What is tonsillar hypertrophy?

Tonsillar hypertrophy is the medical term for persistently enlarged tonsils. The tonsils are two small glands located on either side of the back of the throat. They’re part of your immune system and help to fight off infections that can be caused by bacteria, viruses, and other germs that enter your body through your nose and mouth.

Enlarged tonsils can be a sign of infection or irritation from things like smoke or polluted air. Some people just naturally have larger tonsils. In other cases, there’s no known cause.

Tonsillar hypertrophy is particularly common in children, though it can also affect adults. Children commonly get enlarged tonsils, but the condition can affect adults too. Children’s tonsils are generally larger than adult’s because their bodies are busy fighting off the frequent colds and other viruses of childhood. Large tonsils often get smaller on their own as children age.

Enlarged tonsils don’t always cause symptoms. However, if they’re very large, they can partially block your throat, affecting your breathing.

Other possible signs and symptoms of enlarged tonsils include:

  • difficulty breathing through the nose
  • mouth breathing
  • noisy breathing
  • loud snoring
  • obstructive sleep apnea
  • restless sleep
  • daytime sleepiness
  • constant runny nose
  • repeated ear or sinus infections
  • trouble eating in young children
  • bad breath

Tonsillar hypertrophy tends to affect children, but experts aren’t sure why. Some children are simply born with larger tonsils. There might also be a genetic link, as tonsillar hypertrophy often runs in families.

In both children and adults, enlarged tonsils may also be a sign of an underlying bacterial or viral infection, such as:

These infections all share some common symptoms, including:

  • sore throat
  • fever
  • fatigue
  • swollen glands in the neck

Other things that can make your tonsils swell and look larger include:

It’s best to have painful enlarged tonsils checked out by a doctor to rule out a potential infection that needs treatment. Young children with large tonsils should also be seen by their doctor if they have sleeping or feeding difficulties, even if they don’t seem to be in pain. They’ll start by looking at your medical history and asking about any additional symptoms you have. They may also feel around your neck for any signs of swelling.

Depending on your symptoms, they may also do a throat culture. This involves swabbing the back of the throat and testing the tissue for signs of a bacterial infection. You may also need an X-ray to give your doctor a better view of the soft tissues in your neck.

If you’ve been having symptoms such as trouble sleeping or loud snoring, your doctor might also suggest doing a sleep study to check for sleep apnea caused by tonsillar hypertrophy. To do this, you’ll typically need to spend the night in a specially designed laboratory while a doctor monitors your breathing and other vital signs.

Tonsillar hypertrophy usually only requires treatment if it’s interfering you’re your ability to sleep, eat, or breathe. However, if it’s caused by an underlying infection, you may need antibiotics. If it’s due to allergies, your doctor might recommend using a nasal corticosteroid spray or taking antihistamines to help with your symptoms.


If your enlarged tonsils interfere with your breathing and aren’t due to any underlying condition, you may need to have them surgically removed. This can help improve the symptoms of obstructive sleep apnea in both adults and children. Surgery to remove the tonsils is called a tonsillectomy.

During a tonsillectomy, your doctor might also remove your adenoids, which are two glands located in the back of your nose near the roof of your mouth.

A tonsillectomy is a straightforward procedure done under general anesthesia. Most people go home the same day as their surgery and make a full recovery within 7 to 10 days.

When tonsillar hypertrophy leads to sleep apnea and trouble sleeping, it can cause a range of complications if left untreated, especially in children.

These include:

If you or your child has symptoms of enlarged tonsils, see your primary care doctor or an ear, nose, and throat doctor. Depending on the underlying cause and whether tonsillar hypertrophy interferes with your breathing, you may need antibiotics or surgery to remove your tonsils.