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The Evaluation of Incidentally Detected Head and Neck Region Soft Tissue Calcifications and Ossifications on Computed Tomography Images

Year 2022, Volume: 13 Issue: 3, 393 - 401, 20.12.2022

Ezgi Türk Veysel Atilla Ayyıldız Özlem Görmez

https://doi.org/10.22312/sdusbed.1120234

Abstract

Aims: Unorganized accumulation of calcium stored in soft tissues is termed as heterotopic calcification, organized accumulation of it is termed as heterotopic ossification. The aim of this study was to evaluate retrospectively all head and neck region soft tissue calcifications/ossifications that are detected incidentally on computed tomography (CT) images of Turkish patients and to analyze them according to age and gender.
Methods: CT images of 917 patients were retrospectively analyzed in terms of the presence of head and neck soft tissue calcification/ossification, and demographic characteristics (age and gender) of the patients were recorded. The data were analyzed with descriptive statistical methods and the relationship between soft tissue calcification/ossification and gender was evaluated with the chi-square test.
Results: Soft tissue calcification/ossification was detected on CT images of 214 (mean age= 61.35±14.7 years, 50.5% female, 49.5% male) of 917 patients examined (23.3%). Among the calcifications/ossifications detected, tonsillolith (n=120, 56.1%), arterial calcifications (n=61, 28.5%) and sialolith (n=15, 7%) were determined in the first three rows. Tonsillolith was significantly more common in female and ossified stylohyoid ligament (OSL) was significantly more common in male (p<0.05).
Conclusions: Soft tissue calcifications/ossifications can be detected incidentally in radiographic images taken from head and neck region for various purposes. In the study, tonsillolith was the most common soft tissue calcification on CT images. It was found that the tonsillolith was statistically higher in female, and the OSL in male. These calcifications/ossifications were most frequently found in patients over age 40.

Keywords

Multidetector computed tomography physiologic calcification pathologic calcification heterotopic ossification

