• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.1
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• pp.13-26
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• 2024

Objectives: The aim of this study was to perform a comparative analysis of the ultrastructural and chemical composition of sialoliths, tonsilloliths, and antroliths and to describe their growth pattern. Materials and Methods: We obtained 19 specimens from 18 patients and classified the specimens into three groups: sialolith (A), tonsillolith (B), and antrolith (C). The peripheral, middle, and core regions of the specimens were examined in detail by histology, micro-computed tomography (micro-CT), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy, and transmission electron microscopy (TEM). Results: In the micro-CT, group A showed alternating radiodense and radiolucent layers, while group B had a homogeneous structure. Group C specimens revealed a compact homogeneous structure. Histopathologically, group A showed a laminated, teardrop-shaped, globular structure. Group B demonstrated degrees of immature calcification of organic and inorganic materials. In group C, the lesion was not encapsulated and showed a homogeneous lamellar bone structure. SEM revealed that group A showed distinct three layers: a peripheral multilayer zone, intermediate compact zone, and the central nidus area; groups B and C did not show these layers. The main elemental components of sialoliths were O, C, Ca, N, Cu, P, Zn, Si, Zr, F, Na, and Mg. In group B, a small amount of Fe was found in the peripheral region. Group C had a shorter component list: Ca, C, O, P, F, N, Si, Na, and Mg. TEM analysis of group A showed globular structures undergoing intra-vesicular calcification. In group B, bacteria were present in the middle layer. In the outer layer of the group C antrolith, an osteoblastic rimming was observed. Conclusion: Sialoliths had distinct three layers: a peripheral multilayer zone, an intermediate compact zone and the central nidus area, while the tonsillolith and antrolith specimens lacked distinct layers and a core.

• The Journal of Korean Medicine
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• v.28 no.2 s.70
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• pp.13-21
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• 2007

Objective : Halitosis, or bad breath, is a common concern for many people. The aim of this study was to investigate clinical characteristics of halitosis patients and correlation with their various associated elements. Methods: We surveyed 169 halitosis patients by reviewing questionnaires from the Halitosis Clinic in the Hospital of Oriental Medicine, Kyunghee University from January 2004 to March 2006. The questionnaires contained various items including sex, age, history of smoking and alcohol intake, duration of symptoms in a week, time and condition of severe halitosis, suggestive origin of halitosis, taste abnormality, oral hygiene, self-assessed halitosis severity, dry mouth, postnasal drip, tonsillolith, globus pharyngeus, reflux sensation, too much gas and Winkel tongue coating index. Volatile sulfur compounds were measured with a $Halimeter^{\circledR}$. Results : The halitosis patients actively carried out management methods such as non-smoking, moderation in drink, teeth brushing and tongue scraping in order to decrease their oral malodor. Tongue coating significantly affected the $Halimeter^{\circledR}$ reading score, and tongue coating and dry mouth significantly affected self-assessed halitosis severity. Conclusions: Our results suggest that tongue coating and dry mouth should be treated to improve satisfaction in halitosis patients.

• Imaging Science in Dentistry
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• v.43 no.3
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• pp.163-169
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• 2013

Purpose: Tonsilloliths are calcifications found in the crypts of the palatal tonsils and can be detected on routine panoramic examinations. This study was performed to highlight the benefits of cone-beam computed tomography (CBCT) in the diagnosis of tonsilloliths appearing bilaterally on panoramic radiographs. Materials and Methods: The sample group consisted of 7 patients who had bilateral radiopaque lesions at the area of the ascending ramus on panoramic radiographs. CBCT images for every patient were obtained from both sides of the jaw to determine the exact locations of the lesions and to rule out other calcifications. The calcifications were evaluated on the CBCT images using Ez3D2009 software. Additionally, the obtained images in DICOM format were transferred to ITK SNAP 2.4.0 pc software for semiautomatic segmentation. Segmentation was performed using contrast differences between the soft tissues and calcifications on grayscale images, and the volume in mm3 of the segmented three dimensional models were obtained. Results: CBCT scans revealed that what appeared on panoramic radiographs as bilateral images were in fact unilateral lesions in 2 cases. The total volume of the calcifications ranged from 7.92 to $302.5mm^3$. The patients with bilaterally multiple and large calcifications were found to be symptomatic. Conclusion: The cases provided the evidence that tonsilloliths should be considered in the differential diagnosis of radiopaque masses involving the mandibular ramus, and they highlight the need for a CBCT scan to differentiate pseudo- or ghost images from true bilateral pathologies.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1981.05a
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• pp.11.2-11
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• 1981

Compared with other medical parts, there are relatively rare cases of the calculi in the Otolaryngologic field. The authors have recently experienced cases of the tonsillolith and huge rhinolith. They were removed successfully under the local anesthesia. Small quantities of calcareous or gritty particles are often found in the center of the caseous plugs filling the crypts of the tonsil in chronic follicular tonsillitis. The patients usually give a history of repeated tonsillitis in the earlier years. The patient may be aware of a constant sensation as of a foreign body in the throat. The breath is often fetid. The tonsillar calculi was found to be the accumulated keratohyalin masses in the crypts. The rhinoliths are rare in nasal cavity. They usualy have a foreign body nucleus of bacteria, blood, pus cells, mucus, crusts, or some foreign material from outside the body. They are largely composed of calcium and magnesium salts, principally carbonate with traces of sodium chloride. The condition is commonly found in adults and in female. They are usualy unilateral and are located, in the majority of instances, in the lower portion of the nasal cavity. The first well documented cases of rhinolithiasis, however, were reported by Bartholin in 1654. Since then over 400 cases have been reported.