The presence of actinomyces does not indicate active disease. We are of the opinion that, although actinomyces colonization is more prevalent in patients with sleep-disordered breathing, it does not contribute to tonsillar hypertrophy nor to recurrent tonsillitis.

It is surgically feasible and safe to undertake transoral robotic resection of a large lingual thyroid. This approach may allow faster recovery and shorter hospitalisation for patients. Surgical safety requires a full understanding of the intralingual neurovascular anatomy.