The Tonsillar Cleft - Removal Of Entrapped Cheesy Substance

Several conditions like peritonsillar abscess (infection with pus formation beyond tonsillar capsule), retained food residues, and tonsillolith (tonsillar stone) may form because of tonsillar clefts. The usual presenting symptoms are halitosis and unusual tonsillar appearance, though it can be asymptomatic and found by chance on examination. There is a need to do an oropharyngeal endoscopic assessment, probing with blunt instrument and digital palpation. In the figure we can see cheesy-white materials in the supratonsillar cleft due to cumulating food residue/epithelial sloughs entrapment. Beware of the underlying dysplasia/malignancy and if there is a doubt, examination under anaesthesia with/without tonsillectomy will have to be performed. In this video we can see a use of a blunt instrument (ring curette) after the throat sprayed with topical lignocaine, in a way to remove the entrapped substance from supratonsillar cleft. The careful examination was performed and it did not show suspicious dysplastic mucosal changes over the cleft surface.