The Prevalence of Tonsilloliths and Other Soft Tissue Calcifications in Patients Attending Oral and Maxillofacial Radiology Clinic of the University of Iowa
Objective. The purpose of this study was to determine the prevalence of tonsiliths in patients attending the oral and maxillofacial radiology clinic of The University of Iowa and to determine if there is any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Study Design. This was a two-part study. The first part was a prevalence study whereas the second was a matched pair case-control study. The matched pair case-control study commenced after the prevalence study was concluded. No new or unusual radiographs were made in this study. The study only reviewed radiographs that were made for clinical purposes. Results. A total of 1524 pantomographs were reviewed and 124 subjects (53 males and 71 females) aged 9 years and 2 months to 87 years (mean age 52.6 years) were included for data analysis. Thirty-eight subjects had single tonsiliths whereas 86 subjects had multiple tonsiliths. The prevalence of tonsiliths in the study population was 8.14%. A total of 20 subjects were included in the second part of the study, comprising 10 each for matched pair case-control groups. The observations did not indicate any correlation between the presence of tonsiliths and the presence of stones in other body tissues, ducts, or organs. Conclusion. The prevalence of tonsiliths in our study population was 8.14%. The observations in our study do not support any correlations between tonsiliths and calcifications in other body tissues, organs, or ducts. 1. Introduction 1.1. Tonsiliths Tonsiliths, also known as tonsilloliths and tonsillar concretions or simply called liths, are stones that arise from calcium being deposited on desquamated cells and bacterial growth in the tonsillar or adenoidal crypts and occur in patients with or without a history of inflammatory disorders of either the tonsils or adenoids [1, 2]. Tonsiliths may be associated with symptoms, including nonspecific chronic sore throat, irritable cough, dysphagia, otalgia, chronic halitosis, a foreign body-like sensation, or foul taste [1–7]. Patients with tonsiliths may also be asymptomatic, with the liths discovered incidentally on pantomographic or lateral cephalometric radiographs [7–9]. Superimposition of hard and soft tissue structures on such radiographic images is common, creating a diagnostic challenge. This necessitates the consideration of several interpretations of radiopacity in the mandibular molar-ramus region including sialolith, tonsilith, phlebolith, calcified lymph node, carotid artery arteriosclerosis, stylohyoid ligament
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