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Encyclopedia > Tonsillolith
A small tonsillolith
A large tonsillolith
A tonsillolith protrudes from the tonsil
A tonsillolith protrudes from the tonsil

A tonsillolith (also called tonsil stone or calculus of the tonsil) is a piece (or more commonly, a cluster) of calcareous matter which forms in the rear of the mouth, in the crevasses (called crypts) of the palatine tonsils (which are what most people commonly refer to as simply tonsils). Image File history File linksMetadata No higher resolution available. ... Image File history File links Metadata No higher resolution available. ... Image File history File links Metadata No higher resolution available. ... Calcareous formed from or containing a high proportion of Calcium carbonate. ... Crevasse on the Gorner Glacier, Zermatt, Switzerland. ... The Palatine tonsils with the soft palate, uvula, and tongue visible. ... The Palatine tonsils. ...


Tonsil stones, it is theorized, are the result of a combination of any of the following[1]:

  • food particles
  • dead white blood cells (a.k.a. leukocytes)
  • oral bacteria
  • overactive salivary glands

They are described as having a pungent odor[2]: halitosis concentrated into a small solid object. Visually, they may resemble sesame seeds or cottage cheese in color and texture. White Blood Cells is also the name of a White Stripes album. ... Aroma redirects here. ... Halitosis, oral malodor (scientific term), breath odor, foul breath, fetor oris, fetor ex ore, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in breathing – whether the smell is from an oral source or not. ...


Protruding tonsilloliths have the feel of a foreign object, lodged between the outside of wisdom teeth and the temporomandibular joint region of the fleshed jaw. They may be an especially uncomfortable nuisance, but are not often harmful. Wisdom teeth are third molars that usually appear between the ages of 16 and 24 (although they may appear when older or younger). ... The temporomandibular joint (From the Latin for too much jaw) is a diarthrodial joint that connects the condyle of the mandible (lower jaw) to the temporal bone at the side of a skull. ...

Contents

Appearance and characteristics

Tonsilloliths or tonsil stones are calcifications that form in the crypts of the palatal tonsils. These calculi are composed of calcium salts either alone or in combination with other mineral salts, and are usually of small size - though there have been occasional reports of large tonsilloliths or calculi in peritonsillar locations. Dystrophic calcification is the mineralization of soft tissue without a systemic mineral imbalance. ... A calculus is a stone (a concretion of material, usually mineral salts) that forms in an organ or duct of the body. ...


Tonsilloliths are difficult to diagnose in the absence of clear manifestations, and often constitute casual findings of routine radiological studies. Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ... Radiology is the branch of medical science dealing with the medical use of x-ray machines or other such radiation devices. ...


These calculi are composed of calcium salts such as hydroxyapatite or calcium carbonate apatite, oxalates and other magnesium salts or containing ammonium radicals, and macroscopically appear white or yellowish in color. The mechanism by which these calculi form is subject to debate, though they appear to result from the accumulation of material retained within the crypts, along with the growth of bacteria and fungi such as Leptothrix buccalis – sometimes in association with persistent chronic purulent tonsillitis. In other words, "Because saliva contains digestive enzymes, trapped food begins to break down. Particularly, the starch or carbohydrate part of the food melts away, leaving firmer, harder remains of food in the tonsils." Hydroxylapatite is a naturally occurring form of calcium apatite with the formula Ca5(PO4)3(OH), but is usually written Ca10(PO4)6(OH)2 to denote that the crystal unit cell comprises two molecules. ... An oxalate (called also: ethanedioate) is a salt or ester of oxalic acid. ...


Alternative mechanisms have been proposed for calculi that are located in peritonsillar areas, such as the existence of ectopic tonsillar tissue, the formation of calculi secondary to salivary stasis within the minor salivary gland secretory ducts in these locations, or the calcification of abscessified accumulations. Ectopia is a displacement or malposition of an organ of the body. ... The salivary glands produce saliva, which keeps the mouth and other parts of the digestive system moist. ...


Symptoms

Tonsilloliths occur more frequently in adults than in children. Symptoms are usually non-specific such as sore throat, chronic cough, bad taste in the back of your throat, or otalgia. A foreign body sensation may also exist in the back of throat with recurrent foul breath (halitosis). Treatment is usually removal of concretions by curettage; larger lesions may require local excision. Otalgia is ear pain or an earache. ... Halitosis, oral malodor (scientific term), breath odor, foul breath, fetor oris, fetor ex ore, or most commonly bad breath are terms used to describe noticeably unpleasant odors exhaled in breathing – whether the smell is from an oral source or not. ... In surgery, the use of a curette to remove tissue by scraping or scooping. ... Skin lesions caused by Chickenpox A lesion is any abnormal tissue found on or in an organism, usually damaged by disease or trauma. ... Excision means to remove as if by cutting. It can be a euphemism for Female circumcision. ...


Tonsilloliths tend to be present in young adolescents and can manifest with bad breath and swallowing pain accompanied by a foreign body sensation and, in some cases, referred ear pain. The condition may also prove asymptomatic, with detection upon palpating a hard intratonsillar or submucosal mass. In medicine, a disease is asymptomatic when it is at a stage where the patient does not experience symptoms. ... Submucosal can refer to: Submucous plexus Submucosa Category: ...


