Lingual Tonsillectomy

Just as there are aggregates of lymphoid tissue in the back of the mouth, called the tonsils, or the pharyngeal tonsils, and there are aggregates of lymphoid tissue at the back of the nose called the adenoids, there are aggregates of lymphoid tissue over the base of the tongue. These are called lingual tonsils. This lingular tonsillar tissue can become enlarged in much the same way as the standard tonsils become enlarged. This can be due to low-grade chronic infection, irritants, such as smoking or reflux, or may just be associated with viral upper respiratory tract infections, often by organisms such as glandular fever. If the enlarged lymphoid mass does not shrink down, the airway is narrowed.

Lingual tonsillectomy can be performed several ways. It can be performed endoscopically, using little telescopes, or, an open approach can be undertaken. In most cases, trans-oral endoscopic lingual tonsillectomy, and/ or endoscopic lingual tonsillectomy using a Lindholm type laryngoscope is undertaken. The excessive lymphoid tissue can be excises surgically; it can be vaporized, using a laser, or the application of electrical current, either by way of unipolar or bipolar diathermy or coblation.

The operation is technically difficult to perform and is associated with a fair degree of pain and discomfort, to a degree, which is similar to but less than the pain experienced with a standard tonsillectomy.