A patient reported to my office today with the complaint of a feeling of "something hard or lumpy in the back of my throat." He said that it was present for about a week, and didn't hurt, but he didn't know what it was. His concern was if it should be removed. After examining the area and taking this photo, I removed a small, yellow-white mass which felt like hard cottage cheese. The piece popped right out with a small curette. The most apparent quality of the tonsillolith was an extreme bad smell.
A tonsillolith is reported to be a calcareous mass that can accumulate in the tonsillar crypts in the lateral throat. It is believed that it is generated from an accumulation of food or bacteria in the area, possibly actinomyces bacteria. They are usually not harmful but can contribute to bad breath.
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