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HomeAnswersOtolaryngology (E.N.T)tonsilsWhat can be the cause for unilateral tonsil enlargement?

I have an unilateral tonsil enlargement. Why is it so?

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Nithila. A

Published At June 9, 2019
Reviewed AtDecember 26, 2023

Patient's Query

Hello doctor,

I am a 33-year-old male with no significant medical history aside from essential tremors treated with Inderal 120 mg, and anxiety treated with Venlafaxine 75 mg. Three months before, I consulted an ENT doctor because of an unilateral (right) tonsil enlargement. I am attaching a photo of what it looked like at that moment. Upon clinical examination, my doctor was not worried and suggested to monitor the volume of the tonsil in the upcoming year. I had underwent adenoidectomy during childhood. In the last few months, I have noticed that the same tonsil has gained in volume and now appears round, red and more swollen than before. It is not painful when I swallow, but I have the sensation that something is stuck in my throat (most probably a collateral effect of edema). I am attaching another photo of what it looks like today. I do not feel any lumps in my neck. I have an appointment to see my ENT again, but it is only in one month from now. Being a big fan of catching things early I am a bit worried about waiting another month. Could you please give me your opinion?


Welcome to icliniq.com.

The two tonsils are unevenly enlarged. Whereas it is usually not any abnormal growth, we can say conclusively only after biopsy. I suggest you discuss with the doctor about the option of tonsillectomy and histopathological examination of the sample. Meanwhile you should get some Benzydamine gargles and check if the symptoms resolve.

Patient's Query

Thank you doctor,

Do you think that I can wait for one month to see my ENT doctor again? Or in the worst case scenario, when I would simply keep on monitoring my tonsils myself without consulting, what specific signs and symptoms should I keep an eye on? I will try a Benzydamine gargle like you suggested, if I am able to buy it OTC. In my place, many products that are OTC elsewhere require a prescription. I really appreciate your feedback and I thank you for your time.


Welcome back to icliniq.com.

You can wait for a month or two before you go back to your ENT. Nothing to worry. You need not monitor the tonsillar size regularly. Just check after a month and see. Most likely they are just uneven sized tonsils. However you have a congested throat and the gargles would help in that. That should resolve some of the lump feeling also. Benzdymine gargles come in the name of tantum mouth wash or dressin gargles. If none of these are available I suggest you try Chlorhexidine or Listerine gargles mixed in equal amounts of water and gargles thrice daily. Do not eat spicy oily foods for a while. Avoid smoke dust and pollution. Wear a mask when venturing outside. You should be fine.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shyam Kalyan. N
Dr. Shyam Kalyan. N

Otolaryngology (E.N.T)

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