Tundikeri in Ayurveda and its Management with Special Reference to Chronic Tonsillitis: A Structured Review with Qualitative Meta-Analysis

Abstract

Tundikeri is a disease described in classical Ayurvedic literature under disorders of the mouth and throat and is managed within the branch of Shalakya Tantra. It is characterized by inflammation, swelling, pain, and obstruction in the tonsillar region. The clinical presentation of Tundikeri closely resembles chronic tonsillitis described in modern medicine, a recurrent inflammatory condition affecting the palatine tonsils. According to Ayurveda, the condition develops due to the vitiation of Kapha and Rakta Dosha, leading to persistent enlargement and inflammation of the tonsils. Chronic tonsillitis commonly affects children and young adults and is associated with repeated episodes of sore throat, difficulty in swallowing, halitosis, and other systemic symptoms. This review article aims to explore the classical Ayurvedic concept of Tundikeri and correlate it with the modern understanding of chronic tonsillitis through a structured review and qualitative meta-analysis. Classical Ayurvedic texts along with contemporary medical literature were systematically analyzed to evaluate the etiopathogenesis, clinical manifestations, and management approaches of the disease. The qualitative meta-analysis demonstrated considerable similarities between Ayurvedic and modern perspectives, particularly regarding chronic inflammation, immune involvement, and recurrent nature of the disease. Ayurvedic management approaches such as Nidana Parivarjana (avoidance of causative factors), Shodhana (purification therapy), Shamana (pacification therapy), and Sthanik Chikitsa (local therapeutic procedures) appear to have significant relevance in the conservative management of chronic tonsillitis and may help in reducing recurrence. This review further discusses the etiological factors, pathogenesis, clinical features, diagnosis, and treatment principles in detail, while highlighting the holistic role of Ayurveda in improving immunity, preventing recurrence, and supporting integrative management strategies for chronic tonsillitis.