Panoramic radiographic demonstration of bilateral tonsilloliths

Calcifications can develop within the crypts of the palatine tonsil. During routine dental panoramic radiography, these tonsillar calcifications, or tonsilloliths, may be visualized superimposed upon the mandibular ramus. Their anatomic location and radiographic appearance are such that confusion with parotid sialolithiasis may occur. This report defines the symptomatology and differential diagnosis of these tonsilloliths.