References

  • [1] Kirsch, T. 2006. Determinants of pathological mineralization. Curr Opin Rheumatol,174-180.
  • [2] White, S.C., Pharoah, M.J. 2014. Oral Radiology Principles and Interpretation. 7th Ed. Canada: Elsevier, 524-525.
  • [3] Yıldırım, D., Bilgir, E. 2015. Baş Boyun Bölgesindeki Yumuşak Doku Kalsifikasyon Ve Ossifikasyonları. J Dent Fac Atatürk Uni, 25[13], 82-90.
  • [4] Harorlı, A. 2014. Ağız, Diş ve Çene Radyolojisi. 1. baskı. İstanbul:Nobel Tıp Kitapevi Yayını, 416-419.
  • [5] Avsever, H., Orhan, K. 2018. Çene Kemiği ve Çevre Dokuları Etkileyen Kalsifikasyonlar. Turkiye Klinikleri J Oral Maxillofac Radiol-Special Topics, 4[1], 43-52.
  • [6] Garay, I., Netto, H.D., Olate, S. 2014. Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med, 7[1], 51-56.
  • [7] Missias, E.M., Nascimento, E., Pontual, M. et al. 2018. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral Dis, 24[4], 628-637.
  • [8] Yalcin, E.D., Ararat, E. 2020. Prevalence of soft tissue calcifications in the head and neck region: A cone-beam computed tomography study. Niger J Clin Pract, 23[6], 759-763.
  • [9] Ertaş, E.T., Kalabalık, F. 2014. Bir Türk Örneklem Grubunda Dental Volümetrik Tomografi Endikasyonları. J Dent Fac Atatürk Uni, 24[2], 232-240.
  • [10] Akarslan, Z., Peker, İ. 2015. Bir diş hekimliği fakültesindeki konik ışınlı bilgisayarlı tomografi incelemesi istenme nedenleri. Acta Odontol Turc. 32[1], 1-6.
  • [11] Ergun, T., Lakadamyali, H. 2013. The prevalence and clinical importance of incidental soft-tissue findings in cervical CT scans of trauma population. Dentomaxillofac Radiol, 42[10], 20130216.
  • [12] Çitir, M., Gündüz, K. 2020. Panoramik radyografide yumuşak doku kalsifikasyon/ossifikasyonlarının görülme sıklığı. Selcuk Dent J, 7[2], 226-232.
  • [13] Nunes, L.F.D.S., Santos, K.C.P., Junqueira, J.L.C., Oliveira, J.X. 2011. Prevalence of soft tissue calcifications in cone beam computed tomography images of the mandible. Revista Odonto Ciência, 26[4], 297-303.
  • [14] Icoz, D., Akgunlu, F. 2019. Prevalence of detected soft tissue calcifications on digital panoramic radiographs. SRM Journal of Research in Dental Sciences, 10[1], 21-25.
  • [15] Vengalath, J., Puttabuddi, J.H., Rajkumar, B., Shivakumar, G.C. 2014. Prevalence of soft tissue calcifications on digital panoramic radiographs: A retrospective study. Journal of Indian Academy of Oral Medicine and Radiology. 26[4], 385.
  • [16] Bayramov, N., Üsdat, A., Yalcınkaya, Ş.E. 2019. KIBT Görüntülerinde Rastlantı Bulgusu Olarak Görülen Yumuşak Doku Kalsifikasyonları. Selcuk Dental Journal, 6[4], 228-233.
  • [17] Patil, S.R., Alam, M.K., Moriyama, K., Matsuda, S., Shoumura, M., Osuga, N. 2017. 3D CBCT assessment of soft tissue calcification. Journal of Hard Tissue Biology, 26[3], 297-300.
  • [18] Khojastepour, L., Haghnegahdar, A., Sayar, H. 2017. Prevalence of Soft Tissue Calcifications in CBCT Images of Mandibular Region. J Dent (Shiraz), 18[2], 88-94.
  • [19] Yeşilova, E., Bayrakdar, İ.Ş. 2021. Radiological evaluation of maxillofacial soft tissue calcifications with cone beam computed tomography and panoramic radiography. Int J Clin Pract 75[5], 14086.
  • [20] Thakur, J.S., Minhas, R.S., Thakur, A., Sharma, D.R., Mohindroo, N.K. 2008. Giant tonsillolith causing odynophagia in a child: a rare case report. Cases J, 1[1], 50.
  • [21] Aspestrand, F., Kolbenstvedt, A. 1987. Calcifications of the palatine tonsillary region: CT demonstration. Radiology, 165[2], 479-480.
  • [22[ Scarfe, W.C., Farman, A.G. 2010. Soft tissue calcifications in the neck: Maxillofacial CBCT presentation and significance. Australas Dental Pract, 2[2], 3-15.
  • [23] Price, J.B., Thaw, K.L., Tyndall, D.A., Ludlow, J.B., Padilla, R.J. 2012. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res, 23[11], 1261-1268.
  • [24] Fauroux, M.A., Mas, C., Tramini, P., Torres, J.H. 2013. Prevalence of palatine tonsilloliths: A retrospective study on 150 consecutive CT examinations. Dentomaxillofac Radiol. 42, 20120429.
  • [25] Oda, M., Kito, S., Tanaka, T. et al. 2013. Prevalence and imaging characteristics of detectable tonsilloliths on 482 pairs of consecutive CT and panoramic radiographs. BMC Oral Health,13, 54.
  • [26] Takahashi, A., Sugawara, C., Kudoh, T. et al. 2014. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2,873 consecutive patients. ScientificWorldJournal, 2014, 940960.
  • [27] Kim, M.J., Kim, J.E., Huh, K.H. et al. 2018. Multidetector computed tomography imaging characteristics of asymptomatic palatine tonsilloliths: a retrospective study on 3886 examinations. Oral Surg Oral Med Oral Pathol Oral Radiol, 125[6], 693-698.
  • [28] Ozdede, M., Kayadugun, A., Ucok, O., Altunkaynak, B., Peker, I. 2018. The assessment of maxillofacial soft tissue and intracranial calcifications via cone-beam computed tomography. Current Medical Imaging, 14[5], 798-806.
  • [29] Taguchi, A., Suei, Y., Sanada, M. et al. 2003. Detection of vascular disease risk in women by panoramic radiography. J Dent Res, 82[10], 838-843.
  • [30] Çağlayan, F., Sümbüllü, M.A., Miloğlu, Ö., Akgül, H.M. 2014. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths? J Oral Maxillofac Surg, 72[8]:1531.e1-6.
  • [31] El Deel, M., Holte, N., Gorlin, R.J. 1981.Submandibular salivary gland sialoliths perforated through the oral floor. Oral Surgery, Oral Medicine, Oral Pathology, 51[2],134-139.
  • [32] Colby, C.C., Del Gaudio, J.M. Stylohyoid complex syndrome: a new diagnostic classification. Arch Otolaryngol Head Neck Surg. 2011;137(3):248-252.
  • [33] Alpoz, E,, Akar, G.C., Celik, S., Govsa, F., Lomcali, G. 2014. Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population. Surg Radiol Anat, 36[1], 39-46.
  • [34] Özcan, İ. 2017. Konvansiyonelden Dijitale Diş Hekimliğinde Radyolojinin Esasları, 1. Baskı, İstanbul Medikal Sağlık ve Yayıncılık Tic. Ltd. Şti., İstanbul, 759-778.
  • [35] Centurion, B.S., Imada, T.S., Pagin, O., Capelozza, A.L., Lauris, J.R., Rubira-Bullen, I.R. 2013. How to assess tonsilloliths and styloid chain ossifications on cone beam computed tomography images. Oral Dis, 19[5], 473-478.
  • [36] Gözil, R., Yener, N., Calgüner, E., Araç, M., Tunç, E., Bahcelioğlu, M. 2001. Morphological characteristics of styloid process evaluated by computerized axial tomography. Ann Anat, 183[6], 527-535.
  • [37] Eisenkraft, B.L., Som, P.M. 1999. The spectrum of benign and malignant etiologies of cervical node calcification. AJR Am J Roentgenol, 172[5], 1433-1437.

