MANDIBLE, SINUSES, TEMPORAL BONE Wynn Harrison, MEd
NEW WORDS • Sinusitis: Inflammation of the sinuses • Mucocele: Enlargement of the lacrimal sac. Cystic disease of the air cavities – causes erosion of the bone
Retention Cyst: A cyst retaining the secretion of a gland, ie: mucosal or sebaceous cyst Mastoiditis: Inflammation of the mastoid sinus
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.
AP Axial (Townes) • OML = 30 degrees • IOML = 37 degrees • Center mid-ramus
OML perpendicular to IR Center mid-mandible PA Mandible
Head tilt 15 degrees CR 15 degrees cephalic Axiolateral Mandible
SMV Mandible • IOML parallel to IR and perpendicular to CR. • Image mentum skimming frontal bone • Merrill’s p. 389-390
Relaxed Lateral with 15 degree caudal angulation Merrill’s p. 396 Cone-Down of TMJ
Schullers Projection • The Schullers Projection can be used to evaluate the temporal mandibular joints and mastoid air cells and inner ear.
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.
TMJ Syndrome • Clicking, pain in TMJ • May indicate dysfunction of the TMJ • Caused by inflammation, stress, muscle spasm, etc.
Sinuses: Caldwell Frontal Ethmoid Maxillary
Water’s view (sinuses) Maxillary Sinus Petrous Pyramids
Waters Projection • Waters projection demonstrates: • Cloudy maxillary sinuses worse on left. • Sinus infection that needed antibiotics.
SMV - Sinuses • Demonstrates sphenoid sinus • Merrill’s p. 418
Temporal Mandibular Bone • Law Method • Shuller Method • Stenver’s Method • Arcelin Method • Mayer Method • Hickey Method
These projections will not be on your boards … but review Merrill’s p 430-452