Definition: It is chronic tonsillitis that results in collection of calcareous or gritty particles in the center of caseous plugs filling the crypts of the tonsil.


  1. Chronic repeated attacks of tonsillitis, often inadequately treated.
  2. Adults are much more frequently affected than children.


  1. Patients have recurrent attacks of chronic tonsillitis.
  2. Foreign body sensation in the throat.
  3. Often patients have halitosis.
  4. Small calcareous whitish particles are noticed during gargling.

Clinical findings:

  1. The tonsillolith is oval with somewhat roughened granular surface. There is a marked redness around the tonsillar crypt.
  2. A few patients have a concentrically laminated or radially striated structure.


Often ‘Actinomyces’ like colonies of mixed multiple organisms are found in tonsillar crypts. These colonies grow peripherally with a rayed or clubbed outer zone.

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  1. If the symptoms are severe, tonsillectomy can be done.
  2. Removal- The tonsillolith can be removed from its crypt. If it is firmly in the crypt, an incision is taken on the wall of the crypt. However, there are chances of recurrence.
  3. If the patients are asymptomatic no medical or surgical treatment may be required    .

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