I started getting small tonsil stones recently, and one tonsil is slightly larger. Is this normal?

Hi,

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I have gone through the attached picture (attachment removed to protect patient identity). There is an allergic component and it requires proper precautionary and medical treatment. Do not take Zyrtec (Cetirizine) for a long period of time. The tonsils get enlarged due to chronic throat infections secondary to allergy. One tonsil larger than the other will not pose too much worry unless they are too disproportionately enlarged. Removal is needed when you have recurrent sore throats associated with fever. Having a positive streptococcal culture and inflamed tonsils of grade three cause oropharyngeal luminal obstruction and it potentiates obstructive sleep apnea. The cause of mouth breathing with or without snoring should be found. Enlarged adenoids can cause it with congested nasal passages. This causes disturbance in the ears. Regarding tonsils, there is nothing to worry. Stop taking Zyrtec and you can take topical nasal spray such as Duonase (Fluticasone propionate and Azelasrine). It causes reduced systemic absorption and side effects. You need to stay away from dust and other triggering factors by wearing an N95 mask as medications do not contribute for the long term in the treatment of allergy.