Nasopharyngeal Tonsillolith Mimicking Temporomandibular Joint Pathology: An Incidental Finding Identified on Panoramic Radiography

Year 2026, Volume: 10 Issue: 1, 140 - 144, 31.01.2026

Melih Özdede , Emre Koyuncu , Günnur İlhan , Fatma Akkoca

https://doi.org/10.30621/jbachs.1750911

Abstract

Purpose: To report a rare case of a nasopharyngeal tonsillolith (NT) incidentally detected on panoramic radiography, mimicking a temporomandibular joint (TMJ) lesion, and to emphasize the diagnostic value of cone-beam computed tomography (CBCT).
Case Report: A 58-year-old woman presented with intermittent TMJ pain. A panoramic radiograph revealed a well-defined radiopacity over the left TMJ region. CBCT imaging localized the lesion to the posterosuperior nasopharynx. Based on its location and radiodensity, it was diagnosed as a nasopharyngeal tonsillolith. This prevented misdiagnosis and unnecessary interventions.
Conclusion: Nasopharyngeal tonsilloliths are rarely seen on panoramic images and may simulate TMJ calcifications due to projectional overlap. This case illustrates the importance of considering NTs in the differential diagnosis of TMJ-area radiopacities and highlights CBCT’s role in precise localization.

Keywords

Nasopharynx , Tonsillolithiasis , Panoramic Radiograph , Cone-Beam Computed Tomograph , Temporomandibular joint

Nasopharyngeal Tonsillolith Mimicking Temporomandibular Joint Pathology: An Incidental Finding Identified on Panoramic Radiography

Abstract

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