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August 22, 2014

Hole in Tonsil Area After Tonsillectomy

Rarely, a patient may notice a hole in the mucosa in the area where the tonsil used to be after removal (tonsillectomy). This hole typically is located in the anterior tonsil pillar as shown in the picture to the right.

Less commonly, the hole may occur on the posterior tonsil pillar as shown below.

Typically, this hole appears not immediately after surgery, but 5-10 days afterwards. Known as a fistula, this is a temporary situation as this hole will almost always close up over several months. Even holes much bigger than that shown in these pictures will typically heal closed on its own without any specific intervention.

Fistulas after tonsillectomy occur depending on how thin the pillar mucosa is and the degree of tissue devitalization after tonsillectomy (from cautery to stop any bleeding).

Although benign and temporary, it can be annoying to the patient as food can get caught in this hole. But rest assured, they invariably typically close up with time alone without any specific treatment.

BUT... if the fistula does persist and causes problems, the thin mucosal bridge can be cut marsupializing the hole as shown below in the second picture. Arrow left in same position.

Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids. Google+ Christopher Chang, MD Bio

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