(30 year old obese lady doctor with very large “kissing tonsils” causing severe snoring and obstructive sleep apnea.She selected the surgical option rather than CPAP option and undergoes RF Tonsillectomy, CAUP, Soft palate stiffening procedure under general anesthesia in Jubilee Hospital Trivandrum, Kerala, India.)
Enlarged “kissing Tonsils” that meet in midline when you look at the throat is a common finding in some children and even in adults who has snoring and sleep apnea.
Tonsils are part of the immune system, but when they are too large or are prone to frequent infections, can cause problems and one should consider surgical removal.
Tonsils are paired lymphoid or glandular tissues that sit on the side-walls of your throat just behind your tongue. They are part of a complete circle of lymphoid tissues that is involved in programming your immune system what is foreign and what is self. The adenoids sit in the mid-line at the back of your nose and the lingual tonsils are also in the mid-line at the rear of the tongue, just above the voice box. They are most active from ages 3-5, and this is the time that most problems arise.
Most of the immune system programming occurs in early childhood. As you get older, the tonsils shrink to a much smaller size in adulthood. However, if there is chronic irritation, such as from allergies, colds or acid reflux, they can remain enlarged. Tonsils and adenoids are only a small part of a much larger system of lymph glands and immune mechanisms.
Just because your tonsils are big does not mean they have to be removed. If you have no problems, then with time, they should shrink. But if you have signs or symptoms of a sleep-breathing disorder, such as daytime fatigue, poor concentration, memory problems, attention problems, asthma, cough, nasal congestion, or snoring, then they should be looked at by an ear, nose and throat physician.
Kissing Tonsil can cause snoring and OSA
Anything that narrows the upper airway, from the nose to the voice box, can cause snoring or other breathing problems. In children, large tonsils are a common cause of snoring. Snoring itself in children has been linked to behavioral, memory and concentration problems, asthma, and chronic cough. A signiï¬cant number of children (and adults) who snore are also found to have obstructive sleep apnea, which can lead to fatigue, depression, high blood pressure, heart disease and many other conditions. It\’s also associated with sexual dysfunction and frequent urination at night.
Treatment
Surgical removal of tonsils and adenoid (if large), by traditional dissection, electric cautery, microdebrider, Coblator or Laser under general anesthesia is the treatment of choice.
I perform tonsillectomy by traditional method, using RF Coblator and Co2 laser.
Complications
Rare, but as with any operation, there\’s always a very small chance of bleeding or infection. If it occurs, then it will be addressed appropriately
