Research Article
BibTex RIS Cite

Is Tonsillolith a Protective Factor Against Covid-19 ?

Year 2024, Volume: 51 Issue: 1, 38 - 42, 30.04.2024
https://doi.org/10.52037/eads.2024.0007

Abstract

Object: Tonsilloliths are the most common calcifications of the head and neck region and are also caused by inflammation of the pharyngeal lymphoid tissue. Changes that may occur in the lymphoid tissue due to tonsilloliths may affect the response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This radiological study aims to investigate the potential effect of tonsilloliths on Coronavirus disease 2019 (COVID-19).
Material and Methods: This study, which has a cross-sectional retrospective design, was carried out by evaluating the digital panoramic radiographs taken before the pandemic period of the patient group (n=402) who had COVID -19, who applied to the Akdeniz University Faculty of Dentistry Oral, Dental and Maxillofacial radiology clinic, and the control group (n:400) who did not have COVID -19, in terms of the presence of tonsilloliths. All Statistical analyzes were performed with SPSS version 22.0 and P <0.05 was considered to indicate statistical significance. The Chi-square test and Student's t-test were performed.
Results: The incidence of tonsillolith was significantly lower in the patient group (29.1%) than in the control group (45%) (p <0.01). Both groups were similar in terms of age, gender, and systemic disease status (p = 0.1, 0.08, and 0.08, respectively). Tonsilotiths were located both uni and bilaterally (p = 0.09), but unilateral ones were more common on the right side (p = 0.04).
Conclusions: The results of this study showed that high-frequency tonsilloliths may have a protective effect against COVID -19.

