Tonsillolithiasis and orofacial pain.

doi: 10.1111/j.1741-2358.2011.00456.xTonsillolithiasis and orofacial painTonsilloliths are rare calcified structures that usually result from chronic inflammation of the tonsils.Concretions show differences in size, shape and colour. They are usually asymptomatic but can be asso-ciated with halitosis, foreign body sensation, dysphagia and odynophagia, otalgia, and neck pain. A patientwas referred because panoramic radiography performed by a general dentist revealed radiopaque shadowsover the ascending rami of the mandible, located bilaterally: a solitary structure on the higher portion ofthe right side and two small structures on the left side. Paroxysmal attacks of orofacial pain and symptomssuch as dysphagia and swallowing pain on the left side distributed within the tonsillar fossa and pharynxand the angle of the lower jaw were present. The computed tomography images revealed bilateral ton-silloliths. Clinically, there was no sign of inflammation, and the patient’s past history revealed anapproximately 2-year history of dysphagia, swallowing pain and left-sided neck pain. At the request of thepatient, no surgical intervention was carried out. Glossopharyngeal neuralgia is a rare entity, and the aim ofthis report was to indicate the importance of tonsilloliths as a cause of orofacial pain.Keywords: orofacial pain, glossopharyngeal neuralgia, odynophagia, tonsillolith.Accepted 6 October 2010