A Comparative Study Evaluating Tonsillolith and Stylohyoid Ligament Ossification on Cone Beam Computed Tomography and Panoramic Radiography: A Retrospective Study

Authors : Halil Ayyıldız, Arif Türkoğlu

Pages : 384-392

Doi:10.37990/medr.1631064

View : 62 | Download : 111

Publication Date : 2025-05-09

Article Type : Research Paper

Abstract :Aim: Dentists frequently encounter soft tissue calcifications in their routine practice. Stylohyoid ligament calcification or ossification (SHLO) is a common incidental finding on radiographs. Tonsillolith is a calcified structure formed as a result of chronic and recurrent inflammation in the crypts of the tonsils. The purpose of this study was to compare the prevalence of tonsillolith and SHLO and mean length oh SHL obtained using cone beam computed tomography (CBCT) and panoramic radiography (PR) images. Material and Method: In this study, CBCT and PR images of a total of 289 patients (mean age 41.87 years), including 157 females and 132 males, were evaluated. The prevalence of tonsilloliths and SHLO was recorded as present/absent, and SHL lengths were measured as the linear distance between the base and the apex of the stylohyoid process on CBCT and PR images. The SHL lengths greater than 30 mm were labeled as SHLO and used in the prevalence statistics. Wilcoxon test used for the relationship between SHL/SHLO lengths obtained by two different imaging methods and McNemar test for the prevalence of tonsillolith obtained by two different imaging methods. Results: The prevalence of tonsillolith was found to be 7.4% with PR and 23.5% with CBCT, the prevalence of SHLO was 34.78% with PR and 43.25% with CBCT, and the mean SHL length was 28.67 mm with PR and 30.88 mm with CBCT. The prevalence of SHLO and tonsillolith was found to be higher in CBCT than in PR, and the measured mean SHL length was greater. This difference was statistically significant. No statistically significant differences were observed between genders with respect to SHL length and SHLO prevalence. The prevalence of tonsillolith in males was found to be statistically significantly higher than in females. Conclusion: In cases where the length of the SHL is of critical importance for SHLO or when there is a suspicion of Eagle syndrome, CBCT is more suitable imaging technique instead of PR. This is also the case for tonsillolith evaluations, as the CBCT eliminates superimpositions.
Keywords : Cone-beam computed tomography, heterotopic ossification, palatine tonsil, panoramic radiography

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