Aim. Tonsilloliths are calcified structures that develop in tonsillar crypts. They are commonly detected in daily clinical practice. The prevalence of tonsilloliths was 16 to 24% in previous reports, but it is inconsistent with clinical experience. The aim of this study is to clarify the prevalence, number, and size distribution of tonsilloliths using computed tomography (CT) in a relatively large number of patients. Materials and Methods. We retrospectively reviewed the scans of 2,873 patients referred for CT examinations with regard to tonsilloliths. Results. Palatine tonsilloliths were found in 1,145 out of 2,873 patients (39.9%). The prevalence of tonsilloliths increased with age, and most commonly in patients of ages 50–69. The prevalence in the 30s and younger was statistically lower than in the 40s and older (P < 0.05). The number of tonsilloliths per palatine tonsil ranged from one to 18. The size of the tonsilloliths ranged from 1 to 10 mm. For the patients with multiple CT examinations,the number of tonsilloliths increased in 51 (3.9%) and decreased in 84 (6.5%) of the tonsils. Conclusions. As palatine tonsilloliths are common conditions, screenings for tonsilloliths during the diagnosis of soft tissue calcifications should be included in routine diagnostic imaging.
Objectives: To demonstrate the usefulness of intraoral ultrasonography (IOUS) for tongue mass lesions, we analyzed surgery cases excluding squamous-cell carcinoma and leukoplakia and compared IOUS and pathological findings. Methods: We used the hospital information system and Radiology Information System to evaluate the IOUS and pathological findings of patients who underwent surgeries for tongue masses in the past 11 years. Results: Surgeries for the tongues were performed in 268 cases. Imaging examinations were carried out in 52 (19.4%) cases including 42 (15.7%) cases by IOUS. The pathological results of the surgeries were as follows: 36 cases were inflammatory lesions, 74 cases were tumours, 131 cases were hyperplasia, 8 cases were cystic lesions and 19 cases were other miscellaneous lesions. On the other hand, the number of patients who received IOUS in the same period was 87, and 42 of them had surgeries. In 32 out of the 42 (76.2%) cases, pre-operative IOUS features matched with pathological results. Most of the haemangiomas and lipomas could be diagnosed by IOUS alone. Conclusions: IOUS of the tongue revealed the nature of the lesions including the border, size, location, depth, the presence or absence of a capsule and the internal structure including vascularity of the mass. The ultrasonographic findings well reflected the histological findings. IOUS is a simple and useful technique that provides additional information beyond inspection, clarifying the internal structure, blood flow and relationships with the adjacent tissues. In this article, we indicated 11 representative cases (fibrous polyp, haemangioma, pyogenic granuloma, lipoma, liposarcoma, chondroma, lymphangioma, schwannoma, neurofibroma, pleomorphic adenoma and amyloidosis) to show the usefulness of IOUS.
Lingual tonsilloliths commonly appear on CT. They also appear on panoramic radiography and may superimpose the surrounding soft tissue of the mandible. Although lingual tonsilloliths may resemble other pathological calcifications including submandibular sialoliths and lingual osseous cholistoma, they can be differentiated by carefully observing panoramic radiographs. When clinicians detect calcified bodies near the base of tongue, lingual tonsilloliths should be included in the differential diagnoses.
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