Tonsilloliths (stones or lumps in the tonsils)

Tonsil stones are related to catarrhal symptoms because they can make people constantly want to clear their throat, they feel as if something is stuck in the back of their mouth. Often patients use tooth picks or cotton buds to extract these lumps, which can cause an unpleasant taste and smell from the back of the mouth. The presence of tonsil stones is quite a common condition which people often don’t admit to. They can be associated with acute or chronic sore throats, or may simply occur on their own. They are due to the presence of fissures or crevices on the surface of the tonsils – some people have these, some don’t. If you have them, they can trap particles of food, which become organised over time, enlarging slowly. Eventually they extrude from the surface of the tonsil as a cheesy white or yellow lump. They are soft and smelly and can be quite off putting.

The treatment is mainly surgical, lasers can be used to resurface or remove the crypts so that they can no longer collect food debris. This is a procedure performed using local anaesthetic spray only, and causes very little postoperative discomfort. The surface of the tonsil is sequentially vapourised/removed, so that the depth of the crevices etc is serially lowered such that they no longer are able to trap food or debris etc. The procedure is performed as a “lunchtime” treatment, no injections are required, the tonsils are simply numbed with local anaesthetic spray, which takes around 60 minutes to fully wear off. After this time, patients are free to return to work etc. No time off work is usually required. Postoperatively, painkillers are required for up to 1 week, although no change in lifestyle or diet is needed.

Tonsil stones, or tonsilloliths, form in the crypts and cracks that are often present on the surface of tonsils. Coughs, sore throats, lump sensation, bad breath and bad taste in the mouth can all be symptoms. The best treatment is laser tonsillotomy or laser tonsillectomy.

The London Laser Clinic has more information on local anaesthetic tonsil reduction / resurfacing; click here to visit the relevant LLC page.