A new study describes a revolutionary treatment method for removing tonsilloliths, commonly known as tonsil stones.

Developed by researchers at Fauquier Ear Nose & Throat (ENT) Consultants (Warrenton, VA, USA) and The Ear Nose & Throat Centers of Texas (McKinney, USA), the technique, known as coblation tonsil cryptolysis, can be performed in most adult patients without sedation, using only local anesthesia, similar to laser tonsil cryptolysis. As with laser cryptolysis, pain is significant for only a few days, and most adults can resume a normal diet and activity within one week. But coblation reduces the high equipment costs associated with lasers, as well as avoiding the potential risks associated with laser use, including airway fire, retinal damage, and oral and facial burns.

Coblation tonsil cryptolysis involves injecting local anesthetic into the tonsils and pillars. Following vigorous palpation of the crypt, ablative radio frequency (RF) energy is applied to excite electrolytes in a conductive saltwater medium (such as saline or gel) to create a precisely focused plasma beam, which causes tissue breakdown at the point of contact at relatively low temperature (40-70 °C), causing little to no damage to surrounding tissues. The results of a retrospective case series study that included seven patients showed that after only a single session, a significant decrease and even elimination of tonsil stones can potentially be achieved. The study describing the technique was published in the June 2012 issue of the Ear, Nose & Throat Journal.

“So many people who suffer from tonsil stones will have a safe mechanism for relief, and primary physicians will be able to more easily identify this sometimes misdiagnosed condition and refer patients for treatment,” said study coauthor Christopher Chang, MD, of Fauquier ENT.

Tonsil stones result when mucus, dead cells, and other debris collect in the crypts of the tonsils and gradually condense into small blobs. Bacteria then feed on the collected matter, causing halitosis. Most stones are about the size of a pencil eraser, although doctors have found some to be more than an inch wide. The stones lead to throat pain and a feeling that an object is stuck in the throat. Potential treatments to date include gargling with a non-alcohol based mouthwash and using irrigation tools such as a Waterpik device to dislodge the stones, and surgery (tonsillectomy).

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