Is There a Relationship Between Tonsillolith Formation and Nasal Septal Deviation or Chronic Sinusitis, with or without Nasal Polyps?

Objective: The aim of this study is to assess the prevalence of tonsilloliths and investigate the potential role of nasal septal deviation (NSD) and/or chronic rhinosinusitis (CRS), with or without nasal polyps, in their development.

Methods: A retrospective analysis was conducted on computed tomography (CT) images of 3,516 patients obtained between January 2017 and December 2020. The presence of tonsilloliths was recorded along with NSD and CRS, with or without nasal polyps. The effects of age, gender, NSD, and CRS (with or without nasal polyps) on tonsillolith formation were analyzed. All CT images were re-evaluated for tonsilloliths, CRS, NSD and other pathological findings. The relationships between tonsillolith presence and NSD and CRS were statistically analyzed.

Results: A significant difference in age was observed between individuals with and without tonsillolith (p<0.001). Additionally, the prevalence of tonsillolith was markedly higher in patients diagnosed with NSD compared to those without this condition (p<0.001). Similarly, patients diagnosed with CRS exhibited a significantly increased incidence of tonsillolith when compared to individuals without CRS (p<0.001).

Conclusion: The incidence of tonsilloliths in this study was 27.6%. Tonsillolith prevalence increased with age, while no significant difference was observed based on gender. The presence of NSD, a condition associated with nasal obstruction, or CRS, an inflammatory disorder, was linked to a higher incidence of tonsilloliths.