Investigation of the Prevalence of Tonsillolith in the Aegean Region Using Cone-Beam Computed Tomography

Year 2019, , 129 - 133, 06.09.2019

Fahrettin Kalabalık , Ceren Çiftçi , Emre Aytuğar

https://doi.org/10.30934/kusbed.585147

Abstract

Objective: The purpose of this
research was to investigate the prevalence rate and characteristics of
tonsilloliths in a Turkish population sample living in the Aegean region of
Turkey using cone-beam computed tomography.

Methods: Three hundred ninety-nine
consecutive cone-beam computed tomography data was obtained at the Department
of Oral and Dentomaxillofacial Radiology were retrospectively analyzed for the
characteristics and presence of tonsilloliths. The subjects were divided into
three groups according to age: (1) age ≤20 years; (2) age 21-40 years; (3) age
≥41 years. The correlation between subject demographics and the characteristics
(number and prevalence) of tonsilloliths was investigated.

Results: The prevalence rate of
palatine tonsilloliths in 399 subjects (184 males, 215 females; mean age of
34.3 years) was 25.8%; the prevalence showed no significant difference between
male and female genders (p=0.57). A positive correlation was observed
between the number of tonsillotihs and age (p=0.002). Tonsillar
calcification was significantly more common in Group 3 than Group 1 and 2,
while it was significantly lower in Group 1 than the other groups (p=0.036).

Conclusion: According to our
results, tonsilloliths affect approximately a quarter of the Aegean population.
Tonsilloliths are age-related but sex-independent. These calcifications are
more common in people older than 40 years of age.

Keywords

Cone-beam computed tomography, palatine tonsil, calcification

Thanks

We thank R. A. Büşra Emir for assistance with statistical analysis and Fırat Selvi DDS, PhD in editing the text of the manuscript.

Konik Işınlı Bilgisayarlı Tomografi Kullanılarak Ege Bölgesi’nde Tonsilolit Prevalansının Araştırılması

Abstract

Amaç: Bu çalışmanın amacı, konik ışınlı bilgisayarlı tomografi kullanarak Ege Bölgesi’nde yaşayan bir Türk popülasyonundaki tonsillolit prevalansını ve özelliklerini araştırmaktır.

Yöntem: Fakültemiz Ağız, Diş ve Çene Radyolojisi Anabilim Dalı arşivindeki 399 hastanın konik ışınlı bilgisayarlı tomografi kayıtları retrospektif olarak incelenmiştir. Tonsillolit prevalansı ve özellikleri değerlendirilmiştir. Hastalar yaşlarına gore: (1) ≤20 yaş; (2) 21-40 yaş; (3) yaş ≥41 yaş olacak şekilde üç gruba ayrılmıştır: Hastaların demografik özellikleri ile tonsillolitin görülme sıklığı ve sayısı arasındaki ilişki araştırılmıştır.

Bulgular: Toplam 399 hasta (184 erkek, 215 kadın; ortalama yaş 34,3) incelendiğinde tonsillolit prevalansı %25,8 olarak hesaplanmıştır. Erkek ve kadın hastalar arasında tonsilolit görülme sıklığı bakımından anlamlı bir farklılık görülmemiştir (p=0,57). Tonsillolit sayısı ile yaş arasında pozitif bir korelasyon saptanmıştır (p=0,002). Tonsiller kalsifikasyon oranı Grup 3'te Grup 1 ve 2'den anlamlı derecede fazlayken, Grup 1'de diğer gruplardan anlamlı derecede düşük bulunmuştur (p=0,036).

Sonuç: Çalışmada elde edilen bulgulara göre tonsillolit Ege nüfusunun yaklaşık dörtte birini etkilemektedir. Tonsillolit görülme sıklığı yaşa bağlı değişim göstermekte ancak cinsiyet faktöründen etkilenmemektedir. Bu kalsifikasyonlar en fazla 40 yaş üzerindeki hastalarda görülmektedir.

