Dear XXXXXXX

Thanks for the query.

I am an ENT surgeon and I have read your query with diligence.

On the basis of the information provided
1. It appears that you are suffering from the condition called keratosis of Tonsil. This is a condition where whitish deposits occur in the tonsillar crypts.

2. Sometimes the crypts in the tonsil are deeper and can be a site of lodgement of food particles. This may also give an appearance similar to what you have described. As the food particles which stay in tonsillar crypts are not digested it can lead to foul smell in breath and may also lead to infection of the tonsil. This is described as tonsilolith which is a second possible explanation of your symptoms.

3. As your report of throat swab is negative, presence of infection is unlikely.

In both these situations, tonsillectomy is the treatment of choice. Medicines may not help you. The only conservative way of managing this problem is by frequent gargling. Recurrent and troubling complaints can only be managed by tonsillectomy.

I would request you to discuss it with your doctor about this. There are also other causes of white membrane or white patches on tonsil which can be discussed once the aforementioned common conditions are ruled out.

I hope this answers your concern. Do let me know if anything else is required from my side

With warm regards
Ravinder Sharma

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Dear XXXXXXX,

Thanks for the follow up query. The answers to your questions are as follows

As your problem is associated with tonsils and is recurring in nature - removal of tonsil is a good option. At your age tonsils have no active function and if they are causing problem excision is usually curative. It is a day care surgery and preferably done under general anaesthesia. It is done through oral cavity and in most of the cases; patient can be discharged by evening or next day.

Betadine mouth gargles or warm saline gargles can be tried.

I hope this answers your concern.

With warm regards

Ravinder Sharma     

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