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Enlarged parietal foramina – an incidental finding on a lateral cephalogram

From Volume 9, Issue 3, July 2016 | Pages 110-111

Authors

Alan Attard

BChD, MD, MFDS, FRCS(OMFS)Ed

Consultant TMJ, Oral and Maxillofacial Surgeon, University Hospitals, Birmingham NHS Foundation Trust, UK

Articles by Alan Attard

Richard Cure

BDS, MDS RCS(Eng), FDS RCS(Ed), MOrth RCS(Ed), FFGDP(UK)

Hon Associate Clinical Professor, Warwick Dentistry, University of Warwick

Articles by Richard Cure

Judith Stocker

BDS, MBChB, FRCS

Consultant Oral and Maxillofacial Surgeon, University Hospital, Coventry, West Midlands CV2 2DX, UK

Articles by Judith Stocker

Abstract

This is a case report of a 16-year-old girl referred to the oral and maxillofacial department for further assessment of a radiolucent area noted at the posterior aspect of the skull vertex on a lateral cephalogram by her orthodontist. Following assessment, these were diagnosed as enlarged parietal foramina and managed conservatively.

CPD/Clinical Relevance: With the increased use of the multiple imaging modalities available in dental practice, in particular the use of cone-beam CT imaging, the clinician should be familiar with the appearances of common pathology, as well as some incidental findings in the traditional dental and maxillofacial region, and adjacent territories. The careful review of medical imaging and referral for further evaluation of ambiguous incidental findings is recommended.

Article

A 16-year-old girl was referred to the oral and maxillofacial department by her orthodontist for further assessment of a radiolucent area noted at the posterior aspect of the skull vertex on a lateral cephalogram (Figure 1). The patient was a transfer case, with fixed appliances in place and the radiograph was taken as part of the clinical assessment of her further treatment needs.

The patient was asymptomatic, fit and healthy and had no past medical history of note. The mother reported an uneventful pregnancy, normal labour and vaginal delivery; no instrumentation was used during the second stage of labour.

On palpation, symmetrical depressions could be palpated through the scalp on either side of the sagittal midline just posterior to the skull vertex. Similar depressions could be palpated on the mother. A postero-anterior skull radiograph showed oval symmetrical radiolucent areas on the skull vertex within the parietal bones (Figure 2).

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