Tonsil Crypts: Causes and Solutions for Foul Odors

Q: Tonsil Crypts: Causes and Solutions for Foul Odors

Hello Ms. <br>CC： Using saline solution for gargling is less effective; it is recommended to switch to mouthwashes like Day and Night for better results. <br>After tonsillectomy, this issue will not occur.

Tonsillar crypts often contain foul-smelling yellowish-white substances?

Dear Dr.
Tsai,
I have been experiencing issues for over two years since an episode of tonsillitis.
I have been finding white, foul-smelling substances in the crypts of my tonsils.
Initially, I could cough them out, but now I have to use tools to extract them.
The situation has worsened to the point where these substances are hidden deep within the folds of my tonsils, requiring significant effort to remove.
I often end up bleeding and still cannot extract everything, as I can still smell the foul odor in my throat, indicating that not all of it has been removed.
The constant irritation in my throat has triggered a gag reflex, causing me to vomit bile, which forces me to stop the extraction process.
After several attempts, I have noticed persistent discomfort in my stomach, and I often feel nauseous when my toothbrush touches the back of my tongue.
Therefore, when I attempt to remove the substances from my tonsil crypts and feel the slightest gag reflex, I have to stop.
However, I can still sense the ongoing foul odor emanating from my throat, which is quite distressing and affects my daily interactions.
I constantly worry that others will notice the smell when I talk to them.
A friend of mine, after I confided in him about my issue, honestly told me that he also noticed a strange, unpleasant smell coming from my mouth, but he felt uncomfortable mentioning it.
Currently, I can extract these substances from my tonsil crypts every few days.
If I am fortunate enough to clean them out thoroughly, the foul odor in my throat disappears for a couple of days, only to return gradually, prompting me to repeat the extraction process.
I truly do not want to continue torturing my throat.
Not only do I often cause bleeding and have a sensitive throat and stomach discomfort, but I also worry about how I will manage this in the future if I become older, with unsteady hands and poor eyesight.
The persistent foul odor from my throat has become my greatest, inescapable suffering.
I have followed my doctor's advice to gargle with saltwater regularly, but my condition has not improved.
I apologize for the lengthy message, but I would like to ask Dr.
Tsai if my only option is to have my tonsils removed.
If I undergo a tonsillectomy, will this resolve my issues? I appreciate your time in addressing my concerns.
Thank you.

cc, 30~39 year old female. Ask Date: 2004/04/29

Dr. Cai Zhenggu reply Otolaryngology

Hello Ms.
CC: Using saline solution for gargling is less effective; it is recommended to switch to mouthwashes like Day and Night for better results.
After tonsillectomy, this issue will not occur.

Reply Date: 2004/04/29

More Info

Tonsil crypts, or the small pockets and folds found in the tonsils, can often become a source of discomfort and unpleasant odors, particularly when they trap food particles, bacteria, and dead cells. This condition can lead to the formation of tonsil stones, or tonsilloliths, which are often white or yellowish in color and can emit a foul smell. Your experience of having to manually remove these materials from your tonsils is not uncommon, and it can indeed be frustrating and painful.

The underlying cause of your symptoms likely stems from chronic tonsillitis or recurrent infections, which can lead to the enlargement of the tonsils and the deepening of the crypts. When these crypts become filled with debris, they can become a breeding ground for bacteria, leading to halitosis (bad breath) and discomfort. The fact that you have experienced this issue for over two years suggests that there may be a chronic component to your condition.

While saltwater gargles can help reduce inflammation and bacteria in the mouth and throat, they may not be sufficient to resolve the underlying issue of tonsil crypts. In some cases, individuals find temporary relief through good oral hygiene practices, such as regular brushing of the tongue and using mouthwash, but these methods may not eliminate the problem entirely.

Regarding your question about tonsillectomy (the surgical removal of the tonsils), it is indeed a potential solution for persistent issues related to tonsil crypts and chronic tonsillitis. Tonsillectomy can significantly reduce or eliminate the occurrence of tonsil stones and the associated bad breath, as it removes the crypts where these issues arise. However, it is important to consider the risks and benefits of the procedure. Tonsillectomy is generally safe, but like any surgery, it carries risks such as bleeding, infection, and complications related to anesthesia.

If you are considering this option, it would be wise to consult with an ear, nose, and throat (ENT) specialist. They can evaluate your specific situation, discuss the potential benefits of surgery, and help you weigh them against the risks. Additionally, they may offer other treatment options that could alleviate your symptoms without the need for surgery, such as antibiotics for any underlying infections or other non-invasive procedures to clean the tonsils.

In summary, while tonsillectomy is a viable option for those suffering from chronic tonsil crypt issues, it is essential to have a thorough discussion with a healthcare professional to determine the best course of action for your specific condition. Your ongoing symptoms and the impact they have on your quality of life warrant a comprehensive evaluation and a tailored treatment plan.

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