“In Tonsils, a Problem the Size of a Pea”

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The Story

“In Tonsils, a Problem the Size of a Pea”
by Elizabeth Svoboda
The New York Times, August 31, 2009

The Pitch

Hi David,

…I have an article idea for you that falls squarely into the health category: a piece about tonsil stones (tonsilloliths), pencil eraser-sized concretions of calcified matter that form in deep crypts, or holes, inside the tonsils. Tonsil stones, doctors say, are the result of a combination of dead white blood cells, mucus secretions, and bacteria that consume the protein from these secretions, perhaps explaining why people with postnasal drip are especially prone to the problem. When coughed up or removed, the stones resemble terrible-smelling cottage cheese curds.

A surprisingly large number of people seem to have the stones. In a 2007 study, French doctors found that in a representative sample of 515 CT scans, 31—about 6%—of subjects showed evidence of stones in their nasopharyngeal tonsils, also known as adenoids. Still, the condition is little-known among members of the general population and sometimes even among medical professionals. I had this problem myself for years (gross, I know) before I even realized what was wrong with me. But after I finally figured out they were called “tonsil stones,” I found one online message board after another where people were posting things like, “I can’t believe I’m not the only one who has this problem!”

Like me, many of them had even gone to an ENT to get checked out, only to be told that there was nothing wrong with them or that they simply had food particles trapped in their tonsils that would soon go away. But in reality, tonsilloliths can have very real effects on sufferers’ social lives as well as their health. In a 2008 study at the University of Campinas in Sao Paulo, Brazil, doctors found that tonsilloliths were present in 75% of patients who had bad breath and only 6% of patients with normal breath. In a 2008 case report from India, doctors described removing a giant tonsillolith that was causing a patient to have extreme pain upon swallowing.

I think an article about tonsil stones—what they are, what causes them, and a rundown of available remedies, complete with firsthand testimonies from sufferers, would do a tremendous service to the many thousands of people who have this problem, but think it’s a sign of something more serious (like cancer or some other harmful growth, as I did initially) or have no
idea there’s a specific diagnosis or treatment options for it. I searched the NYT archives and apparently no articles have been published on this topic since 1851, so I think we’d be good to go on that front. Look forward to hearing your thoughts.

Talk soon, Elizabeth

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