title: Triticeous Cartilage CT Imaging Characteristics, Prevalence, Extent, and Distribution of Ossification.
abstract: OBJECTIVE
  The triticeous cartilage is a small ovoid cartilaginous structure variably present as a component of the laryngeal skeleton. This structure has received scant attention in the literature and has yet to be described adequately on cross-sectional imaging.
  
  
  METHODS
  Retrospective study in a tertiary medical center.
  
  
  METHODS
  We investigated triticeous cartilage prevalence in a large population utilizing computed tomography images. The cases of all patients with computed tomography angiography images of the neck from October 1, 2013, to September 31, 2014, were examined. A total of 663 patients were included in this study (age: range, 18-97 years; mean ± SD, 65 ± 15 years), 58.4% men and 41.6% women. The presence of a triticeal cartilage and its site, number, and degree of ossification were recorded.
  
  
  RESULTS
  A total of 53.1% of patients had at least 1 triticeous cartilage (352 of 663). Prevalence was 57.4% (222 of 387) among men and 47.1% (130 of 276) among women. The presence of bilateral triticeous cartilages was more common than unilateral (63.1%, 222 of 352). A minority of patients (4.5%, 16 of 352) had a cartilaginous triticeous with no appreciable ossification, and more than half (54.0%, 190 of 352) had mild triticeal ossification. Moderate ossification was found in 34.9% of patients (123 of 352) and marked ossification in 6.5% (23 of 352).
  
  
  CONCLUSIONS
  The presence of a triticeous cartilage is common and of variable appearance. As the clinical and surgical significance of this anatomic structure may be misinterpreted, it is important for imaging interpreters to be familiar with this seldom-recognized anatomic structure and recognize its variable appearance on cross-sectional imaging to avoid a misdiagnosis.
authors.affiliation: Tufts University School of Medicine, Lahey Clinic, Burlington, Massachusetts, USA eman_alqahtani@hotmail.com.
authors.forename: Eman
authors.initials: E
authors.lastname: Alqahtani
authors.affiliation: Tufts University School of Medicine, Lahey Clinic, Burlington, Massachusetts, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Marrero
authors.affiliation: Tufts University School of Medicine, Lahey Clinic, Burlington, Massachusetts, USA.
authors.forename: Walter L
authors.initials: WL
authors.lastname: Champion
authors.affiliation: Saudi Arabian Cultural Mission, Fairfax, Virginia, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Alawaji
authors.affiliation: Tufts University School of Medicine, Lahey Clinic, Burlington, Massachusetts, USA.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Kousoubris
authors.affiliation: Tufts University School of Medicine, Lahey Clinic, Burlington, Massachusetts, USA.
authors.forename: Juan E
authors.initials: JE
authors.lastname: Small
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002357:Cartilage Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007817:Laryngeal Cartilages / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: cartilago triticea; thyrohyoid complex; triticeal ossification; triticeous cartilage