gms | German Medical Science

82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

01.06. - 05.06.2011, Freiburg

Etiology of tonsilloliths – a case report

Meeting Abstract

Suche in Medline nach

  • corresponding author presenting/speaker Edgar Bachor - Department of Otolaryngology, Sykehuset Østfold, Fredrikstad, Norway
  • Kristian Godøy - Departmet of Pathology, Sykehuset Østfold, Fredrikstad, Norway
  • Edward Berger Messelt - Department of Oral Biology, Dental Faculty, University of Oslo, Oslo, Norway

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 82nd Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Freiburg, 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hno02

doi: 10.3205/11hno02, urn:nbn:de:0183-11hno028

Veröffentlicht: 3. August 2011

© 2011 Bachor et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Introduction: Tonsilloliths are defined as calcifications in the tonsillar region. Large tonsilloliths are rare, but smaller calcifications ranging from 1–7 mm are quite frequent [1].

Material and methods: A 46-year-old caucasian male complained of discomfort in the tonsillar region which was related to bilateral tonsilloliths. The tonsillolith on the left side was previously removed subtotally, but has since then been growing back. After tonsillectomy the tonsilloliths were analyzed with regards to composition and structure by light microscopy as well scanning electronmicroscopy.

Results: The main component of the tonsilloliths consists of calcium and phosphate and with only a minimal amount of sodium. The tonsils demonstrated multiloculated calcifications within the crypts. The larger calcifications showed a concentric growth pattern. The surface of the calcifications (Figure 1 [Fig. 1]) was covered with rods, cocci and spirochetes which all are constituents of a biofilm. A localized immune response was observed adjacent to the calcification. The growth tendency of the calcification was approximated 0,5 g over a period of two years.

Conclusion : Calcifications in the tonsillar crypts are covered with biofilm [2], [3]. Possibly changes in the composition of saliva and local infections and will induce chances of the biofilm and promote growth of the tonsillolith. This process can easily be stopped by tonsillectomy with complete removal of the calcification as well as the biofilm.


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