1. MANDIBLE, SINUSES, TEMPORAL BONE Wynn Harrison, MEd

2. NEW WORDS Sinusitis: Inflammation of the sinuses Mucocele: Enlargement of the lacrimal sac. Cystic disease of the air cavities – causes erosion of the bone

3. Retention Cyst: A cyst retaining the secretion of a gland, ie: mucosal or sebaceous cyst Mastoiditis: Inflammation of the mastoid sinus

4. 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.

5. Mandible

6. AP Axial (Townes) OML = 30 degrees IOML = 37 degrees Center mid- ramus

7. PA Mandible OML perpendicular to IR Center mid- mandible

8. Axiolateral Mandible Head tilt 15 degrees CR 15 degrees cephalic

10. SMV Mandible IOML parallel to IR and perpendicular to CR. Image mentum skimming frontal bone Merrill’s p. 389-390

12. Temporomandibular joints

13. Cone-Down of TMJ Relaxed Lateral with 15 degree caudal angulation Merrill’s p. 396

15. Schullers Projection The Schullers Projection can be used to evaluate the temporal mandibular joints and mastoid air cells and inner ear.

16. 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.

18. TMJ Syndrome Clicking, pain in TMJ May indicate dysfunction of the TMJ Caused by inflammation, stress, muscle spasm, etc.

19. Paranasal Sinuses

22. Lateral Sinus

23. Sinuses: Caldwell Frontal Ethmoid Maxillar y

24. Water’s view (sinuses) Maxillary Sinus Petrous Pyramids

25. What sinuses can you see?

26. Waters Projection Waters projection demonstrates: Cloudy maxillary sinuses worse on left. Sinus infection that needed antibiotics.

27. SMV - Sinuses Demonstrates sphenoid sinus Merrill’s p. 418

28. Temporal Mandibular Bone Law Method Shuller Method Stenver’s Method Arcelin Method Mayer Method Hickey Method

29. These projections will not be on your boards … but review Merrill’s p 430-452

30. PATHOLOGY

31. Fracture to Mandible and Zygomatic Arches

32. Mandibular Ramus Fracture

33. Bilateral Fractures of the Mandible

34. Film critique

35. Critical thinking