口蓋扁桃摘出術後の扁桃結石例

抄録

Tonsilloliths are often observed in general clinical practice, and cases of giant tonsilloliths have been reported. To the best of our knowledge, however, cases with the formation of a giant tonsillolith after having undergone tonsillectomy are very rare.

A dentist detected a calcific lesion in the X-ray of a 65-year old female patient. The patient was referred to the Department of Otolaryngology of a nearby hospital. A cervical CT at this hospital revealed a relatively giant tonsillolith, measuring 20 mm in maximum diameter. A lithectomy to remove the left tonsillar stone was performed under general anesthesia. The tonsillar stone was removed in two pieces. Over 95% of the stone was calcium phosphate. Grocott’s staining led to the suspicion of fungal involvement. We theorize that the core of the stone was formed due to inflammation of the residual tonsil after tonsillectomy; thereafter, smoking and other chronic stimuli let to the growth of the stone into a giant tonsillolith.