TonsilsTonsils and other structures in the back of the throat

Although only one tonsil is labeled, they come in pairs. Note the little indentations over the surface of both tonsils.  These are called tonsillar crypts, and when a patient comes down with strep throat, white colonies of streptococcus can often be seen in the crypts, while the areas surrounding them are generally quite red and inflamed.  This image is of a child’s tonsils.  In children, the tonsils can be quite large.  They take up a lot less room in the throat of an adult.

Tonsils are made up of lymphatic tissue (i.e.. they are really lymph nodes) but have become evolutionarily redundant.  The body contains hundreds of lymph nodes, so their removal is no great loss.  They are frequently removed in children who have numerous sore throats due to tonsillitis, or in adults who suffer from obstructive sleep apnea or recurrent tonsilloliths.  Tonsilloliths are nasty smelling little stones which form in the tonsillar crypts.  They tend to cause bad breath.  They are especially prevalent in patients with chronic post nasal drip.  These stones can be popped out using a pointed instrument, however they may reform in a fairly short time.  The only permanent cure for tonsilloliths is the removal of the tonsils.

Tonsils2The image above shows a severely swollen pair of tonsils in a 22 year old female who has had chronic difficulties with them.  Looking closely, one can see that there is not much room for the passage of air, or food.  When this type of problem occurs, patients often have difficulty eating due to pain on swallowing, and in heavy patients, obstructive sleep apnea is an ever present possibility.


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