Author:
Oda Masafumi,Kito Shinji,Tanaka Tatsurou,Nishida Ikuko,Awano Shuji,Fujita Yuko,Saeki Katsura,Matsumoto-Takeda Shinobu,Wakasugi-Sato Nao,Habu Manabu,Kokuryo Shinya,Kodama Masaaki,Kaneuji Takeshi,Yoshiga Daigo,Miyamoto Ikuya,Nishimura Shun,Yamashita Yoshihiro,Maki Kenshi,Tominaga Kazuhiro,Yoshioka Izumi,Ansai Toshihiro,Morimoto Yasuhiro
Abstract
Abstract
Background
Recent studies suggest that tonsilloliths are clinically related to halitosis and tonsillar abscess. Based on our empirical knowledge, tonsilloliths are relatively commonly encountered in daily clinical practice. It has been reported that the detection rate of tonsilloliths was under 24% in previous reports, although experience suggests otherwise. The purpose of the study was to evaluate the prevalence and characteristics of tonsilloliths using computed tomography (CT). In addition, the possible causes of low detection rates on panoramic radiographs were evaluated based on comparisons between CT images and panoramic radiographs in order to elucidate the limitations of visualizing the area around the palatine tonsils on panoramic radiographs.
Methods
482 pairs of CT images and panoramic radiographs were retrospectively assessed with respect to the presence and characteristics of tonsilloliths. In addition, the causes in cases of disagreement between the two modalities were analyzed.
Results
The detection rate of tonsilloliths was 46.1% using CT scans, unlike previous reports. The characteristics of tonsillolith were dot-like figures with about 300-500 Hounsfield units within the palatine tonsil under the soft palate. The most common length of tonsilloliths was about 3 or 4 mm. As the subjects aged, the detection rate increased gradually. A significant difference in the tonsillolith detection rate was found between the over and under 40-year-old groups (p < 0.0001). However, the detection rate of tonsilloliths was only 7.3% on panoramic radiographs. A significant correlation was observed between the detection rate of tonsilloliths on panoramic radiographs and CT number (Spearman r = 0.429), size, (Spearman r = 0.318), and number of tonsilloliths (Spearman r = 0.333).
Conclusion
The present results suggest that tonsilloliths are relatively more common than previously suggested. However, panoramic radiographs detect only a small percentage of palatine tonsilloliths. The low detection rates on panoramic radiographs might be related to the degree of calcification, size, and number of tonsilloliths.
Publisher
Springer Science and Business Media LLC
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