Tonsils as big as chicken eggs, causing sleep apnea

Ho Chi Minh City: A young man had a swollen tonsil mass measuring 4x4 cm, twice the normal size, blocking most of his airway, causing sleep apnea and loud snoring.

Mr. Nguyen The Bao (31 years old, Go Vap district) said that since he was a child, he had a problem with snoring. Every morning, he woke up feeling lethargic. After many years of medical examination, the doctors said he had tonsillitis and gave him medicine to take. The doctor once advised him to have his tonsils removed, but he delayed it because he was afraid that the surgery would affect his voice.

Recently, his snoring has gotten worse, his snoring is loud and hissing "like thunder", making it impossible for anyone in the family to sleep well. He also often wakes up in the middle of the night, his mouth and throat are sore and dry; during the day he feels sleepy, tired, and lacks concentration at work.

The large tonsils almost completely blocked the patient's airway. Photo: Tam Anh Hospital

MSc. Dr. Nguyen Thi Huong (ENT Department, Tam Anh General Hospital, Ho Chi Minh City) discovered that Mr. Bao's tonsils were about 4x4 cm in size, almost the size of a chicken egg, with grade 4 tonsillitis (tonsils are inflamed repeatedly) (the most severe level), causing sleep apnea and requiring immediate surgical removal. Prolonged tonsillitis, if not treated thoroughly, can lead to dangerous complications such as high blood pressure and sudden death.

Dr. Huong added that the patient's tonsils were too large, covering almost the entire throat area, making it difficult for the doctor to operate. However, thanks to the use of coblator technology, plasma knife and the experience of the team, the surgery went smoothly in 30 minutes. Coblator technology has the advantage of quickly and thoroughly removing the inflammation, preventing recurrence; cutting and stopping bleeding at the same time, thus limiting blood loss. This type of knife uses low temperature, so it is less painful and does not damage the surrounding area, and the wound heals quickly.

Doctors remove tonsils from a patient. Photo: Tam Anh Hospital

Thanks to the shortened surgery time, the amount of anesthesia used is low. After about 10 minutes of surgery, the patient regains consciousness; can eat soup and drink milk after 3 hours. The function of the pharynx such as voice and swallowing after surgery is normal. The patient is discharged the next day.

Tonsillitis is a common disease that is not dangerous until it becomes overgrown. When the tonsils are large, they compress the airway, causing the patient to snore and stop breathing while sleeping. Most people with sleep apnea have symptoms such as loud snoring and daytime sleepiness. Sleep apnea reduces the quality of life, increases the risk of traffic accidents, and reduces work performance. It is also a risk factor for cardiovascular disease, stroke, cancer, metabolic disease (diabetes), neurological diseases (depression) ... and even death.

Sleep apnea can develop at any age, especially in people over 60 years old. Controlling risk factors such as obesity, not smoking, adjusting sleeping position appropriately, and having scientific living habits can help prevent this disease. Enlarged tonsils require surgery to free the airway and prevent complications of sleep apnea.

Before surgery, it is necessary to ensure that the tonsils and nasopharynx are not acutely inflamed. After surgery, the patient must take prescribed medication and follow dietary and lifestyle instructions such as not spitting hard after surgery, eating soft, liquid, and cold foods in the first week of discharge, and limiting strenuous exercise. The patient must avoid hot and hard foods for another 2 weeks after surgery, then can eat and drink normally again; return for a check-up one week after surgery for the doctor to check the surgical wound.

Nguyen Phuong

* Patient name has been changed.

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