One or both tonsils may be absent. It is important to find the cause since this may have implications for the patient.


Congenital with bilateral absence:

(1) agammaglobulinemia (either X-linked to autosomal recessive)

(2) ectopia


Congenital and unilateral absence:

(1) associated with regional defects of external ear and other structures (probably associated with a defect in the first and second branchial structures)


Acquired (may affect one or both tonsils):

(1) surgery

(2) trauma

(3) radiation

(4) chemotherapy


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