Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

ABSTRACT

PURPOSE: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. MATERIALS AND METHODS: A total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values < .05 were considered to indicate statistical significance. RESULTS: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P < .05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and P < .05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. CONCLUSION: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.