Play Video
1
Removal Of Entrapped Impissated Substance cum "Tonsillolith" From The Tonsillar Cleft
Removal Of Entrapped Impissated Substance cum "Tonsillolith" From The Tonsillar Cleft
::2011/01/18::
Play Video
2
tonsillolith.mp4
tonsillolith.mp4
::2009/12/01::
Play Video
3
My Wife
My Wife's Awful Tonsil Stones Removed. Tonsilloliths, Cysts, Pimples, Dermatology
::2014/10/26::
Play Video
4
What Causes Tonsil Stones?   Tonsillolith Questions
What Causes Tonsil Stones? Tonsillolith Questions
::2014/10/26::
Play Video
5
GNARLY TONSIL STONE REMOVAL!!!!
GNARLY TONSIL STONE REMOVAL!!!!
::2010/04/28::
Play Video
6
Tonsillolith  膿栓除去 no.13 2014.01.01  口臭対策 臭い玉
Tonsillolith 膿栓除去 no.13 2014.01.01  口臭対策 臭い玉
::2014/01/02::
Play Video
7
How To Remove Tonsillolith/Tonsil Stones At Home? With Pictures - UD Visions
How To Remove Tonsillolith/Tonsil Stones At Home? With Pictures - UD Visions
::2014/02/21::
Play Video
8
Removing Tonsil Stones - Tonsillolith - Stinky Stones
Removing Tonsil Stones - Tonsillolith - Stinky Stones
::2014/08/10::
Play Video
9
tonsil stones removal tonsillolith removed
tonsil stones removal tonsillolith removed
::2008/08/07::
Play Video
10
Tonsillolith 膿栓除去 no.15 2014.04.18  大きめ 口が臭い 悪臭
Tonsillolith 膿栓除去 no.15 2014.04.18  大きめ 口が臭い 悪臭
::2014/04/17::
Play Video
11
Tonsillolith 膿栓除去 no.14 2014.03.03  口臭 くさい玉
Tonsillolith 膿栓除去 no.14 2014.03.03  口臭 くさい玉
::2014/03/06::
Play Video
12
tonsillolith removed 2.wmv
tonsillolith removed 2.wmv
::2012/11/23::
Play Video
13
膿栓(臭い玉) Tonsillolith
膿栓(臭い玉) Tonsillolith
::2014/10/31::
Play Video
14
What Causes Tonsil Stones! Tonsillolith Questions   YouTube
What Causes Tonsil Stones! Tonsillolith Questions YouTube
::2014/11/17::
Play Video
15
tonsillolith removed 1.wmv
tonsillolith removed 1.wmv
::2012/11/23::
Play Video
16
【閲覧注意】咽喉に詰まった膿栓(くさい玉)Tonsillolith
【閲覧注意】咽喉に詰まった膿栓(くさい玉)Tonsillolith
::2014/04/20::
Play Video
17
Removing Tonsil Stones Tonsillolith
Removing Tonsil Stones Tonsillolith
::2014/01/28::
Play Video
18
tonsil stones removal tonsillolith removed
tonsil stones removal tonsillolith removed
::2014/08/16::
Play Video
19
Tonsil Stone Removal Tonsillolith Removed - VidoEmo - Emotional Video Unity.flv
Tonsil Stone Removal Tonsillolith Removed - VidoEmo - Emotional Video Unity.flv
::2009/12/31::
Play Video
20
Tonsillolith
Tonsillolith
::2014/11/05::
Play Video
21
tonsillolith removed 3 膿栓除去 .wmv
tonsillolith removed 3 膿栓除去 .wmv
::2012/11/23::
Play Video
22
Tonsillolith
Tonsillolith
::2014/07/26::
Play Video
23
OPTOTECHNIK FOX ORL Tonsillolith extract
OPTOTECHNIK FOX ORL Tonsillolith extract
::2012/05/03::
Play Video
24
TONSILLOLITH
TONSILLOLITH
::2013/01/21::
Play Video
25
How to Pronounce Tonsillolith
How to Pronounce Tonsillolith
::2014/08/31::
Play Video
26
Tonsillolith and Tonsillectomy : Dr.K.O.Paulose FRCS
Tonsillolith and Tonsillectomy : Dr.K.O.Paulose FRCS
::2012/05/27::
Play Video
27
Tonsillolith removal video
Tonsillolith removal video
::2012/03/25::
