Facial Bones and Orbits

Lateral Facial Bones

• Position: patient semi prone or oblique seated upright with MSP and IOML parallel to IR and interpupillary line perpendicular

• CR: enter at lateral surface of zygomatic arch halfway between outer canthus and EAM

• SS: lateral facial bones

• EC: superimposed mandibular rami and superimposed orbital roofs and sella turcica

Lateral Facial Bones Image

xray

Parietocanthial Waters Method

• Position: patient prone or seated upright with MSP perpendicular and OML 37 degrees with IR and MML perpendicular to IR

• CR: perpendicular to acanthion

• SS: orbits, maxillae, zygomatic arches

• EC: equal distance b/w lateral border of skull and orbit on each side, petrous ridges below maxillary sinuses

Parietoacanthial Waters Method

xray

Modified Parietocanthial Waters Method

• Position: patient prone or seated upright with OML 55 degrees with IR(neck extended less than waters)

• CR: perpendicular to acanthion

• SS: orbital floor perpendicular to IR, show blow out fx with inferior displacement of orbital floor

• EC: petrous pyramids below orbital floors

Modified Parietocanthial Waters

xray

Acanthioparietal Reverse Waters

• Position: patient supine with OML 37 degrees with IR and MML and MSP perpendicular to IR

• CR: enters at acanthion

• SS: magnified facial bones, superior facial bones

• EC: equal distance b/w lateral border of skull and orbit on each side, petrous ridges below maxillary sinuses

• Trauma angle cephalic 30 degrees to IOML

Acanthioparietal Reverse Waters

PA Axial Caldwell Skull

• Position: patient prone or seated with OML and MSP perpendicular to IR, place sponge under forehead for obese

• CR: angle 15 degrees caudad to nasion

• SS: orbital rims, maxillae, nasal septum, zygomatic bones, petrous pyramids in lower 1/3rd of orbits, frontal bone, frontal and ethmoidal sinuses, crista galli

• EC: equal distance b/w lateral border of skull and lateral orbit

PA Axial Caldwell Skull

7 Orbit Bones

cranial: frontal, ethmoid, sphenoid

facial: lacrimal, palatine, maxillary, zygomatic

Orbit Openings

1.optic foramen(optic nerve)

2.superior orbital fissure(cleft between greater and lesser sphenoid wing)

3.inferior orbital fissure(cleft at lower anteriorlateral sphenoid bone)

Orbits

image

Lateral Orbits

• Position: patient erect in RAO/LAO with MSP and IOML parallel to IR

• CR: enter at outer canthus

• SS: orbit closest to IR

• EC: density and contrast to visualize orbital rims, superimposed orbital roofs, close beam restriction

Lateral Facial Bones

xray

PA Axial Caldwell Orbits

• Position: patient seated upright facing IR with nose and forehead on grid and MSP and OML perpendicular to IR

• CR: angle 15 degrees caudad to nasion

• SS: frontal and ethmoidal sinuses, sphenoidal sinuses projected in nasal fossa, orbits

• EC: equal distance b/w lateral skull borders and orbits, symmetrical petrous ridges in lower 1/3rd of orbits, close beam restriction

PA Axial Caldwell Orbits

Parietocanthial Waters Orbits

• Position: patient seated upright with MSP and MML perpendicular to IR and OML forms 37 degree angle with IR

• CR: perpendicular to acanthion

• SS: both orbits, maxillary sinuses above petrous ridges, frontal and ethmoidal sinuses distorted

• EC: petrous ridges below floor of maxillary sinuses, equal distance from lateral skull borders to lateral orbits, maxillary sinuses and orbits shown with close beam restriction

Parietocanthial Modified Waters Orbits

• Position: patient seated upright with MSP perpendicular to IR and OML forms 50 degree angle with IR

• CR: perpendicular to mid-orbits

• EC: entire orbits, petrous ridges in orbital shadows, close beam restriction centered on orbital region, bony orbit and soft tissues of eye (foreign body localization)

Parietocanthial Modified Waters Orbits

xray