Triticeous Cartilage: Prevalence on Panoramic Radiographs and Diagnostic Criteria

Triticeous cartilage (TC), an entity located in the lateral thyrohyoid ligament, occasionally calcifies and can be detected on panoramic radiographs. Due to its anatomical location, TC may be misdiagnosed for carotid atheromas, a risk factor for stroke. Previously, we reported that the shapes of larger carotid atheromas are roughly linear. Objectives: To determine the prevalence of calcified TC on panoramic radiographs obtained on subjects above 40 years of age. To determine the age and sex distribution of the subjects who have calcified TC. Lastly, to explore if the shape of TC differs from that of carotid atheromas. Methods: In this retrospective study, panoramic radiographs of 788 dental patients above the age of 40 years were interpreted by an oral and maxillofacial radiologist, a general dentist and a senior dental student. Shapes of TC were determined by SigmaScan software after digitizing the radiographs. Results: The population comprised of 381 males and 407 females. The age range was 40-96 years (mean 59.2 years). Calcified TC was radiographically identified in 20 males (5.2%) and 53 females (13.0%). Calcification was 9.9% in the 40-60 year group, (n=433), and 8.5% in the group >61 years (n=355). Shapes of the calcifications were oval with smooth borders. Conclusions: Calcification of TC is more prevalent in females, which is consistent with an earlier cadaver study. The prevalence is not age dependent. Shape, outline and location of TC could help it in differentiating from carotid atheroma. (This study was funded by NIH Grant No. 5T35DE07098 to L.P., who was a NRSA fellow).