References

  • 1. Myers NE, Compliment JM, Post JC, Buchinsky FD. Tonsilloliths a common finding in pediatric patients. Nurse Pract.2006;31(7):53–4. doi:10.1097/00006205-200607000-00010.
  • 2. Stoodley P, Debeer D, Longwell M, Nistico L, Hall-StoodleyL, Wenig B, et al. Tonsillolith: not just a stone but a living biofilm. Otolaryngol Head Neck Surg. 2009;141(3):316–21.doi:10.1016/j.otohns.2009.05.019.
  • 3. Tsuneishi M, Yamamoto T, Kokeguchi S, Tamaki N,Fukui K, Watanabe T. Composition of the bacterial flora in tonsilloliths. Microbes Infect. 2006;8(9-10):2384–9.doi:10.1016/j.micinf.2006.04.023.42 | Günen-Yılmaz & Coşan-Ata
  • 4. Mesolella M, Cimmino M, Di Martino M, Criscuoli G, Albanese L, Galli V. Tonsillolith. Case report and review of the literature. Acta Otorhinolaryngol Ital. 2004;24(5):302–7.
  • 5. Caldas MP, Neves EG, Manzi FR, de Almeida SM, Bóscolo FN, Haiter-Neto F. Tonsillolith–report of an unusual case. Br Dent J. 2007;202(5):265–7. doi:10.1038/bdj.2007.175.
  • 6. Suarez-Cunqueiro MM, Dueker J, Seoane-Leston J, Schmelzeisen R. Tonsilloliths associated with sialolithiasis in the submandibular gland. J Oral Maxillofac Surg. 2008;66(2):370–3. doi:10.1016/j.joms.2006.11.014.
  • 7. Crameri M, Bassetti R, Werder P, Kuttenberger J. [Tonsil calculi in the orthopantomography image]. Swiss Dent J.2016;126(1):29–36.
  • 8. Dykes M, Izzat S, Pothula V. Giant tonsillolith - a rare cause of dysphagia. J Surg Case Rep. 2012;2012(4):4. doi:10.1093/jscr/2012.4.4.
  • 9. Ram S, Siar CH, Ismail SM, Prepageran N. Pseudo bilateral tonsilloliths: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(1):110–4. doi:10.1016/j.tripleo.2003.11.015.
  • 10. Rio AC, Franchi-Teixeira AR, Nicola EM. Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis. Br Dent J. 2008;204(2):E4. doi:10.1038/bdj.2007.1106.
  • 11. Oda M, Kito S, Tanaka T, Nishida I, Awano S, Fujita Y, et al. Prevalence and imaging characteristics of detectable tonsilloliths on 482 pairs of consecutive CT and panoramic radiographs. BMC Oral Health. 2013;13:54. doi:10.1186/1472-6831-13-54.
  • 12. Takahashi A, Sugawara C, Kudoh K, Yamamura Y, Ohe G, Tamatani T, et al. Lingual tonsillolith: prevalence and imaging characteristics evaluated on 2244 pairs of panoramic radiographs and CT images. Dentomaxillofac Radiol. 2018;47(1):20170251. doi:10.1259/dmfr.20170251.
  • 13. Kalabam1k F, Çiftçi C, Aytv ar E. Investigation of the Preva- lence of Tonsillolith in the Aegean Region Using Cone-Beam Computed Tomography. KKocaeli Saglik Bilim Derg. 2019.
  • 14. Ozdede M, Akay G, Karadag O, Peker I. Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths. Med Princ Pract. 2020;29(3):279–284. doi:10.1159/000505436.
  • 15. Yesilova E, Bayrakdar I. Radiological evaluation of maxillofacial soft tissue calcifications with cone beam computed tomography and panoramic radiography. Int J Clin Pract. 2021;75(5):e14086.doi:10.1111/ijcp.14086.
  • 16. El Sherif I, Shembesh FM. A tonsillolith seen on MRI. Comput Med Imag Grap. 1997;21(3):205–208.
  • 17. Babu B B, Tejasvi M L A, Avinash CKA, B C. Tonsillolith: a panoramic radiograph presentation. JCDR. 2013;7(10):23782379. doi:10.7860/jcdr/2013/5613.3530.
  • 18. Takahashi A, Sugawara C, Kudoh T, Uchida D, Tamatani T, Nagai H, et al. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2,873 consecutive patients. Si Rep. 2014;2014:940960. doi:10.1155/2014/940960.
  • 19. Siber S, Hat J, Brakus I, Biočić J, Brajdić D, Zajc I, et al. Tonsillolithiasis and orofacial pain. Gerodontology. 2012;29(2):e115760. doi:10.1111/j.1741-2358.2011.00456.x.
