Tonsiliths are calcifications of tonsilar lymphoid tissue which are normally seen in the superficial layers of the lateral pharyngeal walls.

Usually they are less than 2 mm in size.

Prevalence is reported as only 4% in pans.

However, I see them much more frequently in CBCTs at about 15-20% of adult scans. They can be associated with halitosis. The main concern is not to confuse these with carotid artery calcifications which are approximately halfway between the pharynx and the facial surface at a level of cervical vertebra junction C3-C4.

In the images below, the tonsiliths are at the level of C2-C3 and just below pharyngeal airway surface.

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