An Unusual Cause of Mechanical Dysphagia: An Agglomerate of Calculi in a Tonsillar Residue

Abstract

We report the case of a 68-year-old man affected by severe oropharyngeal dysphagia for solid food, who had undergone tonsillectomy when he was 22 years old. Videolaryngoscopy revealed a smooth-surfaced, elongated overgrowth on the left lateral pharyngeal wall that protruded toward the left pyriform fossa and impeded the transit of solid boli. A computed tomography scan showed that the solid content of the lesion was markedly inhomogeneous and denser than the surrounding soft tissues. The mass was removed by means of direct pharyngoscopy under general anesthesia. It was found that it arose from the inferior pole of the left tonsillar fossa and had a central cavity filled with caseum and multiple calculi. Histopathologic examination showed that its soft tissue component consisted of lymphoid tonsillar tissue. The operation totally resolved the swallowing disturbance. This case report highlights that tonsilloliths in a tonsillar residue should be considered in the differential diagnosis of mechanical oropharyngeal dysphagia, even in tonsillectomized patients.

Palatine Tonsilloliths: A Retrospective Study on 500 Digital Panoramic Radiographs

“…However, large symptomatic calcifications may be superinfected causing peritonsillar abscess and need to be removed surgically (enucleation or even tonsillectomy). 2,[13][14][15][16] Since there are no radiological studies investigating palatine tonsilloliths in Lebanon, this study aimed to evaluate this type of calcifications in a Lebanese sample through digital panoramic radiographs.…”

Dystrophic Calcification in the Oral Cavity Resulting in Mechanical Dysphagia: A Case Report and Review of Calcification in the Head and Neck Region

“…Tonsilloliths are calcium salt deposits arising from material retained in the tonsillar crypts and occur most frequently in young adults affected by recurrent upper airway infections [4]. It may also originate from a mass of retained material and bacterial colonies [5]. There was no evidence of frequent upper respiratory tract infection (URTI) and radiographically the mass was located more towards the mandibular angle region.…”

Tonsillolithiasis and orofacial pain

“…The population of patients with tonsilloliths described in the literature ranges from 10 to 77 years 2 with mean age of occurrence 46.2 6 and a male/female ratio of 1:1 7 . Tonsilloliths have been located in the peritonsillar region, lateral pharyngeal wall 8 and nasopharyngeal region 9 .…”