  • 20. Neville BW, Day TA. Oral cancer and precancerous lesions. CA. 2002;52(4):195–215.
  • 21. Brandtzaeg P. Immunocompetent cells of the upper airway: functions in normal and diseased mucosa. Eur Arch Otorhinolaryngol. 1995;252(1):S8–S21.
  • 22. Capriotti V, Mattioli F, Guida F, Marcuzzo AV, Manto AL, Martone A, et al. COVID-19 in the tonsillectomised population. Acta Otorhinolaryngol Ital. 2021;41(3):197.
  • 23. Guan Wj, Ni Zy, Hu Y, Liang Wh, Ou Cq, He Jx, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720.
  • 24. Pereira NL, Ahmad F, Byku M, Cummins NW, Morris AA, Owens A, et al. COVID-19: understanding inter-individual variability and implications for precision medicine. In: Mayo Clinic Proceedings. vol. 96. Elsevier;. p. 446–463.
  • 25. Gallo O, Locatello LG, Mazzoni A, Novelli L, Annunziato F. The central role of the nasal microenvironment in the transmission, modulation, and clinical progression of SARS-CoV-2 infection. Mucosal Immunol. 2021;14(2):305–316.
  • 26. Hikmet F, Mear L, Edvinsson a, Micke P, Uhlen M, Lindskog C. The protein expression profile of ACE2 in human tissues. Mol Syst Biol. 2020;16(7):e9610.
  • 27. Wong DW, Klinkhammer BM, Djudjaj S, Villwock S, Timm MC, Buhl EM, et al. Multisystemic cellular tropism of SARS-CoV-2 in autopsies of COVID-19 patients. Cells. 2021;10(8):1900.
  • 28. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63. doi:10.1016/j.jcm.2016.02.012.
  • 29. Huang N, Pérez P, Kato T, Mikami Y, Okuda K, Gilmore RC, et al. SARS-CoV-2 infection of the oral cavity and saliva. Nat Med. 2021;27(5):892–903.
  • 30. Missias E, Nascimento E, Pontual M, Pontual A, Freitas D, Perez D, et al. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral diseases. 2018;24(4):628–637.
  • 31. Kadriyan H, Dirja BT, Suryani D, Yudhanto D. COVID-19 infection in the palatine tonsil tissue and detritus: the detection of the virus compartment with RT-PCR. BMJ Case Reports CP. 2021;14(2):e239108.
  • 32. Cooper MM, Steinberg J, Lastra M, Antopol S. Tonsillar calculi: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol. 1983;55(3):239–243.
  • 33. Aragoneses JM, Suárez A, Aragoneses J, Brugal V, Fernández Domínguez M. Prevalence of palatine tonsilloliths in Dominican patients of varying social classes treated in university clinics. Scientific reports. 2020;10(1):1–7.
  • 34. Fauroux M, Mas C, Tramini P, Torres J. Prevalence of palatine tonsilloliths: a retrospective study on 150 consecutive CT examinations. Dentomaxillofac Radiol. 2013;42(7):20120429.
  • 35. Kim MJ, Kim JE, Huh KH, Yi WJ, Heo MS, Lee SS, et al. Multidetector computed tomography imaging characteristics of asymptomatic palatine tonsilloliths: a retrospective study on 3886 examinations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):693–698. doi:10.1016/j.oooo.2018.01.014.
  • 36. Aoun G, Nasseh I, Diab HA, Bacho R. Palatine Tonsilloliths: A Retrospective Study on 500 Digital Panoramic Radiographs. J Contemp Dent Pract. 2018;19(10):1284–1287.
  • 37. Sutter W, Berger S, Meier M, Kropp A, Kielbassa AM, Turhani D. Cross-sectional study on the prevalence of carotid artery calcifications, tonsilloliths, calcified submandibular lymph nodes, sialoliths of the submandibular gland, and idiopathic osteosclerosis using digital panoramic radiography in a Lower Austrian subpopulation. Quintessence Int. 2018:231–242. doi:10.3290/j.qi.a39746.
Year 2024, Volume: 51 Issue: 1, 38 - 42, 30.04.2024
https://doi.org/10.52037/eads.2024.0007

