RADIOGRAPHIC POSITIONING AND PROCEDURES

“PARANASAL SINUSES AND THE ORBITS”

NAME: JASON CRIS R. CO DATE: DEC 14, 2019

TASK I: Identify the paranasal sinuses, the bones containing each sinus, and their location.

Paranasal Sinus Bone Containing the sinus Location

1. FRONTAL SINUS 1. FRONTAL BONE 1. ABOVE THE EYES
2. ETHMOID SINUS 2. ETHMOID BONE 2. BETWEEN THE EYES
3. SPHENOID SINUS 3. SPHENOID BONE 3. BEHIND THE EYES
4. MAXILLARY SINUS 4. MAXILLARY BONE 4. UNDER THE EYES

TASK II: Provide radiographic presentation for the projections listed in the table below and provide description for
each.

Radiographic Presentations Description

A. Lateral Projection

It is the best projection to visualize

all paranasal sinuses. The head is in
true lateral position and also good to
visualize air-fluid level of the
sinuses.

B. Caldwell Method

The Caldwell view is a caudally

angled PA radiograph of the skull,
designed to better visualize the
paranasal sinuses, especially
the frontal sinus.

COLLEGE OF RADIOLOGIC TECHNOLOGY

C. Water’s Method (Open mouth)

This is a good alternative to

demonstrate sphenoid sinuses for
patients who cannot perform the
submentovertex(SMV) position.
Sphenoid sinuses is clearly
visualized through the open mouth.
Demonstrates Maxillary sinuses,
petrous ridge, inferior orbital rim, an
oblique view of the frontal sinuses.

D. Submentovertex Projection

A projection used to demonstrates

Sphenoid sinuses, Ethmoid sinuses,
Nasal fossae, and maxillary sinuses.
If the patient is unable to
hyperextend the neck sufficiently,
angle the tube from the horizontal
axis as needed to align CR
perpendicular to IOML.

COLLEGE OF RADIOLOGIC TECHNOLOGY

TASK III: Provide an image of the gross anatomy of the bony composition of the orbits and identify the bones if they
are cranial or facial bones.

Bony Composition of the Orbits

Gross anatomy Bones
Cranial Bones
1. SPHENOID BONE
2. ETHMOID BONE
3. FRONTAL BONE

Facial Bones
1. ZYGOMATIC BONE
2. MAXILLARY BONE
3. PALATINE BONE
4. LACRIMAL BONE

COLLEGE OF RADIOLOGIC TECHNOLOGY

TASK IV: Describe each opening in the posterior orbit and present its gross anatomy.

Openings in Description Gross anatomy

posterior orbit
1. Optic foramen The opening through which
the optic nerve runs back into
the brain and the large
ophthalmic artery enters the
orbit, is at the nasal side of the
apex; the superior orbital
fissure is a larger hole through
which pass large veins and
nerves.

2. Superior orbital Is a foramen in the skull,

fissure although strictly it is more of a
cleft, lying between the lesser
and greater wings of the
sphenoid bone.

3. Inferior orbital Lies in the floor of the orbit

fissure inferior to the superior orbital
fissure and it is bounded
superiorly by the greater wing
of sphenoid, inferiorly by
maxilla and orbital process of
palatine bone and laterally by
the zygomatic bone. It opens
into posterolateral aspect
of orbital floor.

COLLEGE OF RADIOLOGIC TECHNOLOGY

TASK V: Describe each fracture listed below and provide radiographic image.

Fracture Description Radiographic Image

1. Blow-out Is a traumatic deformity
of the orbital floor or
medial wall, typically
resulting from impact of
a blunt object larger than
the orbital aperture, or
eye socket

2. Tripod Definition = fracture

through:

 - Inferior orbital rim

 - Lateral orbital wall
 - Zygomatic arch
 Causes:
Lower eyelid/cheek
pain, swelling, and
ecchymosis

COLLEGE OF RADIOLOGIC TECHNOLOGY

3. Le Fort Fractures of the
midface, which
collectively involve
separation of all or a
portion of the midface
from the skull base. In
order to be separated
from the skull base, the
pterygoid plates of the
sphenoid bone need to
be involved as these
connect the midface to
the sphenoid bone
dorsally.

4. Contrecoup A contusion resulting

from the brain contacting
the skull on the side
opposite from where
impact occurs.
Contrecoup injury is a
focal phenomenon and
is unlike diffuse axonal
injury or brain edema
which may also result
from trauma.
Contrecoup injury has
also been considered to
play a role in visual
abnormalities following
minor head injuries.

COLLEGE OF RADIOLOGIC TECHNOLOGY