Bilgisayarlı Tomografi Görüntülerinde Rastlantısal Olarak Belirlenen Baş ve Boyun Bölgesi Yumuşak Doku Kalsifikasyonlarının ve Ossifikasyonlarının Değerlendirilmesi

Year 2022, Volume: 13 Issue: 3, 393 - 401, 20.12.2022

Ezgi Türk Veysel Atilla Ayyıldız Özlem Görmez

https://doi.org/10.22312/sdusbed.1120234

Abstract

Amaç: Kalsiyumun yumuşak dokularda birikmesine heterotopik kalsifikasyon, organize birikimine heterotopik ossifikasyon denir. Bu çalışmanın amacı, Türk hastaların bilgisayarlı tomografi (BT) görüntülerinde rastlantısal olarak saptanan tüm baş ve boyun bölgesi yumuşak doku kalsifikasyonlarını/ossifikasyonlarını retrospektif olarak değerlendirmek yaş ve cinsiyete göre analiz etmektir.
Yöntemler: 917 hastanın BT görüntüleri baş boyun yumuşak doku kalsifikasyonu/ossifikasyonu açısından retrospektif olarak incelendi ve hastaların demografik özellikleri (yaş ve cinsiyet) kaydedildi. Veriler tanımlayıcı istatistiksel yöntemlerle analiz edildi ve yumuşak doku kalsifikasyonu/ossifikasyonu ile cinsiyet arasındaki ilişki ki-kare testi ile değerlendirildi.
Bulgular: İncelenen 917 hastanın (%23,3) 214’ünün (ortalama yaş= 61,35±14,7 yıl, %50,5 kadın, %49,5 erkek) BT görüntülerinde yumuşak doku kalsifikasyonu/ossifikasyonu tespit edildi. Tespit edilen kalsifikasyonlardan/ossifikasyonlardan ilk üç sırada tonsillolit (n=120, %56.1), arteriyel kalsifikasyonlar (n=61, %28.5) ve sialolit (n=15, %7) saptandı. Tonsilolit kadınlarda, ossifiye stilohyoid ligament (OSL) erkeklerde anlamlı olarak daha sıktı (p<0.05).
Sonuç: Baş ve boyun bölgesinden çeşitli amaçlarla alınan radyografik görüntülerde rastlantısal olarak yumuşak doku kalsifikasyonları/ossifikasyonları saptanabilmektedir. Çalışmada, BT görüntülerinde en sık görülen yumuşak doku kalsifikasyonu tonsillolit idi. Kadınlarda tonsillolit, erkeklerde OSL istatistiksel olarak daha yüksek bulundu. Bu kalsifikasyonlar/ossifikasyonlar en sık 40 yaş üstü hastalarda bulundu.

