Buch Karen, Nadgir Rohini N, Qureshi Muhammad Mustafa, Ozonoff Al, Sakai Osamu
From the Departments of *Radiology, †Radiation Oncology, and ‡Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine; §Center for Patient Safety and Quality Research, and ∥Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
J Comput Assist Tomogr. 2017 Sep/Oct;41(5):828-832. doi: 10.1097/RCT.0000000000000593.
Calcification of the torus tubarius has been rarely reported in the literature. Histopathologic studies have previously described cases of Eustachian tube calcification and cite an association with increasing patient age. The purpose of this study was to examine the prevalence of torus tubarius calcification and potential clinical significance on an unrestricted patient population using thin-section computed tomography (CT), which has not been previously reported.
After the institutional review board approval, 1571 consecutive patients who underwent noncontrast head CT between January 2011 and July 2011 were retrospectively reviewed for torus tubarius calcification. Images were acquired at 1.25-mm slice thickness using a 64-detector row CT. Medical records were reviewed for chronic medical conditions including chronic kidney disease, alcoholism, autoimmune conditions, endocrine disorders, elevated alkaline phosphatase levels, history of otitis media, purified protein derivative positivity, history of head and neck surgery and radiation, and human immunodeficiency virus infection. Motion-limited studies and patients with limited clinical data were excluded. Statistical analyses were performed using the independent sample t test and Fisher exact test.
Ten (0.6%) of 1571 patients had torus tubarius calcification, of which 7 (70%) were unilateral, and 3 (30%) were bilateral calcification. There was no significant association between torus tubarius calcification and common medical disorders including endocrine disorders, human immunodeficiency virus, chronic kidney disease, alcoholism, purified protein derivative positivity, history of head and neck surgery or radiation, and autoimmune diseases.
Based on the largest series to date on an unrestricted population using thin-section CT imaging, calcification of the torus tubarius is a rare entity with an overall prevalence of 0.6%. Although the clinical significance remains uncertain, there is no significant association between torus tubarius calcification and common medical conditions.
咽鼓管圆枕钙化在文献中鲜有报道。组织病理学研究此前曾描述过咽鼓管钙化病例，并指出其与患者年龄增长有关。本研究的目的是使用薄层计算机断层扫描（CT）检查在无限制的患者群体中咽鼓管圆枕钙化的患病率及其潜在临床意义，此前尚无相关报道。
经机构审查委员会批准，对2011年1月至2011年7月期间连续1571例行非增强头部CT检查的患者进行回顾性分析，以确定咽鼓管圆枕钙化情况。使用64排CT以1.25毫米的层厚采集图像。查阅病历以了解慢性疾病情况，包括慢性肾病、酗酒、自身免疫性疾病、内分泌紊乱、碱性磷酸酶水平升高、中耳炎病史、结核菌素试验阳性、头颈部手术和放疗史以及人类免疫缺陷病毒感染情况。排除运动受限的研究和临床资料有限的患者。采用独立样本t检验和Fisher确切检验进行统计分析。
1571例患者中有10例（0.6%）存在咽鼓管圆枕钙化，其中7例（70%）为单侧钙化，3例（30%）为双侧钙化。咽鼓管圆枕钙化与常见疾病（包括内分泌紊乱、人类免疫缺陷病毒、慢性肾病、酗酒、结核菌素试验阳性、头颈部手术或放疗史以及自身免疫性疾病）之间无显著关联。
基于迄今为止使用薄层CT成像对无限制人群进行的最大规模系列研究，咽鼓管圆枕钙化是一种罕见情况，总体患病率为0.6%。尽管其临床意义仍不确定，但咽鼓管圆枕钙化与常见疾病之间无显著关联。
