Asymmetric tonsillar enlargement and obstructive sleep apnea

Abstract

Craniofacial skeletal features and pharyngeal soft tissues such as the lateral pharyngeal wall and symmetrical tonsillar enlargement reduce the diameter of the upper airway, thereby increasing the risk for obstructive sleep apnea (OSA) [1,2]. While assessment of medical history and risk factors may clearly provide a diagnosis of OSA, asymmetrical enlargement or hypertrophy, especially of the tonsils can be indicative of other etiologies, and should alert the physician for further work-up. A 61-year-old obese male patient with a history of hypertension and alcohol abuse presented with snoring, witnessed apneas, gasping and choking episodes for the last few years, and he complained of a sore throat for