From: anonymous@worldnet.att.net
Subject: Throat consult
Posted-By: xx108 (ENT Clinic Moderator)
Organization: Organization For Community Networks
Date: Sun, 1 Jun 1997 13:41:51 -0700
Newsgroups: ofcn.clinic.ent

Dear Doctor,

One day my 17 year old daughter felt something in the back of her throat. Upon examination, it appeared to be white, bumpy, like a cauliflower appearance, on her right tonsil. There was no redness, no swelling, no pain, no fever. She did however have a sore throat one month previous to this with a negative throat culture.
Thinking that this white thing was food, I tried to dislodge it with a Q-tip, (unsuccessfully). The next day it was gone. She was seen anyway by her pediatrician. He was convinced it was food lodged in a tonsil crypt. I remained unconvinced.
Four days later, my daughter woke up with the same sensation. Again, something white in colored appeared to be attached to her right tonsil. While brushing her teeth, she felt this material dislodge and she spit it out. This tissue, (or whatever it is) is soft but maintains its shape. The only way for me to describe it is, it looks like a small intestine (winding in nature). I remain unconvinced that this is any type of food.
Could this be anything related to her lymph nodes? Do you have any suggestions? I saved the tissue (or whatever it is). Should I bring it to someone?

Thanking you in advance

Reply: --------------------------------

It is indeed most likely partially digested food debris that accumulates in crevaces in the tonsils known as tonsillar crypts. The debris typically looks cheesy or yellow-white, can be mushy to firm, and can adopt the shape of the crypt. Vigorous oral hygiene measures including daily vigorous gargling with dilute salt-baking soda solutions or with antiseptic mouthwashes can be helpful. Severe problems with accumulation of debris in tonsillar crypts may be better treated with the use of a Grossan pharyngeal irrigator tip attached to a water-pik device for daily throat irrigations. When these measures fail to control the problem, tonsillectomy may be considered.

--

Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis

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