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Tonsilolith

Tonsillolith
Tonsillolith in mouth.jpg
A tonsillolith lodged in the tonsillar crypt
Classification and external resources
Specialty Otorhinolaryngology
ICD-10 J35.8
ICD-9-CM 474.8
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Tonsilloliths, also known as tonsil stones, are clusters of calcified material that form in the tonsillar crypts, the crevices of the tonsils. While they occur most commonly in the palatine tonsils, they may also occur in the lingual tonsils. Tonsilloliths have been recorded weighing from 0.3g to 42g. They are composed mostly of calcium, but may contain other minerals such as phosphorus and magnesium, as well as ammonia and carbonate.

Protruding tonsilloliths may feel like foreign objects lodged in the tonsil crypt. They may be a nuisance and difficult to remove, but are usually not harmful. They are one of the causes of halitosis (bad breath) and always give off a putrid smell.

While true tonsillar stones are rare, small areas of calcification or concretions are relatively common.

Tonsilloliths may produce no symptoms, or they may be associated with bad breath, or produce pain when swallowing.

Tonsilloliths occur more frequently in teens than in adults or young children. Many small tonsil stones do not cause any noticeable symptoms. Even when they are large, some tonsil stones are only discovered incidentally on X-rays or CAT scans.

Other symptoms include a metallic taste, throat closing or tightening, coughing fits, and choking.

Larger tonsilloliths may cause multiple symptoms, including recurrent halitosis, which frequently accompanies a tonsil infection, sore throat, white debris, a bad taste in the back of the throat, difficulty swallowing, ear ache, and tonsil swelling. A medical study conducted in 2007 found an association between tonsilloliths and bad breath in patients with a certain type of recurrent tonsillitis. Among those with bad breath, 75% of the subjects had tonsilloliths, while only 6% of subjects with normal halitometry values (normal breath) had tonsilloliths. A foreign body sensation may also exist in the back of the throat. The condition may also be an asymptomatic condition, with detection upon palpating a hard intratonsillar or submucosal mass.


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