Right side of tonsil and ear problem. ).

Hi, I am Dr. Atul Kumar Nimawat MS ENT. Based on the image and the history you’ve provided, here are the possibilities and observations Asymmetrical Tonsillar Enlargement (Right > Left): Asymmetry in tonsil size persisting for more than a year should always be examined carefully. Though commonly due to chronic tonsillitis or lymphoid hyperplasia, persistent asymmetry without recurrent infections raises the need to rule out neoplastic (cancerous or pre-cancerous) changes. Possibility of Malignancy: Given the chronicity, unilateral tonsillar hypertrophy, and now a new red spot, it is advisable not to ignore the possibility of early oropharyngeal carcinoma, especially if there are any risk factors like tobacco use, alcohol, or HPV exposure. However, it’s important to remember that benign causes like fibrous tonsillar hyperplasia, chronic follicular tonsillitis, or even tonsilloliths can present similarly.

ENT Clinical Evaluation: A direct oropharyngeal and otoscopic examination is essential. Nasopharyngoscopy / Flexible Laryngoscopy: To assess deeper tissues and confirm the absence of hidden masses or mucosal changes. FNAC or Biopsy (if needed): If there’s any suspicious mass or persistent lesion, a fine needle aspiration or punch biopsy may be needed. Imaging: A neck ultrasound or contrast-enhanced CT scan might be advised for better anatomical assessment.

Avoid scratching or probing the ear canal. Maintain oral and ear hygiene. Avoid irritants (tobacco, alcohol, etc.) if applicable.