XRays in ENT Dr Sujan Chhetri MS ENT

X-Rays in ENT Dr Sujan Chhetri MS (ENT)

How to read X-ray • Plain or contrast • Region: Nose and PNS, mastoid, soft-tissue neck • View: AP, lateral • Important anatomical landmarks • Pathological findings • Diagnosis

X-ray nose & paranasal sinus

Types of X-Rays • Occipito-mental (Water) view • Occipito-mental view with mouth open (Pierre) • AP or fronto-occipital (Caldwell) view • Lateral oblique of orbit (Rhese) view • Submento-vertical (base skull) view

Best views • Maxillary: occipito-mental (Water’s) view • Frontal: antero-posterior (Caldwell) view • Ethmoid: lateral oblique (Rhese’s) view • Sphenoid: submento-vertical (base skull) view

Water’s view

Water’s view with mouth open (Pierre view)

Lateral view

Pathologies

X-ray mastoid

Why do mastoid x-ray? • Type of pneumatization: cellular, sclerotic, diploetic • Position of dural plate • Position of sinus plate • Presence of bone destruction • Presence of mastoid cavity • Presence of cholesteatoma

Types of mastoid x-ray • Towne’s view: b/l antero-posterior view showing both mastoids & internal auditory canals • Law’s view: 150 lateral oblique view • Schuller’s view: 300 lateral oblique view

Towne’s view

Cellular Mastoid

Sclerotic Mastoid

Diploetic Mastoid

Cholesteatoma erosion

Mastoid cavity 1. Cholesteatoma 2. Post-mastoidectomy cavity 3. Mastoid abscess in coalescent mastoiditis 4. Tympano-mastoid malignancy 5. Eosinophilic granuloma 6. Mega-antrum

X-ray soft tissue neck antero-posterior & lateral view

Coin in esophagus

Coin in bronchus

Acute retropharyngeal abscess

Chronic retropharyngeal abscess

FB bronchus

Acute epiglotitis

Croup