Play Video
28
Tonsillolith Prevention
Tonsillolith Prevention
::2014/07/30::
Play Video
29
Survival Games w/Reep, Episode 17 - Tonsillolith?!
Survival Games w/Reep, Episode 17 - Tonsillolith?!
::2014/08/04::
Play Video
30
What Is The Definition Of Tonsillolith
What Is The Definition Of Tonsillolith
::2014/11/11::
Play Video
31
Tonsillolith
Tonsillolith
::2014/02/19::
Play Video
32
Bad Breath:Halitosis:Tonsillolith Treated By Tonsillectomy: Dr.K.O.Paulose FRCS
Bad Breath:Halitosis:Tonsillolith Treated By Tonsillectomy: Dr.K.O.Paulose FRCS
::2012/05/27::
Play Video
33
Tonsil Stones - Tonsilloliths :  How to get rid of them
Tonsil Stones - Tonsilloliths : How to get rid of them
::2009/05/09::
Play Video
34
tonsilloliths
tonsilloliths
::2013/08/10::
Play Video
35
Asian girlfriend popping a tonsil stone (tonsillolith)
Asian girlfriend popping a tonsil stone (tonsillolith)
::2013/08/30::
Play Video
36
tonsillolith
tonsillolith
::2013/10/13::
Play Video
37
Bad Breath:Halitosis Caused by Tonsillolith: Dr.K.O.Paulose FRCS
Bad Breath:Halitosis Caused by Tonsillolith: Dr.K.O.Paulose FRCS
::2012/05/26::
Play Video
38
Tonsil Stones Removal with Q-tips ♦ Treatment at home (READ DESCRIPTION below)
Tonsil Stones Removal with Q-tips ♦ Treatment at home (READ DESCRIPTION below)
::2013/01/12::
Play Video
39
Mega Tonsilloliths;  Whole Mess of Tonsil Stones!  World
Mega Tonsilloliths; Whole Mess of Tonsil Stones! World's Worst?
::2014/11/23::
Play Video
40
How To Cure Tonsil Stones Naturally | Home Treatment For Tonsil Stones Tonsilloliths
How To Cure Tonsil Stones Naturally | Home Treatment For Tonsil Stones Tonsilloliths
::2012/12/21::
Play Video
41
Get Rid Of Your Tonsil Stones tonsilloliths
Get Rid Of Your Tonsil Stones tonsilloliths
::2011/12/19::
Play Video
42
Removing My Tonsil Stones Round 3
Removing My Tonsil Stones Round 3
::2012/10/13::
Play Video
43
World
World's Greatest Tonsil Stone Removals
::2014/10/02::
Play Video
44
Tonsil Stones
Tonsil Stones
::2012/04/24::
Play Video
45
Tonsil stones removal - Tonsillectomy Surgery
Tonsil stones removal - Tonsillectomy Surgery
::2013/04/29::
Play Video
46
How do you get bad breath ? | www.tinyurl.com/Tonsilloliths
How do you get bad breath ? | www.tinyurl.com/Tonsilloliths
::2011/11/28::
Play Video
47
Tonsil Removal Surgery  ►  Tonsillectomy surgery    Tonsilloliths
Tonsil Removal Surgery ► Tonsillectomy surgery Tonsilloliths
::2014/04/23::
Play Video
48
Removal of a HUGE salivary stone by Cherry Hill Dental in Columbia MO
Removal of a HUGE salivary stone by Cherry Hill Dental in Columbia MO
::2012/05/17::
Play Video
49
편도결석 시술영상
편도결석 시술영상
::2013/09/26::
Play Video
50
My Wife
My Wife's Awful Tonsil Stones; Cysts, Pimples, Dermatology - Call a Dentist or ENT
::2014/11/08::
NEXT >>
RESULTS [51 .. 101]
From Wikipedia, the free encyclopedia
Jump to: navigation, search
Tonsillolith
Tonsillolith in mouth.jpg
A tonsillolith lodged in the tonsillar crypt
ICD-10 J35.8
ICD-9 474.8

