New Kids on the Block: Could Your 2nd “Hidden” Tonsils Be Causing Snoring or Sleep Apnea?

Most people are aware of tonsils that are present in the back of the throat. Tonsils are often the cause of sore throat and sometimes strep throat that are painful and require antibiotic treatment. Sometimes tonsils also accumulate debris and form little pockets that fill with white or yellow cheesy material, known as tonsiliths or cryptic tonsillitis. This debris is not dangerous but often annoying. It can cause halitosis (bad breath) and discomfort. Often the only solution is tonsillectomy in severe cases.

Tonsils are often enlarged in children, but shrink in adulthood. These tonsils in the back of the throat are well recognized and are technically called “palatine” or “faucial” tonsils.

What most people do not know, however, is that we all have a second set of tonsils tucked low in our throats on the back of the base of our tongue. These are called “lingual” tonsils.

Just as palatine tonsils vary in size, from grade 1 to grade 4, so do lingual tonsils. Dr. Friedman in previous publications has created the Friedman Grading System for both lingual and palatine tonsils.

When either lingual tonsils or palatine tonsils become enlarged, they are often the cause of snoring and sleep apnea. Lingual tonsils cannot be seen by looking directly in the throat. They can be visualized by using an endoscope and camera to look behind the tongue. When enlarged, modern techniques using radiofrequency energy can shrink lingual tonsils and may cure snoring and sleep apnea. Robotic surgery can sometimes be helpful to access the lingual tonsils.

Dr. Michael Friedman and his research team recently published two articles describing the “Incidence of Lingual Tonsil Hypertrophy in Adults with and without Obstructive Sleep Apnea.” These studies were published in the Original Research section on Sleep Medicine in Otolaryngology—Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery Foundation in November 2017 and February 2018. These research papers were also presented at the American Academy of Otolaryngology—Head and Neck Surgery Foundation annual meeting in Chicago on September 2017.

Cover Photo by Tanja Heffner on Unsplash

Do you snore or potentially have sleep apnea? Make an appointment today at Chicago ENT, Chicago’s premier ear, nose, and throat specialty center.

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