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CALCIFIED

ATHEROSCLEROTIC
PLAQUE

Deni&on:
Steno'c atheromatous plaque in the extracaro'd vasculature.

Radiographic ndings:
Loca'on:

At the greater cornu of the hyoid bone


Adjacent to the cervical vertebra C3, C4, or the intervertebral space
between them.
Periphery and shape:
Mul'ple, irregular in shape
Sharply dened border
Ver'cal linear distribu'on
Internal Structure:

Heterogeneous radiopacity with radiolucent voids

Dieren&al Diagnosis:

Calcied tri'ceous car'lage


Management:

Risk factor for cerebrovascular accident and stroke


Referral to a physician

SIALOLITH

Deni&on:

Stones within ducts of salivary glands


Clinical features:

Men (middle and later years)

Usually singly (70% to 80%), mul'ple in the paro'd gland

Asymptoma'c (discomfort intensify at meal'mes)

9% with recurrent sialolithiasis

10% with nephrolithiasis

Radiographic Features:
Loca'on:

83% to 94% in the submandibular gland


50% in distal por'on of Whartons duct
20% in the proximal por'on
30% in the gland

4% to 10% in the paro'd gland

1% to 7% in the sublingual gland

Periphery and Shape:

In duct- cylindric, very smooth border

In hilus of gland- larger, more irregularly shaped

Internal Structure:

Homogenous radiopacity

Applied Radiology:

Periapical view at lower premolar and molar apices

Distal por'on of Whartons duct: Mandibular occlusal view

More posterior loca'on: Lateral oblique view or panoramic


image

Paro'd duct gland:


Periapical lm in the buccal ves'bule
Anteroposterior skull view (blows out the cheek)

Noncalcied stone: Sialography


Dieren&al Diagnosis:

Calcica'on of the lymph nodes

Phleboliths

Management:

Small stone: Milked out by bimanual palpa'on

Large stone/in proximal duct: Nonsurgical or minimally invasive


sialolithomy

PHLEBOLITHS
Deni&on:

Calcied thrombi in veins/ venulae, or sinusoidal vessels of


hemangiomas.

Clinical features:

Hemangioma

Swollen so_ 'ssue with throbbing and blanching

Fluctuate in size

Ausculta'on reveal a bruit (in cavernous type)

Radiographic Features:
Loca'on: In hemangiomas
Periphery and Shape:

Round or oval (from the side resemble a straight or slightly curved


sausage)

Mul'ple, random and clustered distribu'on


6mm diameter
Smooth periphery
Internal structure:

Homogenous radiopacity and lamina'ons (give a bulls eye or


target appearance)
Radiolucent center

Dieren&al Diagnosis:

Sialolith

Calcied lymph nodes

LARYNGEAL CARTILAGE
CALCIFICATIONS
Deni&on:

Calcica'on or ossica'on of hyaline car'lage in the thyroid


and tri'ceous car'lages.

Clinical features:

Incidental radiographic nding with no clinical features

Radiographic Features:
Loca'on:
Inferior to the greater cornu of the hyoid bone
Adjacent to the superior border of C4
Periphery and Shape:

7 to 9 mm in length, 2 to 4 mm in width
Smooth and well dened periphery
Internal Structure:
Homogenous radiopacity (occasionally with outer cortex)

Dieren&al Diagnosis:

Calcied atheromatous plaque

Management:

No treatment

RHINOLITH/ANTROLITH

Deni&on:

Calcerous concre'ons in nose (rhinoliths) or antrum of maxillary sinus (antroliths)

Clinical Features:

Asymptoma'c for a long period of 'me

Pain, ulcera'on, and conges'on (the expanding mass impinge on mucosa)

Unilateral rhinnorhea

Sinusi's

Headache

Epistaxis

Anosmia

Fetor

Fever

Radiographic Features:
Loca'on:
Rhinolith in the nose
Antrolith in the antrum of maxillary sinus
Periphery and Shape:
A variety of shapes and sizes
Internal Structure:
Homogenous or heterogenous radiopacity
Some'mes with lamina'ons
Density may exceed the surrounding bone

Dieren&al Diagnosis:

Osteoma
Odontoma
Surgical ciliated cyst
Mycolith

Management:

Referred to otorhinolaryngologist (for endonasal surgical


removal)

Lithotripsy if large