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Güneydoğu Anadolu popülasyonunda panoramik radyograflarda palatin tonsillolit prevalansı: retrospektif bir çalışma

Year 2025, Volume: 6 Issue: 6, 679 - 683, 27.12.2025
https://doi.org/10.47582/jompac.1795627

Abstract

Amaç: Palatin tonsillolitler, tonsil kriptlerinde gelişen kalsifiye yapılar olup genellikle panoramik radyografilerde tesadüfen saptanmaktadır. Bu çalışmanın amacı, palatin tonsillolitlerin prevalansını, demografik dağılımlarını ve sistemik hastalıklarla ilişkisini Güneydoğu Anadolu Bölgesi’nde yaşayan bireylerde değerlendirmektir.

Gereç ve Yöntem: Harran Üniversitesi Ağız, Diş ve Çene Cerrahisi Anabilim Dalı’na Ocak 2023 – Ocak 2024 tarihleri arasında başvuran 901 hastaya (477 kadın, 424 erkek) ait arşivlenmiş panoramik radyografiler retrospektif olarak incelendi. Tonsillolit varlığı, lokalizasyonu (tek taraflı/çift taraflı) ile demografik ve sistemik özellikler kaydedildi. İstatistiksel analizlerde Pearson Ki-kare testi kullanıldı ve anlamlılık düzeyi p<0,05 olarak kabul edildi.

Bulgular: Toplam 901 panoramik radyografiden 30’unda (%3,33) tonsillolit saptandı. Olguların 19’u erkek (%63,3), 11’i kadın (%36,7) idi; erkeklerde daha sık görülmesine rağmen fark istatistiksel olarak anlamlı bulunmadı (p=0,069). Lezyonların yarısı tek taraflı, yarısı çift taraflı idi. Tonsillolit saptanan hastaların yaş ortalaması 43,2±11,4 yıl olup en sık 30–39 yaş grubunda ve ≥50 yaş grubunda gözlendi. Tonsillolitler ile sistemik hastalıklar arasında anlamlı bir ilişki bulunmadı (p=0,566).

Sonuç: Palatin tonsillolitler, göz ardı edilmemesi gereken bir yumuşak doku kalsifikasyonu türüdür. Bu çalışmada prevalans %3,33 olarak saptanmış olup, orta yaş ve ileri yaş bireylerde daha sık görülmüştür. Panoramik radyografiler hızlı ve pratik tanı imkânı sunarken, özellikle küçük veya bilateral olgularda konik ışınlı bilgisayarlı tomografinin (KIBT) ek tanısal katkı sağlayabileceği düşünülmektedir.

Ethical Statement

Tüm prosedürler, insan üzerinde yapılan deneyler için sorumlu komitenin (kurumsal ve ulusal) etik standartlarına ve 1975 Helsinki Bildirgesi’ne (2008’de revize edilmiş şekliyle) uygun olarak gerçekleştirilmiştir. Çalışma protokolü, Harran Üniversitesi Etik Kurulu tarafından onaylanmıştır (onay tarihi ve numarası: 27.01.2025; HRÜ / 25.02.12).

