Q: I am a 41 years old man who gets throat infection very frequently, once in a month or two. My tonsils are asymmetric and my right side tonsil is bigger than the left one. When having infection, mostly on the right tonsil, I can see a few small white crypts like spots. I feel feverish and tired too and during sleep my nose gets blocked but not in the day time when I am awake. 1. Is asymmetric tonsil normal? 2. Is it related to frequent throat infections? 3. Is it connected with nose blockage? 4. Can pituitary focal lesion (right side)/microadenoma be related to this tonsil problem?

A:Asymmetrical tonsils are uncommon in normal persons. They can be associated with unilateral enlargement if associated with tonsil abscessor tonsilolith, which may lead to recurrent tonsil infections. Very large tonsils can push in nasopharynx and block nose. Microadenoma of pituitary can be associated with hormonal changes, which cause susceptibility to infections. Acute infections can be treated by antibiotics etc in quiet phase a tonsillectomy can be done to submit tonsils to pathological examination to rule out malignancy, tuberculosis, lymphoma etc. Treatment of adenoma may help in reducing recurrent attacks if hormonal changes are present and can be dealt with first.