Keywords

Konik ışınlı bilgisayarlı tomografi, palatin tonsil, kalsifikasyon

References

• Silvestre-Donat FJ, Pla-Mocholi A, Estelles-Ferriol E, Martinez-Mihi V. Giant tonsillolith: report of a case. Med Oral Patol Oral Cir Bucal. 2005;10(3):239-242.
• 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.
• Mandel L. Multiple bilateral tonsilloliths: case report. J Oral Maxillofac Surg. 2008;66(1):148-150. doi: 10.1016/j.joms.2006.05.047
• Siber S, Hat J, Brakus I, et al. Tonsillolithiasis and orofacial pain. Gerodontology. 2012;29(2):e1157-1160. doi: 10.1111/j.1741-2358.2011.00456.x
• Ben Salem D, Guiu B, Duvillard C, Couaillier JF, Ricolfi F. [Nasopharyngeal tonsillolith: a report of 31 cases]. J Radiol. 2007;88(2):259-262.
• Monsour PA, Romaniuk K, Hutchings RD. Soft tissue calcifications in the differential diagnosis of opacities superimposed over the mandible by dental panoramic radiography. Aust Dent J. 1991;36(2):94-101. doi: 10.1111/j.1834-7819.1991.tb01336.x
• Kim MJ, Kim JE, Huh KH, 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
• Sezer B, Tugsel Z, Bilgen C. An unusual tonsillolith. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95(4):471-473. doi: 10.1067/moe.2003.65
• Ludlow JB, Davies-Ludlow LE, Brooks SL, Howerton WB. Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol. 2006;35(4):219-226. doi: 10.1259/dmfr/14340323
• Missias EM, Nascimento E, Pontual M, et al. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral Dis. 2018;24(4):628-637. doi: 10.1111/odi.12815
• Moshfeghi M, Navabi SS, Soltani P, Moaddabi A. Prevalence of Tonsillolith on Cone Beam Computed Tomography Images in Patients Attending Shahid Beheshti University of Medical Sciences. Br J Med Med Res. 2017;19(11):1-6. doi: 10.9734/BJMMR/2017/31718
• Icoz D, Akgunlu F. Prevalence of detected soft tissue calcifications on digital panoramic radiographs. SRM Journal of Research in Dental Sciences. 2019;10(1):21. doi: 10.4103/srmjrds.srmjrds_60_18
• Ozcan E, Ural A, Oktemer TK, Alpaslan G. Bilateral tonsillolithiasis: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102(3):e17-18. doi: 10.1016/j.tripleo.2006.01.010
• Demiralp KÖ, Bayrak S, Çakmak EŞK. Prevalence and Characteristics af Palatine Tonsilloliths in Cone Beam Computed Tomography Images: A Retrospective Study. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2017;19(2):97-102. doi: 10.24938/kutfd.318036
• Misirlioglu M, Nalcaci R, Adisen MZ, Yardimci S. Bilateral and pseudobilateral tonsilloliths: Three dimensional imaging with cone-beam computed tomography. Imaging Sci Dent. 2013;43(3):163-169. doi: 10.5624/isd.2013.43.3.163
• Hassen SM, Manson-Hing LR. A study of the zone of sharpness of three panoramic x-ray machines and the effect of screen speed on the sharpness zone. Oral Surg Oral Med Oral Pathol. 1982;54(2):242-249. doi: 10.1016/0030-4220(82)90224-9
• Lo RH, Chang KP, Chu ST. Upper airway obstruction caused by bilateral giant tonsilloliths. J Chin Med Assoc. 2011;74(7):329-331. doi: 10.1016/j.jcma.2011.05.011
• Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc. 2006;72(1):75-80.
• Aghdasi MM, Valizadeh S, Amin-Tavakoli N, Bakhshandeh H. Tonsilolith in routine panoramic radiographies; is it a common incidental finding? Iran J Radiol. 2012;9(2):109-110. doi: 10.5812/iranjradiol.7563
• Fauroux MA, Mas C, Tramini P, Torres JH. Prevalence of palatine tonsilloliths: a retrospective study on 150 consecutive CT examinations. Dentomaxillofac Radiol. 2013;42(7):20120429. doi: 10.1259/dmfr.20120429
• Centurion BS, Imada TS, Pagin O, Capelozza AL, Lauris JR, Rubira-Bullen IR. How to assess tonsilloliths and styloid chain ossifications on cone beam computed tomography images. Oral Dis. 2013;19(5):473-478. doi: 10.1111/odi.12026
• Ergun T, Lakadamyali H. The prevalence and clinical importance of incidental soft-tissue findings in cervical CT scans of trauma population. Dentomaxillofac Radiol. 2013;42(10):20130216. doi: 10.1259/dmfr.20130216
• Takahashi A, Sugawara C, Kudoh T, et al. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2,873 consecutive patients. ScientificWorldJournal. 2014;2014:940960. doi: 10.1155/2014/940960
• 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
• 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
• Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res. 2012;23(11):1261-1268. doi:10.1111/j.1600-0501.2011.02299.x
• Allareddy V, Vincent SD, Hellstein JW, Qian F, Smoker WR, Ruprecht A. Incidental findings on cone beam computed tomography images. Int J Dent. 2012;2012:871532. doi: 10.1155/2012/871532
• Pette GA, Norkin FJ, Ganeles J, et al. Incidental findings from a retrospective study of 318 cone beam computed tomography consultation reports. Int J Oral Maxillofac Implants. 2012;27(3):595-603.
• Garay I, Netto HD, Olate S. Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med. 2014;7(1):51-56.