Triticeous Cartilage CT Imaging Characteristics, Prevalence, Extent, and Distribution of Ossification

Abstract

The presence of a triticeous cartilage is common and of variable appearance. As the clinical and surgical significance of this anatomic structure may be misinterpreted, it is important for imaging interpreters to be familiar with this seldom-recognized anatomic structure and recognize its variable appearance on cross-sectional imaging to avoid a misdiagnosis.

The triticeous cartilage: redefining of morphology, prevalence and function

“…Once the ROI selection was completed, the volume of the TC was calculated via OsiriX-Lite software. All authors confirmed that categorising of the shape and degree of the calcification was completed as described by previous study [3].…”

“…Although calcification patterns of the laryngeal cartilages are not yet clear, Claassen et al [6] hypothesized that the contents of extracellular matrix of the laryngeal cartilage might have a role during calcification processes. There is no known function of the TC but it is assumed that it supports the lateral thyrohyoid ligament [3,18]. Besides this, a cadaveric study demonstrated that one of the functions of TC could be muscle attachment [16].…”

“…Additionally, the TC should be calcified in order to be observed in X-ray images. There are limited studies describing the calcification of the TC and differentiating this calcification from the atherosclerosis located in common carotid artery as shown in Figure 1 [1,3,5]. The TC could also be misdiagnosed as the fractures of the superior horn of the thyroid cartilage in forensic medicine [9].…”

“…Although there was limited description for the degree of calcification, comparison between calcification, age and gender has not been reported before [3]. Alqahtani et al [3] have described scales of shape and calcification degrees of the TC and it was the first report about morphological classification of the TC. Hence, their study can be regarded as the basis for the morphological properties of the TC.…”

Triticeal cartilage calcification

“…7 Most calcified laryngeal cartilages, including TC, can be diagnosed exclusively by panoramic radiographs, except when presenting positioning and morphological variations. 7 A major concern of a calcified TC found incidentally in a routine radiographic examination is the differentiation between this alteration and other calcified tissue manifestations that requires additional investigations, such as carotid artery calcific atherosclerosis 8 or other neck pathologies such as foreign bodies. 4 Hence, the objective of this report is to describe three cases of TC recognized in plain radiographs asked as routine in dental practice, emphasizing its radiographic features in these examinations in order to help clinicians in the differentiation of TC calcifications from other neck pathologies that require additional investigations.…”