Human tonsil tissue includes the pair of tonsils at the back of the mouth, the adenoids behind the nose and a final area of soft tissue behind the tongue. Cases of chronic tonsillitis or infection may become difficult to treat using only antibiotics. Surgery to remove the tonsils is sometimes required, especially if a condition known as hypertrophic tonsils develops.
The term hypertrophic tonsils, also referred to as tonsillar hypertrophy, describes tonsils that are so enlarged that they obstruct breathing. Paediatric Otolaryngology explains that hypertrophic tonsils can be most bothersome at night, when a child is trying to sleep. The condition can also cause difficulty swallowing.
According to the University of Hong Kong Department of Surgery, most cases of hypertrophic tonsils also involve enlarged adenoids. The combination of swollen tissue can lead to more than breathing problems. In fact, ear infections, sinus infections, oral and mental maldevelopment, and eustachian (auditory) tube blockages can also occur.
Biopsies of hypertrophic tonsils that have been surgically removed often show signs of bacterial pathogens. In fact, research outline in the Archives of Otolaryngology-Head and Neck Surgery reveal that hypertrophic tonsils contain significantly higher amounts of microbes than that of healthy tonsils. This pathogenic bacterium has been found to collect in the crypts of hypertrophic tonsils, causing infection and excessive inflammation.
A diagnosis of hypertrophic tonsils is often visually based. According to eCureMe.com, hypertrophic tonsils are very pronounced and tend to bulge out towards the front of the mouth. In fact, the tonsils are often so large that they touch one another---often termed "kissing tonsils." Chronic infections, breathing problems and maldevelopments are also taken into consideration along with other symptoms that may develop. Chronic halitosis, weight loss, decreased appetite and fatigue are also considered in a diagnosis of hypertrophic tonsils.
Hypertrophic tonsils generally warrant surgical intervention. MedicineNet.com explains that when enlarged tonsils or adenoids interfere with sleeping by causing snoring or severe sleep apnoea, surgery is often recommended. Surgery is also recommended when swallowing difficulties occur or dental problems are involved.