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AJNR - American Journal of Neuroradiology

Published ahead of print on May 22, 2008
doi: 10.3174/ajnr.A1127

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What's in Your Mouth? The CT Appearance of Comestible Intraoral Foreign Bodies

M. McDermott^a, B.F. Branstetter, IV^a,b and E.J. Escott^a

^a Departments of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pa
^b Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pa

View larger version (112K): [in this window] [in a new window]   Fig 1. Large hard candy. Contrast-enhanced axial CT demonstrates a perfectly round, attenuated mass (arrowheads) in the left lower gingivo-buccal sulcus. Note the laminated appearance of the mass. The surrounding mucosa is completely collapsed on the mass, except for a tiny locule of air (arrow).

View larger version (129K): [in this window] [in a new window]   Fig 2. Small candy with motion artifact. Contrast-enhanced axial CT shows a small, attenuated focus (arrow) in the left floor of mouth, with seemingly variable attenuation. The heterogeneity is actually the result of motion artifact.

View larger version (108K): [in this window] [in a new window]   Fig 3. Soft foreign body. Unenhanced axial CT demonstrates an attenuated, irregular mass (arrowheads) along the alveolar ridge. On an enhanced scan, this might be mistaken for an enhancing mucosal malignancy.

View larger version (104K): [in this window] [in a new window]   Fig 4. Hard candy. Sagittal reconstruction from enhanced CT shows a curvilinear attenuation (arrowheads) in the oral cavity representing a ring-shaped intraoral foreign body. The attenuation is similar to that of the contrast-enhanced vessels, and the inferior aspect of the foreign body is obscured by dental amalgam, such that the foreign body might be mistaken for an enlarged vessel or vascular abnormality.

View larger version (142K): [in this window] [in a new window]   Fig 5. Small candies. Enhanced axial CT demonstrates 2 rounded densities (arrowheads) in the anterior oral cavity that might be mistaken for sialoliths impacted at the punctum of the Wharton duct.

View larger version (123K): [in this window] [in a new window]   Fig 6. Soft intraoral foreign body. Unenhanced axial CT shows a rectangular foreign body (arrow) in the anterior oral cavity. With this configuration, the foreign body might be mistaken for an implant.

View larger version (131K): [in this window] [in a new window]   Fig 7. Soft intraoral foreign body. Coronally reformatted CT shows a foreign body as a thin attenuation adherent to the palate (arrowheads). This might be mistaken for an enhancing mucosal mass on an enhanced scan or a different foreign body, such as dentures or a mental implant.

View larger version (115K): [in this window] [in a new window]   Fig 8. Chewing tobacco. Unenhanced axial CT shows a mass (arrow) of mixed tissue and air attenuation. There is a rim of denser material. On an enhanced scan, this might be mistaken for facial abscess or traumatic injury.