What is tonsil hypertrophy?

Tonsillar hypertrophy is the medical term for persistent enlargement of the tonsils. The tonsils are two small glands located on either side of the back of the throat. They are part of your immune system and help fight infections that may be caused by bacteria, viruses, and other germs that enter your body through your nose and mouth.

Enlarged tonsils may be a sign of infection or irritation such as smoke or polluted air. Some people are born with larger tonsils. In other cases, there is no known cause.

Enlarged tonsils are particularly common in children but can affect adults as well. Children usually develop enlarged tonsils, but the condition can affect adults as well. Children's tonsils are typically larger than those of adults because their bodies are busy fighting off colds and other viruses common in childhood. Large tonsils often become smaller on their own as children age.

What are the symptoms?

Enlarged tonsils don't always cause symptoms. However, if they are very large, they can partially block your throat and affect your breathing.

Other possible signs and symptoms of enlarged tonsils include:

  • Difficulty breathing through the nose
  • breathe through mouth
  • noisy breathing
  • Snoring loudly
  • obstructive sleep apnea
  • restless sleep
  • daytime sleepiness
  • Frequent runny nose
  • recurring ear or sinus infections
  • Young children have difficulty eating
  • Bad breath

What causes tonsil enlargement?

Enlarged tonsils often affect children, but experts aren't sure why. Some children are simply born with larger tonsils. There may also be a genetic link, as tonsil enlargement often runs in families.

In children and adults, enlarged tonsils may also be a sign of an underlying bacterial or viral infection, such as:

  • Pharyngitis
  • cold
  • mononucleosis
  • influenza

These infections share some common symptoms, including:

  • sore throat
  • fever
  • fatigue
  • swollen glands in the neck

Other things that can make your tonsils swell and appear larger include:

  • allergy
  • Exposure to irritants such as second-hand smoke and air pollution
  • gastroesophageal reflux

How is it diagnosed?

It's best to have painful enlarged tonsils checked by your doctor to rule out an underlying infection that needs treatment. Young children with large tonsils should see a doctor if they have trouble sleeping or feeding, even if they don't seem to be in pain. They will first review your medical history and ask you if you have any other symptoms. They may also feel for any signs of swelling around your neck.

Depending on your symptoms, they may also order a throat culture. This involves swabbing the back of the throat and testing the tissue for signs of bacterial infection. You may also need X-rays to give your doctor a better understanding of the soft tissues in your neck.

If you have trouble sleeping or snoring, your doctor may also recommend a sleep study to check for sleep apnea caused by enlarged tonsils. To do this, you usually stay overnight in a specially designed laboratory while your doctor monitors your breathing and other vital signs.

How is it treated?

Enlarged tonsils usually only require treatment if they interfere with your ability to sleep, eat, or breathe. However, if it's caused by an underlying infection, you may need antibiotics. If it's due to allergies, your doctor may recommend using a nasal corticosteroid spray or taking an antihistamine to help relieve symptoms.


If your enlarged tonsils are interfering with your breathing and are not due to any underlying disease, you may need to have them removed surgically. This helps improve symptoms of obstructive sleep apnea in adults and children. Surgery to remove the tonsils is called a tonsillectomy.

During a tonsillectomy, your doctor may also remove your adenoids, which are two glands located in the back of your nose near the roof of your mouth.

A tonsillectomy is a simple surgery performed under general anesthesia. Most people go home the same day as surgery and make a full recovery within 7 to 10 days.

possible complications

When enlarged tonsils cause sleep apnea and difficulty sleeping, if left untreated, it can lead to a host of complications, especially in children.

These include:

  • Heart and lung diseases, such as pulmonary hypertension or enlarged heart
  • trouble at school
  • behavioral problems
  • often sick

follow up

If you or your child have symptoms of swollen tonsils, see your primary care doctor or otolaryngologist. Depending on the underlying cause and whether enlarged tonsils interfere with your breathing, you may need antibiotics or surgery to remove your tonsils.


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