Oral Radiology

, Volume 35, Issue 1, pp 68–72 | Cite as

Diagnosis of ethmoid sinolith by cone-beam computed tomography: case report and literature review

  • Eliana Dantas da CostaEmail author
  • Francielle Silvestre Verner
  • Priscila Dias Peyneau
  • Deborah Queiroz de Freitas
  • Solange Maria de Almeida
Case Report



The aim of this study was to report the first case of diagnosis of a rare ethmoid sinolith by cone-beam computed tomography (CBCT) and discuss the importance of carefully assessing the entire volume of the images regardless of the region of interest.

Case presentation

A 22-year-old woman underwent CBCT examination to assess the upper permanent canine teeth. Analysis of the entire volume of CBCT revealed an oval-shaped hyperdense, homogeneous, expansive formation with defined boundaries located in the ethmoid bone. The differential diagnosis of a sinolith in the ethmoid sinus was confirmed after removal of the lesion by nasoendoscopy and histopathological examination.


The diagnosis of lesions in the ethmoid sinus is challenging because of the complex anatomy of this region. Considering the limitations of two-dimensional X-ray examination, CBCT examination has become an important imaging modality for the diagnosis of these calcifications. In addition, the ability of the dental surgeon to assess the entire volume of the CBCT images and the knowledge of imaging features of these calcifications allows for recognition of incidental findings, facilitating early diagnosis and appropriate treatment.


Cone-beam computed tomography Ethmoid sinus Paranasal sinus 



The authors thank Espaço da Escrita (General Coordination—UNICAMP) for the language services provided.

Compliance with ethical standards

Conflict of interest

Eliana Dantas da Costa, Francielle Silvestre Verner, Priscila Dias Peyneau, Deborah Queiroz de Freitas, and Solange Maria Almeida declare that they have no conflict of interest.

Human rights statements

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.

Informed consent

Informed consent was obtained from the patient for being included in the study.


  1. 1.
    Almasi M, Andrasovská M, Koval J. Sinolith in the ethmoid sinus: report of two cases and review of the literature. Eur Arch Otorhinolaryngol. 2010;267:1649–52.CrossRefPubMedGoogle Scholar
  2. 2.
    Nayak DR, Bhandarkar AM, Valiathan M, Sandeep VVK. Incidental ‘ethmoid sinolith’—an unusual cause of frontal recess obstruction. BMJ Case Rep. 2014;2014.Google Scholar
  3. 3.
    Özcan C, Vaysoğlu Y, Görür K. Sinolith: a rare isolated sphenoid sinus lesion. J Craniofac Surg. 2013;24:e104–e6.CrossRefPubMedGoogle Scholar
  4. 4.
    Kanzaki S, Sakamoto M. Sinolith in the ethmoid sinus. J Laryngol Otol. 2006;120:e11.CrossRefPubMedGoogle Scholar
  5. 5.
    Lee DH, Yoon TM, Lee JK, Lim SC. Frontal sinolith. J Craniofac Surg. 2015;26:e385–e6.CrossRefPubMedGoogle Scholar
  6. 6.
    Cha JY, Mah J, Sinclair P. Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial. 2007;132:7–14.CrossRefGoogle Scholar
  7. 7.
    Edwards R, Alsufyani N, Heo G, Flores-Mir C. The frequency and nature of incidental findings in large-field cone beam computed tomography scans of an orthodontic sample. Prog Orthod. 2014;15:37.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Yushkevich PA, Piven J, Hazlett HC, Smith RG, Ho S, Gee JC, et al. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage. 2006;31:1116–28.CrossRefGoogle Scholar
  9. 9.
    Güldner C, Diogo I, Windfuhr J, Bien S, Teymoortash A, Werner JA, et al. Analysis of the fossa olfactoria using cone beam tomography (CBT). Acta Otolaryngol. 2011;131:72–8.CrossRefPubMedGoogle Scholar
  10. 10.
    Demeslay J, Vergez S, Serrano E, Chaynes P, Cantet P, Chaput B, et al. Morphological concordance between CBCT and MDCT: a paranasal sinus-imaging anatomical study. Surg Radiol Anat. 2016;38:71–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Fakhran S, Alhilali L, Sreedher G, Dohatcu AC, Lee S, Ferguson B, et al. Comparison of simulated cone beam computed tomography to conventional helical computed tomography for imaging of rhinosinusitis. Laryngoscope. 2014;124:2002–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Al Abduwani J, ZilinSkiene L, Colley S, Ahmed S. Cone beam CT paranasal sinuses versus standard multidetector and low dose multidetector CT studies. Am J Otolaryngol. 2016;37:59–64.CrossRefPubMedGoogle Scholar
  13. 13.
    Stutzki M, Jahns E, Mandapathil MM, Diogo I, Werner JA, Güldner C. Indications of cone beam CT in head and neck imaging. Acta Otolaryngol. 2015;135:1337–43.CrossRefPubMedGoogle Scholar
  14. 14.
    Angelopoulos C. Cone beam tomographic imaging anatomy of the maxillofacial region. Dent Clin North Am. 2008;52:731–52.CrossRefPubMedGoogle Scholar
  15. 15.
    Doğramacı EJ, Rossi-Fedele G, McDonald F. Clinical importance of incidental findings reported on small-volume dental cone beam computed tomography scans focused on impacted maxillary canine teeth. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118:e205–e9.CrossRefPubMedGoogle Scholar
  16. 16.
    Newaz ZA, Barghan S, Katkar RA, Bennett JA, Nair MK. Incidental findings of skull-base abnormalities in cone-beam computed tomography scans with consultation by maxillofacial radiologists. Am J Orthod Dentofacial Orthop. 2015;147:127–31.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd. 2017

Authors and Affiliations

  • Eliana Dantas da Costa
    • 1
    Email author
  • Francielle Silvestre Verner
    • 2
  • Priscila Dias Peyneau
    • 1
  • Deborah Queiroz de Freitas
    • 1
  • Solange Maria de Almeida
    • 1
  1. 1.Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental SchoolState University of CampinasPiracicabaBrazil
  2. 2.Division of Oral Radiology, Department of DentistryFederal University of Juiz de Fora/Governador Valadares Advanced CampusGovernador ValadaresBrazil

Personalised recommendations