Tonsillolith as a Cause of Glossopharyngeal Neuralgia- An Unusual Entity

Abstract

A 36-year-old male presented in our outpatient department with the complaint of radiating pain on the right side of neck, lasting for few seconds. It was mainly in the throat on the right side and radiated to the ear off and on. He had been taking medical treatment from private practitioners in the form of painkillers, but got temporary relief. He was diagnosed as a case of GPN by an ENT specialist in a private institution and given Tegretol 200 mg thrice a day and gabapentin alternately. This gave him relief, but the attacks were not fully controlled. He used to be depressed because the attacks of lancinating pain disturbed his sleep at night and in the morning left him drowsy and unable to perform his daily chores. On detailed clinical examination he gave history of post nasal discharge, so to rule out sinusitis he was advised CT scan (Coronal View) of paranasal sinuses. It showed bilateral almost normal sinuses. The styloid process on the left side was elongated, but on the affected right side it was normal in length. Calcified foci were seen in both the palatine tonsils suggestive of tonsilloliths [Fig. 1].