References

  • Caldas MP, Neves EG, Manzi FR, de Almeida SM, Bóscolo FN, Haiter-Neto F. Tonsillolith–report of an unusual case. Br Dent J. 2007;202:265-267. doi:10.1038/bdj.2007.175
  • Ferguson M, Aydin M, Mickel J. Halitosis and the tonsils: a review of management. Otolaryngol Head Neck Surg. 2014;151(4):567-574. doi:10. 1177/0194599814544881
  • Takahashi A, Sugawara C, Kudoh T, et al. Prevalence and imaging characteristics of palatine tonsilloliths evaluated on 2244 pairs of panoramic radiographs and CT images. Clin Oral Investig. 2017;21(1):85-91. doi:10.1007/s00784-016-1752-0
  • Chan J, Rashid M, Karagama Y. An unusual case of a tonsillolith. Case Rep Med. 2012;2012:587503. doi:10.1155/2012/587503
  • Yıldırım D, Bilgir E. Baş ve boyun bölgesindeki yumuşak doku kalsifikasyonları ve ossifikasyonları. Atatürk Üniv Diş Hek Fak Derg. 2015;13:82-90. doi:10.17567/dfd.53076
  • Ben Salem D, Guiu B, Duvillard C, Couaillier JF, Ricolfi F. Nasopharyngeal tonsillolith: a report of 31 cases. J Radiol. 2007;88:259-262. doi:10.1016/S0221-0363(07)89812-X
  • 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):302-307.
  • Dal Rio AC, Nicola EM, Teixeira AR, et al. Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis. Am J Otolaryngol. 2008;29(6):399-403. doi:10.1016/j.amjoto. 2007.12.004
  • Thakur JS, Hariprasad S, Chauhan A, Mohindroo NK. Giant tonsillolith causing odynophagia in a child. Cases J. 2008;1:50. doi:10.1186/1757-1626-1-50
  • Portka K, Różyło-Kalinowska I. Prevalence and characteristics of tonsillar calcifications visible in dental panoramic radiographs in a sample of Polish population. J Stomatol. 2020;73(1):27-31. doi:10.5114/jos.2020.94174
  • Hiranandani LH. A giant tonsillolith. J Laryngol Otol. 1967;81(7):819-822. doi:10.1017/S0022215100067748
  • Oda M, Kito S, Tanaka T, 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
  • Aghdasi MM, Valizadeh S, Amin-Tavakoli N, Bakhshandeh H. Tonsillolith in routine panoramic radiographies: is it a common incidental finding? Iran J Radiol. 2012;9:109-110. doi:10.5812/iranjradiol. 7563
  • Ozdede M, Kılıç E, Güngör E, Orhan K. The role of cone-beam computed tomography in the detection of tonsilloliths: a retrospective study. Med Principles Pract. 2020;29(2):176-181. doi:10.1159/000505436
  • Huang X, Wang H, Gao Y, Zhang Z. Detection and analysis of tonsilloliths using CBCT in Chinese population. Dentomaxillofac Radiol. 2022;51(3):20210320. doi:10.1259/dmfr.20210320
  • Oda M. Correlation between the presence of tonsilloliths and the extent of periodontitis: a CBCT study. J Clin Med. 2024;13(24):7705. doi:10. 3390/jcm13247705
  • Gujjar SV, Narayan DP, Ramachandran R, et al. Radiographic evaluation of tonsilloliths in digital panoramic radiography. J Indian Acad Oral Med Radiol. 2023;35(4):572-576. doi:10.4103/jiaomr.jiaomr_255_23
  • Azad A, Rehman A, Irfan M, Ahmad M. Tonsilloliths in patients with chronic kidney disease: a radiographic study. Clin Exp Dent Res. 2024; 10(1):112-118. doi:10.1002/cre2.910
  • Kumar S, Bansal R, Singh A, Kaur P. Prevalence and patterns of tonsilloliths on digital panoramic radiographs: a retrospective study. J Clin Diagn Res. 2014;8(6):ZC52-ZC54. doi:10.7860/JCDR/2014/8772. 4489

Prevalence of palatine tonsilloliths on panoramic radiographs in a Southeastern Anatolian population: a retrospective study

Year 2025, Volume: 6 Issue: 6, 679 - 683, 27.12.2025
https://doi.org/10.47582/jompac.1795627

Abstract

Aims: Palatine tonsilloliths are calcified structures that develop in the tonsillar crypts and are often incidentally detected on panoramic radiographs. This study aimed to evaluate the prevalence of palatine tonsilloliths, their demographic distribution, and their relationship with systemic diseases in individuals living in the Southeastern Anatolia region.
Methods: Panoramic radiographs archived from 901 patients (477 females, 424 males) who applied to the Department of Oral and Maxillofacial Surgery, Harran University, between January 2023 and January 2024 were retrospectively examined. The presence of tonsilloliths, laterality (unilateral/bilateral), and demographic/systemic characteristics were recorded. Statistical analyses were performed using Pearson’s Chi-square test, with statistical significance set at p<0.05.
Results: Tonsilloliths were detected in 30 out of 901 radiographs (3.33%). These calcified structures, formed within the palatine tonsillar crypts, represent a subtype of soft-tissue calcification rather than a pathological lesion. Nineteen patients were male (63.3%) and 11 were female (36.7%); although more frequent in males, the difference was not statistically significant (p=0.069). Half of the lesions were unilateral and half were bilateral. The mean age of patients with tonsilloliths was 43.2±11.4 years, and the lesions were more frequently observed among the 30–39 and ≥50 age groups. No significant association was found between tonsilloliths and systemic diseases (p=0.566).
Conclusion: Palatine tonsilloliths represent a type of soft tissue calcification that should not be overlooked. In this study, the prevalence was 3.33%, with higher occurrence in middle-aged and older individuals. While panoramic radiographs allow quick and practical detection, cone-beam computed tomography (CBCT) may provide additional diagnostic value, particularly for small or bilateral cases.

Ethical Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008. The study protocol was approved by the Local Research Ethics Committee of Harran University Ethics Committee (approval date and number: 27.01.2025; HRÜ / 25.02.12).