Tonsilloliths, also known as tonsil stones or tonsillar calculi (singular: calculus), are clusters of calcified material that form in the crevices of the tonsils[1] (tonsillar crypts). While they occur most commonly in the palatine tonsils, they may also occur in the lingual tonsils.[1] Tonsilloliths have been recorded weighing from 300 mg to 42 g.[1] They are composed mostly of calcium, but may contain other minerals such as phosphorus and magnesium, as well as ammonia and carbonate.[1]

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).[2][3]

While true tonsillar stones are rare, small areas of calcification or concretions are relatively common.[1]

Signs and symptoms[edit]

Tonsilloliths may produce no symptoms, or they may be associated with bad breath, or produce pain when swallowing.[4]

Tonsilloliths occur more frequently in adults than in 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.[5] 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.

Classification[edit]

Tonsilloliths or tonsil stones are calcifications that form in the crypts of the palatal tonsils. They are also known to form in the throat and on the roof of the mouth. Tonsils are filled with crevices where bacteria and other materials, including dead cells and mucus, can become trapped. When this occurs, the debris can become concentrated in white formations that occur in the pockets.[5] Tonsilloliths are formed when this trapped debris combines and hardens, or calcifies. This tends to occur most often in people who suffer from chronic inflammation in their tonsils or repeated bouts of tonsillitis.[5] They are often associated with post-nasal drip. These calculi are composed of calcium salts such as hydroxyapatite or calcium carbonate apatite, oxalates and other magnesium salts or containing ammonium radicals, macroscopically appear white or yellowish in color, and are usually of small size - though there have been occasional reports of large tonsilloliths or calculi in peritonsillar locations. Many people have small tonsilloliths that develop in their tonsils, and it is quite rare to have a large and solidified tonsil stone.

Giant[edit]

Much rarer than the typical tonsil stones are giant tonsilloliths. Giant tonsilloliths may often be mistaken for other oral maladies, including peritonsillar abscess, and tumours of the tonsil.[6]

Pathophysiology[edit]

Low-power microscope magnification of a cross-section through one of the tonsillar crypts (running diagonally) as it opens onto the surface of the throat (at the top). Stratified epithelium (e) covers the throat's surface and continues as a lining of the crypt. Beneath the surface are numerous nodules (f) of lymphoid tissue. Many lymph cells (dark-colored region) pass from the nodules toward the surface and will eventually mix with the saliva as salivary corpuscles (s).

The mechanism by which these calculi form is subject to debate,[1] though they appear to result from the accumulation of material retained within the crypts, along with the growth of bacteria and fungi – sometimes in association with persistent chronic purulent tonsillitis.

Recently, an association between biofilms and tonsilloliths was shown. Central to the biofilm concept is the assumption that bacteria form a three dimensional structure, dormant bacteria being in the center to serve as a constant nidus of infection. This impermeable structure renders the biofilm immune to antibiotic treatment. By use of confocal microscopy and microelectrodes, biofilms similar to dental biofilms were shown to be present in the tonsillolith, with oxygen respiration at the outer layer of tonsillolith, denitrification toward the middle, and acidification toward the bottom.[7]

Diagnosis[edit]

Diagnosis is usually made upon inspection. Differential diagnosis of tonsilloliths includes foreign body, calcified granuloma, malignancy, an enlarged temporal styloid process or rarely, isolated bone which is usually derived from embryonic rests originating from the branchial arches.[8]

Tonsilloliths are difficult to diagnose in the absence of clear manifestations, and often constitute casual findings of routine radiological studies.

Imaging diagnostic techniques can identify a radiopaque mass that may be mistaken for foreign bodies, displaced teeth or calcified blood vessels. Computed tomography (CT) may reveal nonspecific calcified images in the tonsillar zone. The differential diagnosis must be established with acute and chronic tonsillitis, tonsillar hypertrophy, peritonsillar abscesses, foreign bodies, phlebolites, ectopic bone or cartilage, lymph nodes, granulomatous lesions or calcification of the stylohyoid ligament in the context of Eagle syndrome (elongated styloid process).[9]

Treatment[edit]

Often, no treatment is needed, as few stones produce symptoms.[5]

Some people are able to remove tonsil stones using the tip of the tongue. Oral irrigators are also simple yet effective and will thoroughly clean the tonsil crypts. Most electric oral irrigators are unsuitable for tonsil stone removal because they are too powerful and are likely to cause discomfort and rupture the tonsils, which could result in further complications such as infection. Irrigators that connect directly to the sink tap via a threaded attachment or otherwise are suitable for tonsil stone removal and everyday washing of the tonsils because they can jet water at low pressure levels that the user can adjust by simply turning the sink tap, allowing for a continuous range of pressures to suit each user's specific requirements.[5]

More simply still, gargling with warm, salty water may help alleviate the discomfort of tonsillitis, which often accompanies tonsil stones. Vigorous gargling each morning can also keep the tonsil crypts clear of all but the most persistent tonsilloliths.[5] Drinking carbonated beverages allows for the nucleation of bubbles to occur around the tonsil stone and in between the tonsil stone and tonsil body, which may loosen or completely dislodge the stone. Tonsil stones may also be dislodged during the process of eructation, promoted by ingestion of carbonated beverages.

