In adults, tonsillar asymmetry may represent oropharyngeal squamous cell carcinoma (SCC), lymphoma or other primary tumours of the tonsil. For this reason, many patients with asymmetrical tonsils undergo tonsillectomy. True unilateral tonsillar enlargement can be caused by several causes other than malignancy, including tonsillar hyperplasia resulting from repeated or chronic infection. In addition, a prolapsed tonsil or asymmetry of the tonsillar pillars can demonstrate a false asymmetry.
70 patients underwent tonsillectomy for asymptomatic asymmetrical tonsils at our institution with no other features of malignancy. No cases of malignancy were identified on histology.
We have reviewed the existing literature and suggested a novel guideline on the management of adult tonsillar asymmetry.
Keywords: Cancer, Head and neck surgery, Magnetic resonance imaging, Tonsil, Tonsillectomy.