Definition: Calcifications formed within the crypts of palatine tonsils.
Radiographic Features:
- Location:
- 2D imaging: Superimposed over ramus and angle of mandible on pantomographs
- CBCT: Lateral to airway and medial to mandibular ramus (axial and coronal views)
- Edge:
- Well-defined
- Smooth to irregular outline
- Shape: Round to irregular masses
- Internal: Radiopaque
- Other: Can be unilateral or bilateral
- Number: Single or multiple
Key Diagnostic Signs:
- Multiple small radiopaque masses in tonsillar region
- Often incidental finding on dental radiographs
Clinical Significance:
- May cause persistent sore throat or sensation of foreign body
- Associated with halitosis (bad breath)
- Usually asymptomatic and don’t require treatment
- Can be confused with other calcifications in the area
Clinical Features:
- Appear as yellow-white stones in tonsillar crypts
- Size ranges from millimeters to centimeters
- May have extremely unpleasant odor when expelled
Note: While often an incidental finding, recognizing tonsiloliths is important to avoid misdiagnosis as other pathological conditions. CBCT provides more accurate localization compared to 2D imaging. Management is usually conservative unless causing significant symptoms.