Abstract

References

  • 1. Myers NE, Compliment JM, Post JC, Buchinsky FD. Tonsilloliths a common finding in pediatric patients. Nurse Pract.2006;31(7):53–4. doi:10.1097/00006205-200607000-00010.
  • 2. Stoodley P, Debeer D, Longwell M, Nistico L, Hall-StoodleyL, Wenig B, et al. Tonsillolith: not just a stone but a living biofilm. Otolaryngol Head Neck Surg. 2009;141(3):316–21.doi:10.1016/j.otohns.2009.05.019.
  • 3. Tsuneishi M, Yamamoto T, Kokeguchi S, Tamaki N,Fukui K, Watanabe T. Composition of the bacterial flora in tonsilloliths. Microbes Infect. 2006;8(9-10):2384–9.doi:10.1016/j.micinf.2006.04.023.42 | Günen-Yılmaz & Coşan-Ata
  • 4. Mesolella M, Cimmino M, Di Martino M, Criscuoli G, Albanese L, Galli V. Tonsillolith. Case report and review of the literature. Acta Otorhinolaryngol Ital. 2004;24(5):302–7.
  • 5. Caldas MP, Neves EG, Manzi FR, de Almeida SM, Bóscolo FN, Haiter-Neto F. Tonsillolith–report of an unusual case. Br Dent J. 2007;202(5):265–7. doi:10.1038/bdj.2007.175.
  • 6. Suarez-Cunqueiro MM, Dueker J, Seoane-Leston J, Schmelzeisen R. Tonsilloliths associated with sialolithiasis in the submandibular gland. J Oral Maxillofac Surg. 2008;66(2):370–3. doi:10.1016/j.joms.2006.11.014.
  • 7. Crameri M, Bassetti R, Werder P, Kuttenberger J. [Tonsil calculi in the orthopantomography image]. Swiss Dent J.2016;126(1):29–36.
  • 8. Dykes M, Izzat S, Pothula V. Giant tonsillolith - a rare cause of dysphagia. J Surg Case Rep. 2012;2012(4):4. doi:10.1093/jscr/2012.4.4.
  • 9. Ram S, Siar CH, Ismail SM, Prepageran N. Pseudo bilateral tonsilloliths: a case report and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(1):110–4. doi:10.1016/j.tripleo.2003.11.015.
  • 10. Rio AC, Franchi-Teixeira AR, Nicola EM. Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis. Br Dent J. 2008;204(2):E4. doi:10.1038/bdj.2007.1106.
  • 11. Oda M, Kito S, Tanaka T, Nishida I, Awano S, Fujita Y, et al. Prevalence and imaging characteristics of detectable tonsilloliths on 482 pairs of consecutive CT and panoramic radiographs. BMC Oral Health. 2013;13:54. doi:10.1186/1472-6831-13-54.
  • 12. Takahashi A, Sugawara C, Kudoh K, Yamamura Y, Ohe G, Tamatani T, et al. Lingual tonsillolith: prevalence and imaging characteristics evaluated on 2244 pairs of panoramic radiographs and CT images. Dentomaxillofac Radiol. 2018;47(1):20170251. doi:10.1259/dmfr.20170251.
  • 13. Kalabam1k F, Çiftçi C, Aytv ar E. Investigation of the Preva- lence of Tonsillolith in the Aegean Region Using Cone-Beam Computed Tomography. KKocaeli Saglik Bilim Derg. 2019.
  • 14. Ozdede M, Akay G, Karadag O, Peker I. Comparison of Panoramic Radiography and Cone-Beam Computed Tomography for the Detection of Tonsilloliths. Med Princ Pract. 2020;29(3):279–284. doi:10.1159/000505436.
  • 15. Yesilova E, Bayrakdar I. Radiological evaluation of maxillofacial soft tissue calcifications with cone beam computed tomography and panoramic radiography. Int J Clin Pract. 2021;75(5):e14086.doi:10.1111/ijcp.14086.
  • 16. El Sherif I, Shembesh FM. A tonsillolith seen on MRI. Comput Med Imag Grap. 1997;21(3):205–208.
  • 17. Babu B B, Tejasvi M L A, Avinash CKA, B C. Tonsillolith: a panoramic radiograph presentation. JCDR. 2013;7(10):23782379. doi:10.7860/jcdr/2013/5613.3530.
  • 18. Takahashi A, Sugawara C, Kudoh T, Uchida D, Tamatani T, Nagai H, et al. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2,873 consecutive patients. Si Rep. 2014;2014:940960. doi:10.1155/2014/940960.
  • 19. Siber S, Hat J, Brakus I, Biočić J, Brajdić D, Zajc I, et al. Tonsillolithiasis and orofacial pain. Gerodontology. 2012;29(2):e115760. doi:10.1111/j.1741-2358.2011.00456.x.
  • 20. Neville BW, Day TA. Oral cancer and precancerous lesions. CA. 2002;52(4):195–215.
