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

2. 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

3. X-ray nose & paranasal sinus

4. 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

6. 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

7. Water’s view

9. Water’s view with mouth open (Pierre view)

11. Lateral view

13. Pathologies

26. X-ray mastoid

27. 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

28. 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

29. Towne’s view

30. Cellular Mastoid

31. Sclerotic Mastoid

32. Diploetic Mastoid

33. Cholesteatoma erosion

35. Mastoid cavity Cholesteatoma Post-mastoidectomy cavity
Mastoid abscess in coalescent mastoiditis
Tympano-mastoid malignancy
Eosinophilic granuloma
Mega-antrum

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

38. Coin in esophagus

39. Coin in bronchus

41. Acute retropharyngeal abscess

42. Chronic retropharyngeal abscess

43. FB bronchus

44. Acute epiglotitis

45. Croup

47. Thank You