(0316) Incidence of Head and Neck Calcifications in Patients With Sialolithiasis Compared to a General Population

Introduction: A variety of etiologies have been hypothesized for sialadenitis with sialolithiasis (SS), yet the exact cause has remained elusive. Other benign head and neck calcifications (HNCs) arise from a variety of known physiologic or pathologic causes. The aim of this study is to retrospectively examine rates of co-incidental HNCs in patients with SS compared to a cohort of non-stone disease patients to distinguish possible associations.

Methods: A single institution retrospective cohort study examined 100 consecutive computerized tomography (CT) images from SS patients versus 100 consecutive CTs from patients presenting without SS. Patients were excluded if their CT scan did not extend to the carotid bifurcation. Each scan was independently reviewed by the three authors on a radiographic bone window which is highly sensitive at evaluating for calcifications. Tonsillolithiasis, calcified stylohyoid ligament, carotid calcification, triticeous calcification, lymph node calcification, dystrophic calcification, osteoma cutis, and rhinoliths were recorded. Patient comorbidities, including hypertension, hyperlipidemia, peripheral vascular disease, smoking, hyperparathyroidism, history of kidney stones, or tonsillectomy were also recorded.

Results: In total, 94 patients without SS and 64 patients with SS were enrolled. There was no statistical difference between reported comorbidities. Incidental HNCs were found in 74.4% in the SS cohort compared to 68.8% in the non-SS cohort (p = 0.43). Incidence and co-existence of triticeous cartilage calcifications were significantly higher in the SS cohort compared to the non-SS cohort at 26.6% and 9.4% respectively (p = 0.007). Carotid calcifications, tonsilloliths, calcified stylohyoid ligament, and soft tissue calcifications did not differ significantly (p > 0.05).

Conclusions: HNCs are frequent incidental findings encountered on CT scans of the head and neck. HNCs were not seen at a significantly higher rate in patients with SS versus those without. It is important to differentiate physiological from pathological calcifications when reviewing CTs of the head and neck.