Facial Bones- Orbits Procedures

Modified Waters - Pareitalacanthial

• Recumbent or erect

• Close eyes and hold them still for exposure

  *Many facilities do the modified and regular waters

• MSP centered

• OML 50 degrees from cassette

  *Even though 50 is a bigger number than the usual 37, it is actually less extension of the head

• CR perpendicular to midorbits

Lateral Orbits

• Patient adjusted true lateral

• Patient looks straight ahead for exposure

• IOML, MSP, Interpupillary line

• CR perpendicular to outer canthus

Evaluation Criteria:

• Density and contrast optimal

• Superimposed orbital roofs

• No rotation

• Collimate to just orbital region

PA Axial - Exaggerated Caldwell

• Pt. prone or seated

• OML perpendicular to IR

• MSP perpendicular to IR

• For demonstration of orbital rims, in particular the orbital floors, CR to exit through orbits at an angle of 30 caudad

Evaluation Criteria:

• Petrous pyramids lying below orbital shadows

What are some things that stay the same from skull and sinus imaging?

• Radiation protection

• Patient Prep

• Room prep i.e. cleanliness

• General body positioning

• Techniques

Why are orbits done?

• Pressure directed to the eyeball forces it back into the orbit and may cause a “blow out” fracture of the delicate bony floor

• In order to demonstrate bleeding into the sinus cavity, orbits must be done erect when possible

• The injury must be diagnosed and treated accurately so that the person’s vision is not jeopardized

• Also done for foreign body localization