Curettage[edit]

Larger tonsil stones may require removal by curettage (scooping) or otherwise, although thorough irrigation will still be required afterwards to effectively wash out smaller pieces. Larger lesions may require local excision although these treatments may not completely help the bad breath issues that are often associated with this condition.

Laser[edit]

Another option is to decrease the surface area (crypts, crevices, etc.) of the tonsils via laser resurfacing. The procedure is called laser cryptolysis. It can be performed using a local anesthetic. A scanned carbon dioxide laser selectively vaporizes and smooths the surface of the tonsils. This technique flattens the edges of the crypts and crevices that collect the debris, preventing trapped material from forming stones.

Surgery[edit]

Tonsillectomy may be indicated if bad breath due to tonsillar stones persists despite other measures.[10]

At-home remedies[edit]

Home intervention may be used to help dislodge or remove the stones and provide temporary comfort. Several methods have been used, including using a flashlight and Q-tip, oral irrigator, gargling with warm salt water, and even specialized devices for the sole purpose of removing the invasive stones.[5]

Epidemiology[edit]

Tonsilloliths or tonsillar concretions occur in up to 10% of the population, frequently due to episodes of tonsillitis.[11] While small concretions in the tonsils are common, true tonsilloliths or stones are rare.[1] They commonly occur in young adults and are rare in children.[1]


References[edit]

  1. ^ a b c d e f g h Ram S, Siar CH, Ismail SM, Prepageran N (July 2004). "Pseudo bilateral tonsilloliths: a case report and review of the literature". Oral Surg Oral Med Oral Pathol Oral Radiol Endod 98 (1): 110–4. doi:10.1016/S1079210403007042. PMID 15243480. 
  2. ^ Tsuneishi M, Yamamoto T, Kokeguchi S, Tamaki N, Fukui K, Watanabe T (2006). "Composition of the bacterial flora in tonsilloliths". Microbes Infect. 8 (9–10): 2384–9. doi:10.1016/j.micinf.2006.04.023. PMID 16859950. 
  3. ^ Svoboda, Elizabeth (2009-09-01). "In Tonsils, a Problem the Size of a Pea". The New York Times. Retrieved 2010-05-25. 
  4. ^ Giudice M, Cristofaro MG, Fava MG, Giudice A (July 2005). "An unusual tonsillolithiasis in a patient with chronic obstructive sialoadenitis". Dentomaxillofac Radiol 34 (4): 247–50. doi:10.1259/dmfr/19689789. PMID 15961601. 
  5. ^ a b c d e f g Tonsil Stones - WebMD.com
  6. ^ Padmanabhan TK, Chandra Dutt GS, Vasudevan DM, Vijayakumar (May–Jun 1984). "Giant tonsillolith simulating tumour of the tonsil – a case report". Indian J Cancer 21 (2): 90–1. PMID 6530236. 
  7. ^ Tonsillolith: not just a stone but a living biofilm.
  8. ^ Images
  9. ^ Silvestre-Donat F, Pla-Mocholi A, Estelles-Ferriol E, Martinez-Mihi V (2005). "Giant tonsillolith: report of a case" (PDF). Medicina oral, patología oral y cirugía bucal 10 (3): 239–42. PMID 15876967. 
  10. ^ Darrow DH, Siemens C (August 2002). "Indications for tonsillectomy and adenoidectomy". Laryngoscope 112 (8 Pt 2 Suppl 100): 6–10. doi:10.1002/lary.5541121404. PMID 12172229. 
  11. ^ S. G. Nour; Mafee, Mahmood F.; Valvassori, Galdino E.; Galdino E. Valbasson; Minerva Becker (2005). Imaging of the head and neck. Stuttgart: Thieme. p. 716. ISBN 1-58890-009-6. 
Wikipedia content is licensed under the GFDL License
Powered by YouTube
LEGAL
  • Mashpedia © 2014