Rastlantısal Olarak Tespit Edilen Multiple Tonsillolit: Bir Olgu Sunumu

Öz

Bu olgu sunumunun amacı; panoramik radyografik muayene sonucu rastlantısal olarak tespit edilen multiple tonsillolitin klinik ve radyografik bulgularını sunmaktır. Akdeniz Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Radyolojisi Anabilim Dalı'na rutin dental muayene için başvuran 64 yaşındaki kadın hastanın Hipotiroidi rahatsızlığı dışında herhangi bir sistemik hastalığı bulunmamaktaydı. Hastanın radyografik görüntüsünde bilateral multiple radyopak oluşumlar tespit edildi. İlgili radyopasiteler sol tarafta daha büyük boyutta ve sayıca daha fazla izlendi. İncelenen Konik Işınlı Bilgisayarlı Tomografi (KIBT) kesitlerinde, bilateral, parafarengeal yerleşimli, sol tarafta daha belirgin ve 7 x 5 x 4 (meziodistal x superioinferior x anterioposterior) mm boyutlarında olan multiple hiperdens odaklar izlendi. Hasta tonsillolit ön tanısı ile Kulak, Burun, Boğaz Anabilim Dalı’na yönlendirildi. Sunulan olguda tonsillolitin hastada herhangi bir semptom yaratmamasından dolayı takip önerilmiştir.

Anahtar Kelimeler

• Konik ışınlı bilgisayarlı tomografi
• panoramik radyografi
• radyoopak
• tonsilolit

Multiple Tonsilloliths Detected By Chance: A Case Report

Abstract

The aim of this case report is to present the clinical and radiographic findings of multiple tonsillolitis incidentally detected by panoramic radiographic examination. A 64-year-old female patient was admitted to Akdeniz University Faculty of Dentistry, Department of Oral, Dental and Maxillofacial Radiology for a routine dental examination. She had no systemic disease other than hypothyroidism. Bilateral multiple radiopaque formations were detected in the radiographic image of the patient. The radiopacities were larger in size and more numerous on the left side. Cone Beam Computed Tomography (CBCT) sections showed bilateral, parapharyngeal localized multiple hyperdense foci measuring 7 x 5 x 4 (mesiodistal x superioinferior x anterioposterior) mm, more prominent on the left side. The patient was referred to the Department of Ear, Nose, and Throat with a prediagnosis of tonsillolitis. In the present case, follow-up was recommended because tonsillolitis did not cause any symptoms in the patient.

Keywords

• Cone-beam computed tomography
• Panoramic radiography
• Radiopaque
• tonsilollith

Kaynakça

1. 1. Nasseh I, Sokhn S, Noujeim M, Aoun G. Considerations in Detecting Soft Tissue Calcifications on Panoramic Radiography. J Int Oral Health. 2016;8:742-6.
2. 2. Çağlayan F, Sümbüllü MA, Miloğlu Ö, Akgül HM. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths? J Oral Maxillofac Surg. 2014;72:1531.
3. 3. Monalisa Muduli. Soft tissue calcifications in the orofacial region. Indian J Forensic Med Toxicol. 2020;14:8573-6.
4. 4. White SC, Pharoah MJ. Oral Radiology - Principles and Interpretation, Elsevier Health Sciences, 2014, s697.
5. 5. Fauroux MA, Mas C, Tramini P, Torres JH. Prevalence of palatine tonsilloliths: a retrospective study on 150 consecutive CT examinations. Dentomaxillofacial Radiol. 2013;42:20120429.
6. 6. 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;24:302-7.
7. 7. Ben Salem D, Guiu B, Duvillard C, Couaillier JF, Ricolfi F. Nasopharyngeal tonsillolith: a report of 31 cases. J Radiol. 2007;88:259-62.
8. 8. Mandel L. Multiple bilateral tonsilloliths: case report. J Oral Maxillofac Surg. 2008;66:148-50.

