RADIOPACITIES OUTSIDE THE JAWS Flashcards
(35 cards)
What are the types of radiopacities outside of the jaw?
- Tonsilliths
- Calcified Lymph nodes
- Atherosclerosis
- Rhinolith and Antroliths
- Sialolith
- Ossified stylohyoid ligament
- Mucus retention pseudocysts
- Mucositis
- Sinusitis
- Mucocele
What are tonsilliths?
After repeated inflammation, the tonsillar crypts enlarge and incomplete resolution of organic debris (dead bacteria and pus, epithelial cells, and food) can lead to dystrophic calcification
What are the features of tonsilliths?
◦ Cluster of small radiopacities
◦ Large tonsilliths may be symptomatic
Where are tonsilliths located?
◦ On panoramic image: single or multiple radiopaque entities superimposed over the mid portion of the ramus
◦ On CBCT: in the tonsils or adenoids surrounding the airway
tonsilliths in the palatal tonsils
tonsilliths in the lingual tonsils
tonsilliths in the lingual tonsils
What is the management for tonsilliths?
◦ Small lesions: no treatment if not symptomatic; with symptomatic patients tonsilliths may be removed manually.
◦ Lange lesions: require tonsillectomy
◦ In elderly immunocompromised patients’ treatment may be considered because of the risk for aspiration pneumonia
What are the features of calcified lymph nodes?
- Usually present in patients who have a history of chronic inflammation. However, can be the result of tuberculosis, sarcoidosis, metastases of thyroid cancer or associated with a patients who have been treated for lymphoma (radiation)
- The presence of calcification implies either active disease or disease that has been previously treated
- The lymphoid tissue becomes replaced by calcium salts
- Has a cauliflower shape
- Generally asymptomatic
calcified lymph nodes
What are the features of atherosclerosis?
◦ Calcification of the atheromatous plaques within the intima of arteries.
◦ The lumen is narrowed → Increased risk of cerebrovascular accident
Where do you usually see atherosclerosis on panoramic?
◦ Verticolinear radiopacities
◦ Mostly seen at the carotid bifurcation (C3 and C4). Do not confuse with thyroid or triticeous cartilage
Where do you usually see atherosclerosis on CBCT?
◦ Radiopaque circular (on axial view) or linear (on sagittal or coronal view) radiopacity located anywhere in the course of any artery
atherosclerosis
atherosclerosis
What is sometimes confused with atherosclerosis but is completely normal?
Thyroid and Triticeous cartilage - below the hyoid
What are antroliths?
◦ Calcified mass in the sinuses, most commonly in the maxillary sinuses
◦ The source is usually endogenous (chronically inflamed mucosa)
◦ Deposition of mineral salts around a central nidus (lamination)
◦ Not attached to the sinus walls
◦ Mostly asymptomatic. However, expanding mass may impinge on the mucosa, producing pain, congestion, and ulceration
Antroliths
What are rhinoliths?
◦ Calcified mass in the nose (usually an exogenous foreign body)
◦ Deposition of mineral salts around a central nidus (lamination)
◦ Not attached to the nasal cavity walls
◦ Mostly asymptomatic. However, expanding mass may impinge on the mucosa, producing pain, congestion, and ulceration
rhinolith
What is the periphery and shape of rhinolith and antroliths?
various shapes and sizes, depending on the nature of the nidus but all have well-defined periphery
What is the internal structure of rhinolith and antroliths?
homogenous or hterogenous radiopacities, depending on the nidus, and sometimes may have laminations
What is the treatment for rhinolith and antroliths?
Referral to an otorhinolaryngologist for endonasal or sinus endoscopic surgical removal
What is a sialolith?
Calcifications found within the salivary glands or their ducts:
- Submandibular gland (83% to 94%)
- Parotid gland (4% to 10%)
- Sublingual gland
- Minor salivary glands stones are exceedingly rare, occurring mostly in the upper lip and buccal mucosa
◦ Patients may be asymptomatic, but they may have a history of pain and swelling at mealtimes
