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Ovassapian and workers (12) retrospectively reviewed the management of 33 cases of lingual tonsil hypertrophy and found that routine physical examination would not identify these cases.
Previous work (13) using MRI scanning in assessing lingual tonsil hypertrophy has been confined to its use for evaluating obstructive sleep apnoea.
This elucidated that the cause of the difficulty was lingual tonsil hypertrophy.
In light of the nonspecific symptoms and the difficulty encountered in examining the area, a high index of suspicion is necessary to adequately diagnose and treat dysphagia caused by lingual tonsil hypertrophy.
The patient then underwent an upper endoscopy, which revealed that the lingual tonsils were greatly enlarged and that there was a slight irregularity of the mucosa in the upper one-third of the esophagus.
The size of the lingual tonsils forced the epiglottis to retroflex toward the pharyngeal wall.