bubble_chart Overview

Chronic lingual tonsillitis, also known as hypertrophy of the lingual tonsil, often results from repeated episodes of acute lingual tonsillitis turning chronic. It is commonly associated with chronic inflammation of the upper respiratory tract, excessive smoking and alcohol consumption, a preference for spicy foods, and exposure to harmful gases. It frequently coexists with chronic tonsillitis, and compensatory hypertrophy of the lingual tonsil may occur after a tonsillectomy. This condition is more prevalent in adults and is rare in children.

bubble_chart Clinical Manifestations

The symptoms are mainly local, such as a foreign body sensation, obstruction, irritation in the throat, and dry cough, which worsen with excessive talking. Sometimes, there may be no symptoms, and the condition is incidentally discovered during an oral examination.

Using a tongue depressor to press firmly on the tongue or performing an indirect laryngoscopy may reveal hypertrophic lymphoid tissue at the base of the tongue, appearing as granular patches distributed symmetrically or more prominently on one side. In severe cases, the tissue may extend to the vallecula or laterally to connect with the tonsils. Due to infection of the lymphoid follicles in the lingual tonsil, small yellowish-white punctate abscesses may be observed beneath the mucous membrane.

bubble_chart Treatment Measures

1. Eliminate disease causes: Actively treat inflammatory and sexually transmitted diseases in the respiratory tract, such as chronic pharyngitis and chronic tonsillitis. Quit smoking and alcohol, reduce the intake of irritating foods, and address environmental pollution. Topical application of 5-10% silver nitrate or 1% iodine glycerin can often alleviate symptoms.

2. Surgical treatment: Under surface anesthesia with 0.5-1% tetracaine and local infiltration anesthesia with 1% procaine or lidocaine containing adrenaline, the lingual tonsil can be removed using instruments such as a lingual tonsillectomy knife, grasping forceps, snare, long scissors, hemostatic forceps, and a metal angular tongue depressor. Alternatively, it can be treated in stages with cryotherapy, electrocoagulation, or laser therapy, all of which can achieve a cure.