THROAT - Tonsillar keratosis

What is Tonsillar keratosis?

Synonym: Mycosis Leptothrica
Tonsillar keratosis is characterized by appearance of multiple white projections from cryptal orifices of1he tonsil, lymph follicles, the posterior and the lateral pharyngeal walls, posterior part of the tongue and glossa-epiglottic fold.

What are the causes of  Tonsillar keratosis?

1. Usually affects young adults
2. Takes two to three years to develop.
3. Viral and fungal infective Aetiology have been suggested
4. Nutritional deficiency theory.

Most common site: Lateral glossa-epiglottic fold and posterior part of the inferior pole of the tonsil.

What is the pathology of Tonsillar keratosis?

 This condition usually affects the faucial and the lingual tonsil during deglutition, the contraction of the muscles prevents food from coming with intimate contact with the surface. It thus permits these projections to grow.

This horny projection breaks up into layers. Between these layers multiple organisms multiply and grow. The toxins released from these organisms are absorbed by the tonsillar tissue.

What are symptoms of Tonsillar keratosis?

The symptoms in this condition are usually mild.

  1. Irritating tickling sensation in throat.
  2. Dry hacking cough
  3. Patient may have history of chronic tonsillitis

Examination :
Oral cavity shows hard, whitish, horny plugs. They may project from the tongue base, and can be touching the epiglottis.

What is the treatment of tonsillar keratosis?

  1. If symptomatic no treatment required
  2. Antiseptic gargles help empirically
  3. Horny masses can be removed by electrocautery. Three  to four masses may be treated at each sitting at weekly intervals.

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