nasal bones and orbits positioning

nasal bones projections

bilateral lateral and waters method

lateral nasal structres

shows the nasofrontal suture, nasal bone, and anterior nasal spine of maxilla and must include the anterior nasal spine of the maxilla up to the glabella

CR for lateral nasal bones

directed to the bridge of the nose

MS plane for lateral nasal bones and lateral orbits

parallel to IR

inter-pupillary line for lateral nasal bones; IOML for AP or PA axial orbits; MS and MML for waters method of nasal bones

perpendicular to IR

IOML for lateral nasal bones

perpendicular to edge of IR

patient position for waters method of nasal bones

upright with chin against IR

OML for waters method nasal bones

37 degrees with IR

CR for waters method of nasal bones

exiting the acanthion

structures shown for waters method

any lateral dislocations or fractures; deviated septum

orbits projections

modified parientoacanthial (modified waters), AP or PA axial (for blowouts), lateral, parietoacanthial oblique (rhese)

patient position for modified waters method

up right; patients chin and nose are against IR

CR for modified waters method

directed to the level of the outer canthus

OML of modified waters method

forms an angle of 55 degrees with IR

structures shown for modified waters of orbits

both orbits completely free of petrous ridges; good to see foreign bodies

AP or PA axial for blowouts pt position

Pt. upright or laying down

CR for AP axial orbits

- angled 30 degrees cephalic (AP) 30 degrees caudal (PA)

- directed to the lips

- will exit 2" superior to the inion

structures for axial blowouts

see blowout fractures

lateral orbits

affected side against IR; CR directed to outer canthus

IPL for lateral orbits

perpendicular to IR

IOML for lateral orbits

perpendicular to EDGE of IR

CR for lateral orbits

directed to outer canthus

structures shown for lateral orbits 

affected side only; good for foreign bodies 

rhese method

PA; parieto-orbital oblique

3 point landing

nose, cheek, chin

AMl for parietoorbital oblique (rhese)

perpendicular to IR

MSP for parietoorbital oblique (rhese)

forms 53 degree angle with IR

CR for parietoorbital oblique (rhese)

 directed 1" superior and 1" posterior to the TEA (top of ear attachment) on the side up (unaffected)

structures shown for rhese method

affected side only; looking at optic foramen opening