Upper airway obstruction caused by bilateral giant tonsilloliths

Lo, Ru-Hsiao; Chang, Kuo-Ting; Chu, Sau-Tung

doi:10.1016/j.jcma.2011.05.011

Cited by 19 publications

(19 citation statements)

References 5 publications

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“…Clinically, these calcifications may be associated with halitosis, odynophagia, otalgia, and upper airway obstruction. Symptomatic or larger tonsillar calcifications should be removed [1,[7][8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths

et al. 2019

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Significance of the Study• The aim of this study was to compare cone-beam computed tomography (CBCT) and panoramic radiography (PR) for the detection of tonsilloliths. • The detection rate of tonsilloliths was 33.2% on CBCT. • Only 51.4% of the tonsilloliths detected on CBCT were identified by PR. • PR was not adequate to detect tonsilloliths 1 mm or smaller in size. AbstractObjective: A tonsillolith is a concretion of the tonsillar crypt. The aim of this retrospective study was to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the detection of tonsilloliths. Materials and Methods: The CBCT images of 527 patients with maxillofacial volume were evaluated retrospectively. Of these, 175 patients (81 females, 94 males; mean age 51.05 years) had unilateral or bilateral tonsilloliths. In total, 151 of them (67 females, 84 males; mean age, 51.03 years) had PR images performed in the same period and were included in the study. The PR images were examined to ascertain whether known tonsilloliths (from CBCT images) could be detected. The location (unilateral; left or right and bilateral), size, and number of the tonsilloliths were examined on both CBCT and PR images. Descriptive analysis, Spearman's rho correlation coefficient, and χ 2 tests were used for the statistical analysis. Results: The detection rate of tonsillolith was 33.2% on CBCT images. Only 51.4% of the tonsilloliths detected on CBCT were evaluated by PR; the correlation between CBCT and PR was found to be significant (Spearman's r = 0.399, p = 0.000). PR was not adequate to detect tonsilloliths 1 mm or smaller in size. All the calcifications larger than 5 mm were detected on PR images. Conclusion: The results of this study showed that more than half of the tonsilloliths observed in CBCT were also detected in PR. Tonsilloliths larger than 2 mm were more likely to be detected on PR images.

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Section: Discussionmentioning

confidence: 99%

Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths

et al. 2019

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“…Through multiple slices and alternative views, surgeons can relatively easily and accurately determine the size and location of a tonsillolith within the surrounding inflammation, although the appearance is still not pathognomonic 7. In comparison to CT, cone-beam computed tomography (CBCT) offers the advantages of significantly lower radiation exposure, reasonably short scanning times, and a more compact design with sufficient accuracy 8.…”

Section: Introductionmentioning

confidence: 99%

Bilateral and pseudobilateral tonsilloliths: Three dimensional imaging with cone-beam computed tomography

et al. 2013

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PurposeTonsilloliths are calcifications found in the crypts of the palatal tonsils and can be detected on routine panoramic examinations. This study was performed to highlight the benefits of cone-beam computed tomography (CBCT) in the diagnosis of tonsilloliths appearing bilaterally on panoramic radiographs.Materials and MethodsThe sample group consisted of 7 patients who had bilateral radiopaque lesions at the area of the ascending ramus on panoramic radiographs. CBCT images for every patient were obtained from both sides of the jaw to determine the exact locations of the lesions and to rule out other calcifications. The calcifications were evaluated on the CBCT images using Ez3D2009 software. Additionally, the obtained images in DICOM format were transferred to ITK SNAP 2.4.0 pc software for semiautomatic segmentation. Segmentation was performed using contrast differences between the soft tissues and calcifications on grayscale images, and the volume in mm3 of the segmented three dimensional models were obtained.ResultsCBCT scans revealed that what appeared on panoramic radiographs as bilateral images were in fact unilateral lesions in 2 cases. The total volume of the calcifications ranged from 7.92 to 302.5mm3. The patients with bilaterally multiple and large calcifications were found to be symptomatic.ConclusionThe cases provided the evidence that tonsilloliths should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and they highlight the need for a CBCT scan to differentiate pseudo- or ghost images from true bilateral pathologies.

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“…Approximately 30 cases have been reported since 1990. The majority of them consisted of giant unilateral tonsillolith causing dysphagia or dyspnea [1,2] and a very few were bilateral asymptomatic macroscopic tonsilloliths [3,4]. To our knowledge, MRI presentation of tonsilloliths have been described in only one report [5].…”

Section: Discussionmentioning

confidence: 91%