Differential diagnosis

Differential diagnosis of tonsilloliths includes foreign body, calcified granuloma, malignancy, an enlarged styloid process or rarely, isolated bone which is usually derived from embryonic rests originating from the branchial arches.[3] This article does not cite any references or sources. ... H&E section of non-caseasting granuloma seen in the colon of a patient with Crohns disease In medicine (anatomical pathology), a granuloma is a group of epithelioid macrophages surrounded by a lymphocyte cuff. ... When normal cells are damaged or old they undergo apoptosis; cancer cells, however, avoid apoptosis. ... In anatomy, a styloid process refers to the slender, pointed process (protrusion) of the temporal bone of the skull or the radius and ulna bones of the lower arm. ... In the development of vertebrate animals, the branchial arches (or pharyngeal arches) develop during the fourth and fifth week in utero as a series of mesodermal outpouchings on the left and right sides of the developing pharynx. ...


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’s syndrome (elongated styloid process).[4] Radiopaque is matter that does not allow a certain amount of electromagnetism to pass through. ... Tomography is imaging by sections or sectioning. ... Bodybuilder Markus Rühl has marked hypertrophy of skeletal muscle. ... Lymph nodes are components of the lymphatic system. ... In connection with the stylohyoideus muscle a ligamentous band, the stylohyoid ligament, may be described. ...


Giant tonsilloliths

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.[5]


Treatment and prevention

The most aggressive form of treatment involves surgical removal of the stone, via oral curette or a tonsillectomy to remove the tonsils. Throat with Tonsils Throat after tonsillectomy A tonsillectomy is a surgical procedure in which the tonsils are removed. ...


Tonsilloliths can be removed by the patient. Using a medicine dropper (especially one with a curved tip) can help to suck out the stones if they are small enough. A cotton swab dipped in hydrogen peroxide applied directly on the tonsil stones will not necessarily dislodge them - it may help some sufferers of tonsilloliths while others may experience only an unpleasant gagging sensation. The use of a water pick (irrigator) to clear out the crypts of accumulated debris may also help (only use an adjustable unit on the low pressure setting as you may damage tissue with the high pressure units). Use a solution of salt water, or a mixture of hydrogen peroxide with mouthwash in the water pick tank instead of (or combined with) water to cleanse the tonsil crypts and help prevent future tonsilloliths. While difficult to perform due to the gag reflex, a quick brushing with a toothbrush will generally remove any tonsilloliths. Another effective way to remove tonsil stones is by pressing a finger against the bottom of the tonsil and pushing upward. The pressure squeezes out stones. Some people can even reach them with their tongue, which is the best method as the tongue doesn't stimulate the gag reflex. R-phrases , , , , S-phrases , , , ,, , , , Flash point Non-flammable Related Compounds Related compounds Water Ozone Hydrazine Except where noted otherwise, data are given for materials in their standard state (at 25 Â°C, 100 kPa) Infobox disclaimer and references Hydrogen peroxide (H2O2) is a very pale blue liquid which appears colourless in... Look up Water pick in Wiktionary, the free dictionary. ... This article does not cite any references or sources. ...


For large crevices, an effective tool for digging out a stone is an ear curette. The curette is used primarily for the removal of ear wax, but is effective for removal of tonsil stones as well. It comprises a long thin metal stick with a tiny metal loop at the end. Alternatives include the curved end of a hair grip or a cotton swab.


A longer term cure is possible by using laser resurfacing. The procedure is called laser tonsillotomy, or laser tonsillectomy. This technique can be performed under local anaesthetic, using the scanned carbon dioxide laser, which vaporises and removes the surface of the tonsils. In this way, the edges of the crypts and crevices that collect the debris are flattened out, so that they can no longer trap material. Therefore stones, which are almost like pearls forming from a grain of sand, cannot form. Anesthesia (AE), also anaesthesia (BE), is the process of blocking the perception of pain and other sensations. ...


The most drastic method, a tonsillectomy, is not usually indicated or recommended, but will provide permanent relief. Throat with Tonsils Throat after tonsillectomy A tonsillectomy is a surgical procedure in which the tonsils are removed. ...


Prevention

Prevention methods include gargling with salt water, cider vinegar, dissolvable paracetamol or a non-alcohol-, non-sugar-based mouth wash. In medicine, saline is a solution of sodium chloride (a substance also commonly known as table salt) in sterile water, used frequently for intravenous infusion, rinsing contact lenses, and nasal irrigation (or the yogic practice called jala neti). ... Paracetamol (INN) (IPA: ) or acetaminophen (USAN), is the active metabolite of phenacetin, a so-called coal tar analgesic. ... This article does not cite any references or sources. ... This article is about sugar as food and as an important and widely traded commodity. ... Antiseptic mouth rinse, often called mouthwash, is an oral hygiene product that claims to kill the germs that cause plaque, gingivitis, and bad breath. ...


Some alternative practitioners state that reducing the amount of white sugar, alcohol, or dairy in the diet will reduce the frequency of buildup. There are, however, no reliable data that supports this theory. A dairy farm near Oxford, New York in the United States. ...


References

  1. ^ Treating Tonsil Stones - DrGreene.com
  2. ^ Composition of the bacterial flora in tonsilloliths.
  3. ^ images
  4. ^ 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. 
  5. ^ 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. 

See also

Oral candidiasis, also oral thrush, is an infection of yeast fungus, Candida albicans, (or, less commonly, Candida glabrata or Candida tropicalis) in the mucous membranes of the mouth. ...

External links

  • Giant tonsillolith: Report of a case (In Spanish with English abstract)
  • www.tonsilstones.org

  Results from FactBites:
 
Tonsillolith - Wikipedia, the free encyclopedia (807 words)
Protruding tonsilloliths have the feel of a foreign object, lodged between the outside of wisdom teeth and the temporomandibular joint region of the fleshed jaw.
Tonsilloliths or tonsil stones are calcifications that form in the crypts of the palatal tonsils.
Tonsilloliths are difficult to diagnose in the absence of clear manifestations, and often constitute casual findings of routine radiological studies.
  More results at FactBites »

 
 

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