Practical management recommendations for incidental otolaryngologic findings on cone beam computed tomography.

Cone beam computed tomography (CBCT) frequently captures unexpected structural abnormalities unrelated to the original intent of the diagnostic test. Once identified by dentists, these findings often require appropriate clinical referral for further investigation. This study reviewed recent literature using a comprehensive search to identify and curate common CBCT incidental findings (IFs). Studies were included if they reported CBCT IFs and included more than 10 cases. The review included 16 primary studies in addition to 4 studies described in recent relevant systematic reviews. A total of 51 descriptive terms used to describe key IFs across studies were identified, and terms were organized semantically into 15 core finding categories. Recommendations for management and referral acuity were derived from otolaryngologic clinical practice guidelines and input from practicing otolaryngologists, and the results were integrated into a clinical management algorithm for acuity of referral. This comprehensive review offers practical recommendations to facilitate appropriate clinical management of CBCT IFs via otolaryngologic referral.

Hallazgos incidentales en ortopantomografías maxilomandibulares de pacientes adultos jóvenes / Incidental findings on panoramic radiographs of the maxilla and mandible of young adult patients

Introducción: la valoración radiográfica rutinaria en la práctica odontológicaes esencial para un adecuado diagnóstico y plan de tratamiento. Laortopantomografía o radiografía panorámica es una técnica simple, rápida, de bajo costo y a una baja dosis de radiación. Objetivos: Caracterizarlos hallazgos incidentales más comunes en radiografías panorámicas de pacientes adultos jóvenes de una clínica dental universitaria. Materialy métodos: Se realizó un estudio descriptivo, retrospectivo, de cortetransversal de radiografías panorámicas digitales, tomadas e interpretadas de manera ciega, explorando alteraciones óseas y anomalías dentales. Se realizó la caracterización de su presentación por género de los participantes. Para el análisis de datos se utilizaron pruebas no paramétricas (la prueba χ2, exacta de Fisher y binomial). Resultados: Se tomaron 98 radiografías del mismo número de pacientes, con edad promedio de 19.45 años, predominando las mujeres (69/70.40 por ciento), solteros (94/95.91 por ciento) y de zona urbana (77/78.57 por ciento). Existieron 387 alteraciones, 268 (69.25 por ciento) enmujeres, y 119 (30.74 por ciento) en hombres, con un promedio de 3.88 y 4.10 alteraciones por paciente, respectivamente. La distribución mostró en total 122 (31.52 por ciento) lesiones a nivel de senos maxilares, 124 (32.04 por ciento) en fosasnasales, 16 (4.13 por ciento) lesiones radiolúcidas u opacas, y 125 (32.29 por ciento) anomalías asociadas a retención dental. La comparación de acuerdo al género mostró diferencia (p ≤ 0.001) en la frecuencia de alteraciones, en todos los casos determinada por las mujeres, para cada sitio y tipo de lesión presentada. Conclusiones: El valor de la radiografía panorámica para detectar anomalías de estructuras orofaciales demostró en este estudio su utilidad en la práctica asistencial desde una perspectiva epidemiológica.

Background: doutine dental X-Ray assessment in dental practice isessential for proper diagnosis and treatment. Orthopantomographyor panoramic radiography is a quick, simple, low-cost, and low-doseradiation technique. Objective: To describe the most common incidentalfi ndings on the panoramic radiographs of young adult patients ata university dental clinic. Material and methods: A descriptive,retrospective, cross-sectional study was carried out, in which digitalpanoramic radiographs were taken and interpreted blindly to examinebone disorders, and dental anomalies, and the prevalence of theseaccording to the gender of the participants. Nonparametric statistics(Chi-square χ2, Fisher’s exact, and binomial tests) were used for dataanalysis. Results: 98 radiographs were taken of the same number ofpatients with a mean age of 19.45 years, most of whom were women(69/70.40%), single (94/95.91%), and from urban areas (77/78.57%). 387alterations were found, 268 (69.25%) in women and 119 (30.74%) in men,with an average of 3.88 and 4.10 alterations per patient, respectively. Thedistribution presented a total of 122 (31.52 %) lesions in the maxillarysinus, 124 (32.04 %) in the nostrils, 16 (4.13 %) radiolucent or opaquelesions, and 125 (32.29%) anomalies associated with tooth retention. Acomparison by sex revealed a diff erence (p < 0.001) in the frequency ofalterations, which was greater in women for all sites and types of lesion.Conclusions: The study showed the usefulness of panoramic radiographyin clinical practice to detect anomalies of the orofacial structure from anepidemiological perspective.