II. 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

III. Symptoms

  1. Recurrent Pharyngitis
  2. Halitosis
  3. Foreign body Sensation at the posterior pharynx
  4. Odynophagia
  5. Hoarse voice

IV. 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

V. Imaging

  1. Not typically needed, as Tonsilloliths are a clinical diagnosis
  2. Tonsilloliths are radiopaque on CT and panoramic XRays

VI. 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

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