TECHNIQUE:  Routine cone beam computed tomography was performed from the mid orbits through the mandibular base.  Data was acquired as a volume acquisition and reconstructed in multiple planes.  No intravenous contrast was administered. Evaluation of soft tissues is somewhat limited by bone algorithm processing. 

Comparison:  None. 

Findings: 

Airway:   There is scattered mucoperiosteal thickening of the bilateral ethmoid air cells.  The osteomeatal units are widely patent.  There is no evidence of bony sclerosis or erosion. The airway is widely patent. 

Orbits:   Evaluation limited by technique, however, no gross abnormality noted. 

Oral Cavity:  The maxilla is edentulous, as is the mandible with exception of the mandibular incisors and canines.  The soft tissues of the oral cavity are without radiographically evident abnormality. 

TMJ:  There is asymmetric narrowing of the temporal mandibular joint spaces, worse on the right, with condylar remodeling and flattening.  A small erosion vs. subchondral cyst is seen medially on the left.  Early osteophyte formation is present medially on the right. 

Other:  There are prominent bilateral stylohyoid calcifications.  Incidental note is made of ossification of the posterior longitudinal ligament extending from C2-C4, associated with partially characterized disc-osteophyte complexes.  These charges result in suggested central canal stenosis. 

IMPRESSION:

1)    Bilateral TMJ degenerative changes, right greater than left.

2)   Ossification of the posterior longitudinal ligament with associated discogenic degenerative changes and suggested central canal stenosis.  Neurological examination and correlation for symptoms of central canal stenosis are recommended.

3)   Stylohyoid ligament calcifications, as above.

4)   Non specific ethmoid air cell mucoperiosteal thickening may be a manifestation of acute or chronic inflammation.