Giant sialolith and tonsillolith with ghost images: rare presentations

Area of Science:

• Dentistry
• Radiology
• Oral and Maxillofacial Surgery

Background:

• Panoramic radiography is a valuable screening tool for dental and non-dental calcifications, trauma, and maxillofacial development.
• Rotational mechanics in panoramic imaging can lead to ghost image artifacts, especially with radiopaque objects.
• These artifacts can complicate radiographic interpretation and mimic true pathologies.

Observation:

• This article presents cases of giant submandibular gland sialoliths and tonsilloliths.
• These were initially interpreted as bilateral due to contralateral ghost images on panoramic radiography.
• Computed tomography (CT) was used to confirm unilateral presentation and assess soft tissue involvement.

Findings:

• Ghost images can falsely suggest bilateral conditions, such as sialoliths and tonsilloliths.
• Distinguishing ghost artifacts from actual findings is critical for accurate diagnosis.
• CT imaging is essential for confirming the unilateral nature and extent of these lesions.

Implications:

• Accurate differentiation between ghost artifacts and true pathologies on panoramic radiographs is vital.
• Avoiding misinterpretation can prevent unnecessary surgical interventions.
• Improved diagnostic accuracy leads to better patient outcomes in oral and maxillofacial imaging.