Modified Monday: Reviewing a Baseline Image

There are benefits of viewing a brief baseline video or a still image prior to initiating barium presentations. Obtaining a baseline image is good practice in order to: 1) Assure your patient is in an optimal position for the study, 2) Evaluate anatomy prior to oral presentations, and 3) Identify any additional anatomical or image artifacts (e.g. looking for areas of calcification that might “mimic” or be confused with barium contrast residue). In this particular case, please note the anatomical variation on the roof of the mouth/hard palate in the still image provided below. An additional video sequence is included to see how it is visualized when the patient was moving her head during mastication of a solid bolus.

This anatomical variation is a torus palatinus and is typically a harmless boney outgrowth on the roof of the mouth, however it is important to be able to differentiate it from something more serious like oral cancer. Swallow function is rarely impacted, but a torus can interfere with oral hygiene, the fitting of dentures, or use of a mouth guard etc. Tori can also form on the lower mandible of the mouth (torus mandibularis) typically near the premolars.

References:

Torus Palatinus: Symptoms, Diagnosis, Causes, and More (healthline.com)

Torus palatinus and torus mandibularis: a review of the literature - PubMed (nih.gov)