I am 29 years old and for the past few years I have had frequent sore throats. The ENT says I have very deep crypts in my tonsills. At first he was reluctant to remove my tonsills, but after having mono last year I have had more severe problems. I have recurring pharyngitis constantly, and it's been 10 months since the mono and I still feel like it's not completly gone. Antibiotics do not work, and the right side of my throat feels like I have a lump there and is very red. He said the right tonsill never went back to normal after having mono (he said it is not uncommon for an adult to have tonsill problems after mono). I also have allergies that irritate my throat. He now suggests that I have my tonsills removed as he thinks they may still be harboring the mono infection. Have you ever heard of anyone having to have their tonsills removed after mono. Do you think this would help? Any suggestions would be greatly appreciated!
Thank you,
Reply: ---------------------
Your symptoms are suggestive of chronic tonsillitis. Lymphoid hyperplasia of the tonsils typically results from severe tonsil infections or many tonsil infections. Infectious mononucleosis certainly could result in chronic lymphoid hyperplasia of the tonsils. The deep crypts or crevasses in the tonsils may harbor partially digested food debris or may be colonized with bacteria thereby causing chronic symptoms of sore throat. Antibiotic therapy often either helps only for short periods or does not help at all. Perhaps the best management initially is vigorous oral hygiene measures and possibly the use of pulsating irrigation of the tonsils with a "water-pik" device. However, when such treatments fail to improve symptoms after several months, then consideration of tonsillectomy may be appropriate.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
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