Keywords

Çok kesitli bilgisayarlı tomografi fizyolojik kalsifikasyon patolojik kalsifikasyon heterotopik osifikasyon Multidetector computed tomography physiologic calcification pathologic calcification heterotopic ossification

References

  • [1] Kirsch, T. 2006. Determinants of pathological mineralization. Curr Opin Rheumatol,174-180.
  • [2] White, S.C., Pharoah, M.J. 2014. Oral Radiology Principles and Interpretation. 7th Ed. Canada: Elsevier, 524-525.
  • [3] Yıldırım, D., Bilgir, E. 2015. Baş Boyun Bölgesindeki Yumuşak Doku Kalsifikasyon Ve Ossifikasyonları. J Dent Fac Atatürk Uni, 25[13], 82-90.
  • [4] Harorlı, A. 2014. Ağız, Diş ve Çene Radyolojisi. 1. baskı. İstanbul:Nobel Tıp Kitapevi Yayını, 416-419.
  • [5] Avsever, H., Orhan, K. 2018. Çene Kemiği ve Çevre Dokuları Etkileyen Kalsifikasyonlar. Turkiye Klinikleri J Oral Maxillofac Radiol-Special Topics, 4[1], 43-52.
  • [6] Garay, I., Netto, H.D., Olate, S. 2014. Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med, 7[1], 51-56.
  • [7] Missias, E.M., Nascimento, E., Pontual, M. et al. 2018. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral Dis, 24[4], 628-637.
  • [8] Yalcin, E.D., Ararat, E. 2020. Prevalence of soft tissue calcifications in the head and neck region: A cone-beam computed tomography study. Niger J Clin Pract, 23[6], 759-763.
  • [9] Ertaş, E.T., Kalabalık, F. 2014. Bir Türk Örneklem Grubunda Dental Volümetrik Tomografi Endikasyonları. J Dent Fac Atatürk Uni, 24[2], 232-240.
  • [10] Akarslan, Z., Peker, İ. 2015. Bir diş hekimliği fakültesindeki konik ışınlı bilgisayarlı tomografi incelemesi istenme nedenleri. Acta Odontol Turc. 32[1], 1-6.
  • [11] Ergun, T., Lakadamyali, H. 2013. The prevalence and clinical importance of incidental soft-tissue findings in cervical CT scans of trauma population. Dentomaxillofac Radiol, 42[10], 20130216.
  • [12] Çitir, M., Gündüz, K. 2020. Panoramik radyografide yumuşak doku kalsifikasyon/ossifikasyonlarının görülme sıklığı. Selcuk Dent J, 7[2], 226-232.
  • [13] Nunes, L.F.D.S., Santos, K.C.P., Junqueira, J.L.C., Oliveira, J.X. 2011. Prevalence of soft tissue calcifications in cone beam computed tomography images of the mandible. Revista Odonto Ciência, 26[4], 297-303.
  • [14] Icoz, D., Akgunlu, F. 2019. Prevalence of detected soft tissue calcifications on digital panoramic radiographs. SRM Journal of Research in Dental Sciences, 10[1], 21-25.
  • [15] Vengalath, J., Puttabuddi, J.H., Rajkumar, B., Shivakumar, G.C. 2014. Prevalence of soft tissue calcifications on digital panoramic radiographs: A retrospective study. Journal of Indian Academy of Oral Medicine and Radiology. 26[4], 385.
  • [16] Bayramov, N., Üsdat, A., Yalcınkaya, Ş.E. 2019. KIBT Görüntülerinde Rastlantı Bulgusu Olarak Görülen Yumuşak Doku Kalsifikasyonları. Selcuk Dental Journal, 6[4], 228-233.
  • [17] Patil, S.R., Alam, M.K., Moriyama, K., Matsuda, S., Shoumura, M., Osuga, N. 2017. 3D CBCT assessment of soft tissue calcification. Journal of Hard Tissue Biology, 26[3], 297-300.
  • [18] Khojastepour, L., Haghnegahdar, A., Sayar, H. 2017. Prevalence of Soft Tissue Calcifications in CBCT Images of Mandibular Region. J Dent (Shiraz), 18[2], 88-94.
  • [19] Yeşilova, E., Bayrakdar, İ.Ş. 2021. Radiological evaluation of maxillofacial soft tissue calcifications with cone beam computed tomography and panoramic radiography. Int J Clin Pract 75[5], 14086.
  • [20] Thakur, J.S., Minhas, R.S., Thakur, A., Sharma, D.R., Mohindroo, N.K. 2008. Giant tonsillolith causing odynophagia in a child: a rare case report. Cases J, 1[1], 50.
  • [21] Aspestrand, F., Kolbenstvedt, A. 1987. Calcifications of the palatine tonsillary region: CT demonstration. Radiology, 165[2], 479-480.
