variation that can be seen in benign adult tonsils. Such new information can be incorporated into the surgeon's preoperative discussion with patients with respect to informed consent and patient reassurance. Methods A chart review was conducted to identify pathology-proven benign bilateral tonsillectomies in the adult population. The review timeframe was from January 2012 to December 2017 (inclusive). All patients underwent surgery in an Eastern Health facility in Newfoundland and Labrador, Canada. In total, 403 cases were identified that fulfilled the inclusion criteria. Results Out of the 403 cases studied, the average tonsillar volume was 42.81 cm³. When differentiating between men and women, it can be seen that men have a higher average tonsil size (52.4 cm³) than women (37.85 cm³). The average difference in tonsil volume for all cases was 24.3%, with a standard deviation of 19.2%. Moreover, for men, the average difference in tonsil volume was 24.2%, with a standard deviation of 19.74%. Similarly, for women, the average difference in tonsil volume was 24.36%, with a standard deviation of 18.94%. Conclusions Findings from this study show that, on average, benign tonsils can vary in size by approximately 24% and that such a difference does not necessarily indicate malignancy.