Radiation damage and anatomical changes to your mouth can be quite radical. For sure the ENT would not choose this route using surgery. Many of the normal anatomical structures in my mouth are gone, for instance I have no epiglottis. Wasn't anything wrong with it, it was just in a very persistent beam of radiation that was on its way to somewhere else... I went through before IMRT so my damage is worse than most.

Tonsillectomies would not make future screenings any more difficult. My assumption here is the doc talking about cervical is referring to the fact that this would leave scar tissue on the surface. I have never heard of this being an issue in the oral cavity.