9. 9. Pruet CW, Duplan DA. Tonsil concretions and tonsilloliths. Otolaryngol Clin North Am. 1987;20:305-9.
10. 10. Mısırlıoglu M, Nalcaci R, Adisen MZ, Yardımcı S. Bilateral and pseudobilateral tonsilloliths: three dimensional imaging with cone-beam computed tomography. Imaging Sci Dent. 2013;43:163-9.
11. 11. Kim MJ, Kim JE, Huh KH, Yi WJ, Heo MS, Lee SS, Choi SC. Multidetector computed tomography imaging characteristics of asymptomatic palatine tonsilloliths: a retrospective study on 3886 examinations. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:693-8.
12. 12. Takahashi A, Sugawara C, Kudoh T, Uchida D, Tamatani T, Nagai H, Miyamoto Y. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2873 consecutive patients. Sci World J. 2014;2014:1-4. 13. Aspestrand F, Kolbenstvedt A. Calcifications of the palatine tonsillary region: CT demonstration. Radiology. 1987;165:479-80.
13. 14. Ozdede M, Kayadugun A, Ucok O, Altunkaynak B, Peker I. The Assessment of maxillofacial soft tissue and ıntracranial calcifications via cone-beam computed tomography. Curr Med Imaging Rev. 2018;14:798-806. 15. 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.
14. 16. Moshfeghi M, Navabi S, Soltani P, Moaddabi A. Prevalence of tonsillolith on cone beam computed tomography ımages in patients attending Shahid Beheshti University of Medical Sciences. Br J Med Med Res. 2017;19:1-6.
15. 17. İçöz D, Akgunlu F. Prevalence of detected soft tissue calcifications on digital panoramic radiographs. SRM J Res Dent Sci. 2019;10:21.
16. 18. Aghdasi MM, Valizadeh S, Amin-Tavakoli N, Bakhshandeh H. Tonsilolith in routine panoramic radiographies; is it a common incidental finding? Iran J Radiol Q J Publ Iran Radiol Soc. 2012;9:109-10.
17. 19. Takahashi A, Sugawara C, Kudoh K, Yamamura Y, Ohe G, Tamatani T, Miyamoto Y. Lingual tonsillolith: prevalence and imaging characteristics evaluated on 2244 pairs of panoramic radiographs and CT images. Dentomaxillofacial Radiol. 2018;47:20170251.
18. 20. 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;7:51-6.
19. 21. Yalçın ED, Ararat E. Prevalence of soft tissue calcifications in the head and neck region: a cone‑beam computed tomography study. Niger J Clin Pract. 2020;23:759-63.
20. 22. Yeşilova E, Bayrakdar İŞ. Radiological evaluation of maxillofacial soft tissue calcifications with cone beam computed tomography and panoramic radiography. Int J Clin Pract. 2021;75:e14086.
21. 23. Çi̇ti̇r M, Gündüz K. Panoramik radyografide yumuşak doku kalsifikasyon/ossifikasyonlarının görülme sıklığı. Selcuk Dent J. 2020;7:226-32.
22. 24. Mandel L. Multiple bilateral tonsilloliths: case report. J Oral Maxillofac Surg. 2008;66:148-50.
23. 25. Howerton WB, Mora MA. Use of conebeam computed tomography in dentistry. Gen Dent. 2007;55:54-7.
24. 26. Yildirim D, Bi̇lgi̇r E. Baş ve boyun bölgesindeki yumuşak doku kalsifikasyonları ve ossifikasyonları. Atatürk Üniv Diş Hek Fak Derg. 2015;13:82-90.
25. 27. Nguyen DK, Van Huynh D. Clinical and radiological characteristics of odontomas: a retrospective study of 90 cases. Imaging Sci Dent. 2023;53:117-26.
26. 28. Williams TP, Brooks SL. A longitudinal study of idiopathic osteosclerosis and condensing osteitis. Dentomaxillofacial Radiol. 1998;27:275-8.
27. 29. Kalyoncu Z, Kalyoncu Z, Arslan A, Kurtuluş B, Kurtuluş B, Sofiyev N, Sofiyev N, Doğan Onur Ö, Doğan Onur Ö. Çene Kemiklerinde görülen idiyopatik osteosklerozisin Türk popülasyonundaki sıklığının belirlenmesi (pilot çalışma). J Istanbul Univ Fac Dent. 2012;46:1-10.
28. 30. Nayak V, Rao PK, Kini R, Shetty U. Peripheral osteoma of the mandible. BMJ Case Rep. 2020;13:e238225. 31. Shaw SE, Chan CH. Non-Odontogenic Tumors of the Jaws. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 25, 2023.
29. 32. Altuğ HA, Büyüksoy V, Okçu KM, Doğan N. Hemangiomas of the head and neck with phleboliths: clinical features, diagnostic imaging, and treatment of 3 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103:60-4.
30. 33. Özdede M, Hacıosmanoğlu N, Kaya E, Özer H, Akın E, Seçkin A, Rzayev S. Sialolit: 3 olgunun klinik, radyografik ve ultrasonografik bulguları ile birlikte değerlendirilmesi. Acta Odontol Turc. 2016;33:35-8
31. 34 Özemre MÖ, Köseoğlu Seçgin C, Gülşahı A. Yumuşak doku kalsifikasyonları ve ossifikasyonları: derleme. Acta Odontol Turc. 2016;33:166-75.