ST Calcifications Flashcards
Heterotopic
Unorganized deposition of calcium phosphate in ST
Distrophic
- Calcification in degenerating, diseased, or dead tissue
- Normal serum calcium/phosphate levels
Idiopathic
- Calcification in normal tissue
- Normal serum calcium/phosphate levels
Phlebolith
- Idiopathic calcification
- Thrombus forms bc of venous stagnation
- Minerals in the blood calcify when standstill
- H&N: Phleobliths always in presence of hemangioma
Phlebolith: Location & features
- Anywhere hemangiomas form
- Laminated appearance
- Bull’s eye or targetoid
Phlebolith: Tx
- None needed
- Important if surgical procedures indicated
Laryngeal Cartilage Calcifications
- Idiopathic calcification AND ossification
- Triticeous and thyroid cartilage
Laryngeal Cartilage Calcifications: Location & features
- W/in ST of pharynx
- Inferior to greater horn of hyoid
- Adjacent to C4
- Well-defined, smooth edges
- Homogenous in RO
Laryngeal Cartilage Calcifications: Tx
No tx needed
What would you include in differential dx for laryngeal cartilage calcification?
- Calcified carotid artery
- Triticeous cartilage uniform in size and shape
Calcified Lymph Nodes
- Dystrophic calcification
- Occurs in chronically inflamed tissue
- Typically w/ granulomatous disorders
- Lymphoid tissue replaced by hydroxyapatite-like Ca2+ salts
Calcified Lymph Nodes: Location & features
- SubMN region
- Angle of MN
- Posterior border of ramus
- Lobulated
- Linear series = “chaining”
What would you include in differential dx for Calcified Lymph Nodes?
- Sialolith = smooth borders
- Phlebolith = smaller, multiple, concentric RO and RL rings
Calcified Lymph Node: Tx
No tx needed; need to establish underlying disease
Tonsoliths
- Dystrophic calcification
- Repeated bouts of tonsillar inflammation
- Organic debris serves as nidus for formation
Tonsoliths: Location
- Midportion of MN ramus
- May extend inferior to MN canal
Tonsoliths: Tx
- Asymptomatic: None
- Symptomatic:
- Small: Expressed manually
- Large: Removed surgically
Calcified Atherosclerotic Plaque
- Dystrophic calcification
- Evolution of plaque w/in intima of vessel
Calcified Atherosclerotic Plaque: Location & features
- Atherosclerosis develops at arterial bifurcations
- In region of hyoid bone
- Adjacent to cervical vertebrae: C3-C4
- Multiple, irregularly shaped
- Sharply defined
- Vertical linear distribution
Calcified Atherosclerotic Plaque: Tx
- Heightened risk for cerebrovascular accident
- Referred to physicians for further investigations
Antroliths
- Idiopathic calcification in nose (rhinolith) or MX sinus (antrolith)
- Deposition of nasal, lacrimal, inflammatory mineral salts around a nidus
- Nose
- Kids: Foreign body
- Sinus:
- Root tip
- Bone fragment
- Long standing sinusitis
- Features: various shapes and sizes
What would you include in differential for antroliths?
- Osteoma: Not separate from bone
- Odontoma: RL rim around RO area
Antroliths: Tx
Remove mass
Ossification of Stylohyoid Ligament
- Clinical features
- Hard, pointed structure over tonsil
-
Classic Eagle’s Syndrome: Cranial nn impingement
- H/o neck trauma, tonsillectomy
-
Carotid Artery Syndrome: Carotid artery impingement
- No h/o neck trauma
- ECA impinged: Suborbital pain
- ICA impinged: Eye pain, headache, visual symptoms, vertigo, syncope
Ossification of Stylohyoid Ligament
- Asymptomatic: None
- Symptomatic: Styloidectomy
Sialolith
- Idiopathic calcification
- Stones found w/in salivary glands
Sialolith: Location & features
- Most common in subMN gland
- Longer more tortuous duct
- Uphill flow in proximal portion
- Higher mineral content
- Usually single, but can be multiple esp in parotid
- Smooth outline
- May have multiple layers of calcification
- Not seen radiographically
Sialolith: Tx
- Small stones = “milked out”
- Large stones = surgical removal
