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 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 Cholesteatoma Post-mastoidectomy cavity Mastoid abscess in coalescent mastoiditis Tympano-mastoid malignancy Eosinophilic granuloma 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

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