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Tonsillolith

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Tonsillolith, Amygdalolith, Tonsil stone, Tonsillar Calculus, Tonsillolithiasis

  • Definitions
  1. Tonsillolith (Amygdalolith, Tonsil stone)
    1. Food, cellular debris and microorganisms form calcified accumulations
    2. These aggregates collect in the Tonsillar surface invaginations or crypts
  • Symptoms
  1. Recurrent Pharyngitis
  2. Halitosis
  3. Foreign body Sensation at the posterior pharynx
  4. Odynophagia
  5. Hoarse voice
  • Signs
  1. White or yellow concretions within the Tonsillar crypts
  2. Most Tonsilloliths are 1 to 5 mm in size (rarely >5 mm)
  3. Patients will often describe expressing Tonsilloliths from the Tonsil with their finger
  • Imaging
  1. Not typically needed, as Tonsilloliths are a clinical diagnosis
  2. Tonsilloliths are radiopaque on CT and panoramic XRays
  • Management
  1. General measures
    1. Salt water gargles
    2. Regular Tooth Brushing
  2. Surgery
    1. Tonsillectomy is rarely indicated
    2. May be considered for large Tonsilloliths that result in local compression and necrosis
  • References
  1. Smith (2023) Am Fam Physician 107(1): 35-41 [PubMed]