The treatment of tonsil stones is one of the most common procedures we perform at the Mike Dilkes ENT Laser Surgery. So what are the signs of tonsil stones, how do they appear and what can you do about them?
1. Tonsil stones form when cracks (crypts) and holes appear in the tonsils, usually due to expansion and contraction during tonsillitis, often several years previously. They are usually in the top of the tonsil, hidden behind the flap of tissue in front of the tonsil. They can occur anywhere in the tonsil though.
2. Food that you are chewing enters these cracks and holes, the chewing and swallowing motion forces it deep into the tonsils where it is compressed into a ball and lodges.
3. The lodged food decays, causing a bad taste and smell. As it decays it crumbles and becomes liquefied or soft, whereupon it is expelled from the cracks and holes at now has a soft consistency. This can set off tonsillitis as an inflammatory response occurs around the decaying food.
4. Some tonsil stones harden within the crypts and can stay present for many months, and can be seen on cross sectional imaging – CT scanning is the best – where they show as calcified lumps.
5. Tonsil stones can be treated by the patient using water jet instruments to flush them out, or cotton buds etc – this can make the tonsil bleed and can be quite uncomfortable.
6. Laser Tonsillectomy under local anaesthetic is usually enough to remove all of the holes and cracks, which go right to the deep parts of the tonsil, yet leave a small amount of tonsil tissue behind, so that the function of the tonsils – to recognise infection and help produce antibodies etc - is retained.