Stromal syndrome, also known as stromal hyperacusis, used to be considered a rare disease, but in recent years the disease has become more and more clinical due to the increasing availability of screening tools, as well as the importance patients attach to their disease! The clinical manifestation is persistent sore throat on one side, which can occur after tonsil surgery, and the symptoms are aggravated when swallowing makes head and neck movement, which can be accompanied by ear pain, headache or tinnitus. Clinically, it is often misdiagnosed as chronic pharyngitis due to the inertia of physicians; the condition is commonly seen in adults over 20 years of age, often on one side. The patient in this case is the longest stem syndrome that I have ever surgically removed. In this case, the patient was resected by a trans-caliber approach to the stalk syndrome; general anesthesia was routinely applied, the right tonsil was resected, and the stalk was separated from the right tonsil fossa, fully exposed and then completely resected. The diagnosis of cauda equina syndrome was based on 1, according to the above symptoms and signs. 2. X-rays or CT films show a long (usually 2.5 cm long), thickened or oblique stem. Why is it easy to misdiagnose? In fact, as long as the doctor has it in mind, he will not miss it! Because of the atypical symptoms, none of the patients I have met so far who have been diagnosed with protrusion syndrome have been definitively diagnosed the first time the patient visited the doctor with symptoms! Many patients have been misdiagnosed with chronic pharyngitis, pharyngeal heterosensitivity, neurological dysfunction, tinnitus, otitis media, psychological disorders, etc.