MANDIBLE, SINUSES, TEMPORAL BONE Wynn Harrison, MEd
NEW WORDS Sinusitis: Inflammation of the sinuses Mucocele: Enlargement of the lacrimal sac. Cystic disease of the air cavities – causes erosion of the bone
Retention Cyst: A cyst retaining the secretion of a gland, ie: mucosal or sebaceous cyst Mastoiditis: Inflammation of the mastoid sinus
Otitis: Inflammation of the ear: ie: otitis media; can be internal or external Acoustic Neuroma: benign tumor of the eighth cranial nerve. Symptoms = hearing loss, pain, headache, balance problems.
Mandible
AP Axial (Townes) OML = 30 degrees IOML = 37 degrees Center mid- ramus
PA Mandible OML perpendicular to IR Center mid- mandible
Axiolateral Mandible Head tilt 15 degrees CR 15 degrees cephalic
SMV Mandible IOML parallel to IR and perpendicular to CR. Image mentum skimming frontal bone Merrill’s p
Temporomandibular joints
Cone-Down of TMJ Relaxed Lateral with 15 degree caudal angulation Merrill’s p. 396
Schullers Projection The Schullers Projection can be used to evaluate the temporal mandibular joints and mastoid air cells and inner ear.
Schullers Protection for TMJ Open and closed mouth view are taken of both TM joints. The TMJ closest to the Bucky will be the one seen at the center or top of the film. Accurate positioning is essential to being able to compare joints.
TMJ Syndrome Clicking, pain in TMJ May indicate dysfunction of the TMJ Caused by inflammation, stress, muscle spasm, etc.
Paranasal Sinuses
Lateral Sinus
Sinuses: Caldwell Frontal Ethmoid Maxillar y
Water’s view (sinuses) Maxillary Sinus Petrous Pyramids
What sinuses can you see?
Waters Projection Waters projection demonstrates: Cloudy maxillary sinuses worse on left. Sinus infection that needed antibiotics.
SMV - Sinuses Demonstrates sphenoid sinus Merrill’s p. 418
Temporal Mandibular Bone Law Method Shuller Method Stenver’s Method Arcelin Method Mayer Method Hickey Method
These projections will not be on your boards … but review Merrill’s p
PATHOLOGY
Fracture to Mandible and Zygomatic Arches
Mandibular Ramus Fracture
Bilateral Fractures of the Mandible
Film critique
Critical thinking