References

  • Caldas MP, Neves EG, Manzi FR, de Almeida SM, Bóscolo FN, Haiter-Neto F. Tonsillolith–report of an unusual case. Br Dent J. 2007;202:265-267. doi:10.1038/bdj.2007.175
  • Ferguson M, Aydin M, Mickel J. Halitosis and the tonsils: a review of management. Otolaryngol Head Neck Surg. 2014;151(4):567-574. doi:10. 1177/0194599814544881
  • Takahashi A, Sugawara C, Kudoh T, et al. Prevalence and imaging characteristics of palatine tonsilloliths evaluated on 2244 pairs of panoramic radiographs and CT images. Clin Oral Investig. 2017;21(1):85-91. doi:10.1007/s00784-016-1752-0
  • Chan J, Rashid M, Karagama Y. An unusual case of a tonsillolith. Case Rep Med. 2012;2012:587503. doi:10.1155/2012/587503
  • Yıldırım D, Bilgir E. Baş ve boyun bölgesindeki yumuşak doku kalsifikasyonları ve ossifikasyonları. Atatürk Üniv Diş Hek Fak Derg. 2015;13:82-90. doi:10.17567/dfd.53076
  • Ben Salem D, Guiu B, Duvillard C, Couaillier JF, Ricolfi F. Nasopharyngeal tonsillolith: a report of 31 cases. J Radiol. 2007;88:259-262. doi:10.1016/S0221-0363(07)89812-X
  • 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):302-307.
  • Dal Rio AC, Nicola EM, Teixeira AR, et al. Relationship between the presence of tonsilloliths and halitosis in patients with chronic caseous tonsillitis. Am J Otolaryngol. 2008;29(6):399-403. doi:10.1016/j.amjoto. 2007.12.004
  • Thakur JS, Hariprasad S, Chauhan A, Mohindroo NK. Giant tonsillolith causing odynophagia in a child. Cases J. 2008;1:50. doi:10.1186/1757-1626-1-50
  • Portka K, Różyło-Kalinowska I. Prevalence and characteristics of tonsillar calcifications visible in dental panoramic radiographs in a sample of Polish population. J Stomatol. 2020;73(1):27-31. doi:10.5114/jos.2020.94174
  • Hiranandani LH. A giant tonsillolith. J Laryngol Otol. 1967;81(7):819-822. doi:10.1017/S0022215100067748
  • Oda M, Kito S, Tanaka T, 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
  • Aghdasi MM, Valizadeh S, Amin-Tavakoli N, Bakhshandeh H. Tonsillolith in routine panoramic radiographies: is it a common incidental finding? Iran J Radiol. 2012;9:109-110. doi:10.5812/iranjradiol. 7563
  • Ozdede M, Kılıç E, Güngör E, Orhan K. The role of cone-beam computed tomography in the detection of tonsilloliths: a retrospective study. Med Principles Pract. 2020;29(2):176-181. doi:10.1159/000505436
  • Huang X, Wang H, Gao Y, Zhang Z. Detection and analysis of tonsilloliths using CBCT in Chinese population. Dentomaxillofac Radiol. 2022;51(3):20210320. doi:10.1259/dmfr.20210320
  • Oda M. Correlation between the presence of tonsilloliths and the extent of periodontitis: a CBCT study. J Clin Med. 2024;13(24):7705. doi:10. 3390/jcm13247705
  • Gujjar SV, Narayan DP, Ramachandran R, et al. Radiographic evaluation of tonsilloliths in digital panoramic radiography. J Indian Acad Oral Med Radiol. 2023;35(4):572-576. doi:10.4103/jiaomr.jiaomr_255_23
  • Azad A, Rehman A, Irfan M, Ahmad M. Tonsilloliths in patients with chronic kidney disease: a radiographic study. Clin Exp Dent Res. 2024; 10(1):112-118. doi:10.1002/cre2.910
  • Kumar S, Bansal R, Singh A, Kaur P. Prevalence and patterns of tonsilloliths on digital panoramic radiographs: a retrospective study. J Clin Diagn Res. 2014;8(6):ZC52-ZC54. doi:10.7860/JCDR/2014/8772. 4489
There are 19 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Surgery
Journal Section Research Article
Authors

Halil İbrahim Durmuş 0000-0003-4762-4788

Mehmet Emrah Polat 0000-0002-3249-1997

Cansu Geben 0009-0006-2829-8920

Submission Date October 3, 2025
Acceptance Date November 18, 2025
Publication Date December 27, 2025
Published in Issue Year 2025 Volume: 6 Issue: 6

Cite

AMA Durmuş Hİ, Polat ME, Geben C. Prevalence of palatine tonsilloliths on panoramic radiographs in a Southeastern Anatolian population: a retrospective study. J Med Palliat Care / JOMPAC / jompac. December 2025;6(6):679-683. doi:10.47582/jompac.1795627

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