Radiology of nose and paranasal sinuses

conventional x-ray only,5 types of views with advantages and disadvantages of x-rays

1. RADIOLOGY OF NOSE AND PARANASAL SINUSES ANDREA R SALINS

2. Paranasal sinuses Water’s view Caldwell view Lateral view Submentovertical view Right and left vertical view

3. Water’s view Also called as occipitomental view or nose-chin position In 1914,Dr C.A.Waters and C.W.Waldron,two B ritish radiologists introduced this view Nose and chin touch the film and X-ray beam is projected from occipital side Open mouth view shows sphenoid sinus

4. Structures seen Maxillary sinuses(seen best) Frontal sinuses Sphenoid sinus Zygoma Zygomatic arch Nasal bone Frontal process of maxilla Superior orbital fissure Intratemporal fossa

5. Caldwell view Also called occipitofrontal view or nose-forehead position Eugene W C aldwell,in 1903 described this view Nose and forehead touch the film and x-ray beam is projected 15-20 º caudally

6. Structures seen Frontal sinuses(best) Ethmoid sinuses,maxillary sinuses Frontal process of of zygoma and zygomatic process of frontal bone Superior margin of orbit and lamina papyracea Superior orbital fissure Foramen rotundum

7. Lateral view Lateral side of skull lies against the film and x-ray beam is projected perpendicular from the other side Fluid levels of all sinuses can be seen

8. Structures seen Anterior and posterior extent of sphenoid,frontal and maxillary sinuses Sella tursica Ethmoid sinuses Alveolar process Condyle and neck of mandible

9. Submento vertical (basal) view This view is taken with vertex near the film and x-ray beam projected at right angles to the film from the submental area

10. Structures seen Sphenoid,posterior ethmoid and maxillary sinuses(seen best in that order) Zygoma and zygomatic arch Mandible

11. Right and left oblique view

12. X-rays for nasal fractures Lateral view of nasal bones Occlusal view of nasal bone Water’s view

13. Water’s view Fractures of right and left nasal bones and their lateral displacement can be seen

14. Water’s view

15. Advantages of X-ray imaging Cost effectiveness Easy availability

16. Disadvantages Plain X-ray have false positivity of 4% False negativity-more than 30% Currently available digital imaging techniques provide better bone and soft tissue resolution when compared to conventional X-ray

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