Key Pointers:
- Enlarged tonsils can cause breathing, swallowing, or sleep problems in both children and adults.
- ENT specialists evaluate tonsils through history-taking, physical examination, and sometimes imaging.
- Treatment ranges from medication and lifestyle measures to surgery such as tonsillectomy.
What are Enlarged Tonsils?
The tonsils are two oval-shaped tissues at the back of the throat. They form part of the immune system, helping to trap germs that enter through the nose and mouth. In many children, the tonsils are naturally larger, but sometimes they become enlarged due to repeated infections, allergies, or other conditions.
When tonsils are significantly enlarged, they can block the airway, affect swallowing, or lead to sleep disturbances such as snoring or obstructive sleep apnoea (OSA). Adults may also experience problems, although enlarged tonsils are more common in children.
The ENT’s Evaluation Process
When you visit an ENT specialist with concerns about enlarged tonsils, the evaluation is usually systematic:
1. History-Taking
The consultation begins with a detailed discussion about symptoms. The doctor may ask:
- How often do sore throats or infections occur?
- Is there frequent snoring or pauses in breathing during sleep?
- Are there difficulties with swallowing, eating, or speaking?
- Does the patient experience recurrent ear infections or nasal obstruction?
This background helps the ENT understand whether enlarged tonsils are causing day-to-day health issues.
2. Physical Examination
The specialist will then examine the throat directly. With a light and tongue depressor, the tonsils are checked for:
- Size and shape
- Redness, swelling, or white patches (signs of infection)
- Presence of tonsil stones (small, hardened debris lodged in the tonsils)
The ENT may also look at the nose and ears, since enlarged tonsils are often linked to related problems such as blocked nasal passages or middle ear issues.
3. Additional Tests
In some cases, further investigations are advised. These can include:
- Sleep studies: to evaluate sleep apnoea or frequent nighttime breathing pauses.
- Imaging (X-ray or MRI): to assess the airway, particularly in children with severe symptoms.
- Endoscopy: using a thin scope to examine the throat and airway more closely.
Treatment Options
The right treatment depends on the cause, severity, and impact of enlarged tonsils.
1. Watchful Waiting
If the tonsils are enlarged but not causing major symptoms, the ENT may recommend monitoring. Children often “outgrow” the problem as their airways enlarge with age.
2. Medication
For mild cases, treatment may include:
- Antibiotics (for bacterial infections)
- Anti-inflammatory medicines
- Nasal sprays for allergy-related enlargement
3. Tonsillectomy
When enlarged tonsils cause severe snoring, sleep apnoea, recurrent infections, or difficulty swallowing, surgery may be advised. A tonsillectomy is a procedure to remove the tonsils, usually performed under general anaesthesia.
While surgery is more commonly recommended in children, adults with persistent symptoms may also benefit. Recovery involves a sore throat for about one to two weeks, but most patients experience significant improvement in breathing, sleep, and quality of life.
When to See a Specialist
You should consult an ENT if you or your child experiences:
- Loud snoring or pauses in breathing during sleep
- Frequent throat infections (several times a year)
- Persistent difficulty swallowing
- Swollen tonsils that don’t improve
Early evaluation helps prevent complications such as chronic sleep disturbance, growth problems in children, or recurrent infections in adults.
ENT Specialist Care in Singapore
At Aurion ENT & Hearing Centre, Dr Liu Jiaying sees both adults and children for tonsil-related conditions, from recurrent sore throats to sleep apnoea caused by enlarged tonsils. With a thorough evaluation and personalised care plan, you’ll understand the best next step, whether it’s simple monitoring, medical treatment, or surgery.
📞 Call +65 6908 1266 or Book an Appointment to consult Dr Liu Jiaying at Aurion ENT & Hearing Centre, conveniently located at Farrer Park Medical Centre.
