Halitosis as an indication for tonsillectomy in chronic hypertrophy tonsillitis


Halitosis as an indication for tonsillectomy in chronic hypertrophy tonsillitis


Agata Zalewska1, Marek Bochnia2, Monika Morawska-Kochman3

1MD, PhD, Wroclaw Medical University Poland, Faculty od Dentistry Department of Otolaryngology; 2MD, PhD, Wroclaw Medical University Poland, Faculty od Dentistry Department of Otolaryngology; 3MD, PhD, Wroclaw Medical University Poland Faculty of Medicine, Clinic of Otolaryngology, Head and Neck Surgery.


International Research Journal of Otolaryngology

Main purpose: This paper aimed to confirm a relationship between chronic hypertrophic tonsillitis (CHT) and bad mouth odour. To this end, detailed identification of the microbial flora inhabiting affected tonsils was carried out. The results obtained might be helpful in specifying indications for tonsillectomy.

Materials and method: From among 247 patients with clinically diagnosed CHT, 33 generally healthy individuals aged 18- 40 (10 male and 23 female) were selected. Patients in whom other causes could be the possible reason for their fetor ex ore (halitosis) were not included. Before and 2 to 3 months after tonsillectomy, organoleptic and halimeter testing was undertaken for each patient. A swab was collected from the interior of the enucleated tonsils in a sterile manner, and was inoculated onto surfaces enabling the culture of aerobic and anaerobic bacteria and fungi. A histopathological examination was subsequently performed.

Results: Fetor ex ore was initially found in 95% of the patients with CHT. In 90% of cases with confirmed halitosis, after tonsillectomy a significant reduction in its intensity was observed. On average, the concentration of VSC in the patient decreased by approximately 75 ppb (62%), which was statistically significant (p < 0.0001). It was also shown that the concentration of VSC in carriers of anaerobic bacteria, compared to carriers of only aerobic bacteria, was significantly reduced (p < 0.05). The results obtained confirm the role of CHT in the pathogenesis of halitosis.

Conclusions: Halitosis in patients with CHT requires a number of laboratory tests and specialist consultations to exclude other possible causes of fetor ex ore. A dental examination plays an important role in the differential diagnosis. Performing targeted microbiological testing to determine the patient’s carrier state for anaerobes should eventually be considered. When these conditions are met, halitosis can be considered an independent indication for tonsillectomy.


Keywords: Halitosis, Indication for Tonsillectomy, Chronic Hypertrophy Tonsillitis

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How to cite this article:
Agata Zalewska, Marek Bochnia, Monika Morawska-Kochman. Halitosis as an indication for tonsillectomy in chronic hypertrophy tonsillitis.International Research Journal of Otolaryngology, 2019, 2:8. DOI: 10.28933/irjo-2019-07-0205


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