  • 21. Brandtzaeg P. Immunocompetent cells of the upper airway: functions in normal and diseased mucosa. Eur Arch Otorhinolaryngol. 1995;252(1):S8–S21.
  • 22. Capriotti V, Mattioli F, Guida F, Marcuzzo AV, Manto AL, Martone A, et al. COVID-19 in the tonsillectomised population. Acta Otorhinolaryngol Ital. 2021;41(3):197.
  • 23. Guan Wj, Ni Zy, Hu Y, Liang Wh, Ou Cq, He Jx, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720.
  • 24. Pereira NL, Ahmad F, Byku M, Cummins NW, Morris AA, Owens A, et al. COVID-19: understanding inter-individual variability and implications for precision medicine. In: Mayo Clinic Proceedings. vol. 96. Elsevier;. p. 446–463.
  • 25. Gallo O, Locatello LG, Mazzoni A, Novelli L, Annunziato F. The central role of the nasal microenvironment in the transmission, modulation, and clinical progression of SARS-CoV-2 infection. Mucosal Immunol. 2021;14(2):305–316.
  • 26. Hikmet F, Mear L, Edvinsson a, Micke P, Uhlen M, Lindskog C. The protein expression profile of ACE2 in human tissues. Mol Syst Biol. 2020;16(7):e9610.
  • 27. Wong DW, Klinkhammer BM, Djudjaj S, Villwock S, Timm MC, Buhl EM, et al. Multisystemic cellular tropism of SARS-CoV-2 in autopsies of COVID-19 patients. Cells. 2021;10(8):1900.
  • 28. Koo TK, Li MY. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J Chiropr Med. 2016;15(2):155–63. doi:10.1016/j.jcm.2016.02.012.
  • 29. Huang N, Pérez P, Kato T, Mikami Y, Okuda K, Gilmore RC, et al. SARS-CoV-2 infection of the oral cavity and saliva. Nat Med. 2021;27(5):892–903.
  • 30. Missias E, Nascimento E, Pontual M, Pontual A, Freitas D, Perez D, et al. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral diseases. 2018;24(4):628–637.
  • 31. Kadriyan H, Dirja BT, Suryani D, Yudhanto D. COVID-19 infection in the palatine tonsil tissue and detritus: the detection of the virus compartment with RT-PCR. BMJ Case Reports CP. 2021;14(2):e239108.
  • 32. Cooper MM, Steinberg J, Lastra M, Antopol S. Tonsillar calculi: report of a case and review of the literature. Oral Surg Oral Med Oral Pathol. 1983;55(3):239–243.
  • 33. Aragoneses JM, Suárez A, Aragoneses J, Brugal V, Fernández Domínguez M. Prevalence of palatine tonsilloliths in Dominican patients of varying social classes treated in university clinics. Scientific reports. 2020;10(1):1–7.
  • 34. Fauroux M, Mas C, Tramini P, Torres J. Prevalence of palatine tonsilloliths: a retrospective study on 150 consecutive CT examinations. Dentomaxillofac Radiol. 2013;42(7):20120429.
  • 35. Kim MJ, Kim JE, Huh KH, Yi WJ, Heo MS, Lee SS, et al. Multidetector computed tomography imaging characteristics of asymptomatic palatine tonsilloliths: a retrospective study on 3886 examinations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(6):693–698. doi:10.1016/j.oooo.2018.01.014.
  • 36. Aoun G, Nasseh I, Diab HA, Bacho R. Palatine Tonsilloliths: A Retrospective Study on 500 Digital Panoramic Radiographs. J Contemp Dent Pract. 2018;19(10):1284–1287.
  • 37. Sutter W, Berger S, Meier M, Kropp A, Kielbassa AM, Turhani D. Cross-sectional study on the prevalence of carotid artery calcifications, tonsilloliths, calcified submandibular lymph nodes, sialoliths of the submandibular gland, and idiopathic osteosclerosis using digital panoramic radiography in a Lower Austrian subpopulation. Quintessence Int. 2018:231–242. doi:10.3290/j.qi.a39746.
There are 37 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Radiology
Journal Section Original Research Articles
Authors

Sevcihan Günen Yılmaz 0000-0002-4566-2927

Gamze Coşan Ata 0000-0003-4926-4405

Early Pub Date April 30, 2024
Publication Date April 30, 2024
Submission Date February 29, 2024
Acceptance Date April 24, 2024
Published in Issue Year 2024 Volume: 51 Issue: 1

Cite

Vancouver Günen Yılmaz S, Coşan Ata G. Is Tonsillolith a Protective Factor Against Covid-19 ?. EADS. 2024;51(1):38-42.