Can sinusitis affect my tonsils?

[mbbebb]

My adult son (22 yrs)has a very long history of both sinus infections and asthma. When he was 5 years old he had an infection that was seriously out of control, it effected all sinus cavities and required numerous hospitlizations that spanned 7 years. For those 7 years he was always on prednizone and alternating antibiotics, one month amoxcillon and the next month ceclor, back and forth. By the time he turned 12 the infections grew less frequent. However, by age 15 whenever he had any kind of upper respitory problem it would always result in severly swollen, reddened tonsils. More importantly he would develop these white, blister like lesions all over his tonsils that would then spread into his throat and mouth. This condition always panics him as he has difficulty breathing (no wheezing) and swollowing. The family doctor always takes a swab test which comes back negative and shrugs his shoulders, perplexed.

I was recently at my own ENT's office and on the wall was a large laminated poster showing throat conditions, one picture looked just like these lesions and was called "mononucleosis tonsilitis". Is it possible it could be this? Given that it has continued to reappear about once a year since its onset? Or could it be related to continues sinus infections? And if so, what home treatment could he use, or what kind of doctor should he seek out? Any ideas?

[National Jewish]

It is not likely that this is mononucleosis.  That infection is not seen in this way.  It is possible that an infection could be coming from the sinuses or another area, such as the tonsils themselves.  If this is an infection, no home remedy is likely to get rid of it.  An ENT specialist is still the best person to evaluate the problem.  This could include culturing of the sinuses and tonsils for a variety of infections, including fungal infections.

[Ellis7]

These are probably tonsil stones; he could consult an ENT.

More info:
http://www.doctorhoffman.com/xlith.htm
Tonsilloliths
These things are called tonsilloliths ("tonsil stones.") You have described them perfectly. They are typically white, or whitish-yellow, irregularly-shaped, foul-smelling, and usually smaller than a pea. The tissue lining the tonsils (oral mucosa) is fairly sensitive, so people with this problem often report that they feel an irritation in the back of their throat and are able to pick these critters out of their tonsils.

Like your skin, oral mucosa sheds continuously. The dead cells become incorporated in your saliva and then you swallow them. Yum! One more anatomical fact that you need to know: the surface of your tonsils is pockmarked with deep pits, appropriately called "crypts" (since dead stuff accumulates in these pits.) Oral mucosa lines the crypts. Under normal circumstances, as this mucosa sheds, the dead cells leave the crypts and are swallowed. In some unlucky people, like you and your sister, the dead cells accumulate and glom together to form hard little balls. All of this dead stuff makes great food for bacteria, and of course your oral cavity is colonized by all kinds of bacteria. Consequently, the tonsilloliths are ripe with bacteria. This accounts for the smell.

The only sure-fire method for ridding yourself of this problem is to have your tonsils removed (tonsillectomy), but there are nonsurgical alternatives which you should certainly pursue before you ask an ENT to take out your tonsils:

– You could try gargling frequently with warm salt water (1 teaspoon of table salt mixed with one pint of water– gargle with about 1/4 cup of this mixture three times per day, after meals.)

– You could also gargle with a mouthwash called Alkalol, which is essentially salt water combined with a variety of natural aromatic extracts; some people prefer Alkalol to plain salt water. Most other commercial mouthwashes contain sugar or alcohol, which are pleasant-tasting but are, in the long run, fairly irritating if used frequently.

– There is a doctor in Los Angeles, Murray Grossan, who markets a water-jet device for "hosing down" the tonsils. Relative to gargling, this device provides a more aggressive technique for clearing out those nasty crypts.

– In the hopes of avoiding tonsillectomy, I will often put my patient on a long (3 to 4 week) course of antibiotics in the hope that this will allow the tonsils to "settle down" (become less inflamed.) I must admit that antibiotics are not a very effective cure for this problem.

If I had this problem, I would try all of these things before resorting to a tonsillectomy. You should also discuss your problem with an ENT, since he/she may have other suggestions to help eradicate these nasty critters, and could also give you information on what to expect from a tonsillectomy

[Di_2007]

A related discussion, Why does Sinus cause my tonsil to get infected? was started.