  • [22[ Scarfe, W.C., Farman, A.G. 2010. Soft tissue calcifications in the neck: Maxillofacial CBCT presentation and significance. Australas Dental Pract, 2[2], 3-15.
  • [23] Price, J.B., Thaw, K.L., Tyndall, D.A., Ludlow, J.B., Padilla, R.J. 2012. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res, 23[11], 1261-1268.
  • [24] Fauroux, M.A., Mas, C., Tramini, P., Torres, J.H. 2013. Prevalence of palatine tonsilloliths: A retrospective study on 150 consecutive CT examinations. Dentomaxillofac Radiol. 42, 20120429.
  • [25] Oda, M., Kito, S., Tanaka, T. et al. 2013. Prevalence and imaging characteristics of detectable tonsilloliths on 482 pairs of consecutive CT and panoramic radiographs. BMC Oral Health,13, 54.
  • [26] Takahashi, A., Sugawara, C., Kudoh, T. et al. 2014. Prevalence and imaging characteristics of palatine tonsilloliths detected by CT in 2,873 consecutive patients. ScientificWorldJournal, 2014, 940960.
  • [27] Kim, M.J., Kim, J.E., Huh, K.H. et al. 2018. Multidetector computed tomography imaging characteristics of asymptomatic palatine tonsilloliths: a retrospective study on 3886 examinations. Oral Surg Oral Med Oral Pathol Oral Radiol, 125[6], 693-698.
  • [28] Ozdede, M., Kayadugun, A., Ucok, O., Altunkaynak, B., Peker, I. 2018. The assessment of maxillofacial soft tissue and intracranial calcifications via cone-beam computed tomography. Current Medical Imaging, 14[5], 798-806.
  • [29] Taguchi, A., Suei, Y., Sanada, M. et al. 2003. Detection of vascular disease risk in women by panoramic radiography. J Dent Res, 82[10], 838-843.
  • [30] Çağlayan, F., Sümbüllü, M.A., Miloğlu, Ö., Akgül, H.M. 2014. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths? J Oral Maxillofac Surg, 72[8]:1531.e1-6.
  • [31] El Deel, M., Holte, N., Gorlin, R.J. 1981.Submandibular salivary gland sialoliths perforated through the oral floor. Oral Surgery, Oral Medicine, Oral Pathology, 51[2],134-139.
  • [32] Colby, C.C., Del Gaudio, J.M. Stylohyoid complex syndrome: a new diagnostic classification. Arch Otolaryngol Head Neck Surg. 2011;137(3):248-252.
  • [33] Alpoz, E,, Akar, G.C., Celik, S., Govsa, F., Lomcali, G. 2014. Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population. Surg Radiol Anat, 36[1], 39-46.
  • [34] Özcan, İ. 2017. Konvansiyonelden Dijitale Diş Hekimliğinde Radyolojinin Esasları, 1. Baskı, İstanbul Medikal Sağlık ve Yayıncılık Tic. Ltd. Şti., İstanbul, 759-778.
  • [35] Centurion, B.S., Imada, T.S., Pagin, O., Capelozza, A.L., Lauris, J.R., Rubira-Bullen, I.R. 2013. How to assess tonsilloliths and styloid chain ossifications on cone beam computed tomography images. Oral Dis, 19[5], 473-478.
  • [36] Gözil, R., Yener, N., Calgüner, E., Araç, M., Tunç, E., Bahcelioğlu, M. 2001. Morphological characteristics of styloid process evaluated by computerized axial tomography. Ann Anat, 183[6], 527-535.
  • [37] Eisenkraft, B.L., Som, P.M. 1999. The spectrum of benign and malignant etiologies of cervical node calcification. AJR Am J Roentgenol, 172[5], 1433-1437.
There are 37 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Araştırma Articlesi
Authors

Ezgi Türk 0000-0001-9811-7677

Veysel Atilla Ayyıldız 0000-0003-0252-9023

Özlem Görmez 0000-0001-9516-6625

Publication Date December 20, 2022
Submission Date May 23, 2022
Published in Issue Year 2022 Volume: 13 Issue: 3

Cite

Vancouver Türk E, Ayyıldız VA, Görmez Ö. The Evaluation of Incidentally Detected Head and Neck Region Soft Tissue Calcifications and Ossifications on Computed Tomography Images. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2022;13(3):393-401.
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