The lingual tonsil is a small mound of lymph tissue located at the back of the base of the tongue. There are two lingual tonsils in the mouth, one on each side of the tongue. They are composed of lymphatic tissue that functions to assist the immune system in the production of antibodies in response to invading bacteria or viruses. Repeated infections or inflammation of the lingual tonsils over an extended period of time may necessitate the surgical removal of the enlarged tonsils.

An infection of the lingual tonsils causes many uncomfortable symptoms. The first sign of an infection is usually a sore throat, followed by very painful swallowing. Swollen lingual tonsils are easily visible on the back of both sides of the tongue, a condition called tonsillitis. A fever may develop as the immune system tries to fight off the infection.

Diagnosis of a lingual tonsil bacterial infection is usually made by a family doctor. A visual examination will indicate if a bacterial culture should be made from a throat swab. Preliminary antibiotics may be prescribed until the results of the culture have returned from the laboratory. If no bacteria are revealed in the cultures, the antibiotics will be discontinued.

If the infection is caused by a virus, the physician may be able to prescribe medication to relieve the painful sore throat and other uncomfortable symptoms. A solution of salt and water can be gargled to relieve some of the sore throat pain. The salt water also acts as an antiseptic rinse for the tonsil.

In extreme cases, the inflamed lingual tonsil may grow large enough to block the airway. This may make breathing and speaking very difficult. Some people develop obstructive sleep apnea as the lingual tonsils enlarge. A surgical procedure called coblation lingual tonsillectomy is used to remove the inflamed tonsils and restore the airway.

During the lingual tonsillectomy, the patient will be put to sleep with general anesthesia. The surgeon will remove the lingual tonsils and seal the excision area. After the procedure, antibiotics and painkillers will be prescribed for up to ten days. A diet of soft and cold foods is recommended for at least the first three days after surgery.

Occasionally, a person may develop cancer in the lingual tonsils. A lymphoma can cause a large mass of tissue to grow from the tongue into the throat. The most common lingual tonsil cancer is a squamous cell carcinoma (SCC), which may manifest as a cluster of ulcers in the back of the throat. Treatment for these lingual tonsil cancers may include surgery, radiation, and chemotherapy.