MODULE OF SKILL LABORATORIUM PRACTICE

BLOCK : RESPIRATORY SYSTEM

TOPIC : DEMONSTRATE KNOWLEDGE INTERPRETING
NORMAL PARANASAL SINUSES RADIOGRAPH

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I. GENERAL OBJECTIVE

After finishing skill practice, the students

will be able to interpret normal paranasal
sinuses radiograph .

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II. SPECIFIC OBJECTIVE

At the end of skill practice, the students

will be able to demonstrate knowledge
a. radiopositioning of the paranasal sinuses
b. radioanatomy of the paranasal sinuses
c. radiological appearances of normal
paranasal sinuses

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 RADIOPOSITIONING OF THE PARANASAL
SINUSES
• Water’s projection:
- Prone or upright (posteroanterior).
- Midline, with no head tilt or rotation.
- The head is extended such that
the canthomeatal line is elevated 37o
relative to the central ray.
- TFD 40 inches (102 cm).
- CR should exit just below the nares.

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Water’s projection

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Water’s projection

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Water’s projection

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• Lateral projection:
- Semiprone or upright.
- Head is turned to a true lateral position.
- The midsagittal plane is parallel to the
cassette.
- The interpupillary line is perpendicular.
- TFD 40 inches (102 cm).
- CR at the lateral canthus of the eye.

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Lateral projection

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Lateral projection

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• Caldwell projection:
- Prone or upright.
- Frontal bone in contact with the bucky.
- Remove all head tilt & rotation.
- The orbitomeatal line (OM line) should be
perpendicular to the cassette.
- TFD 40 inches.
- Tube tilt 15o caudad.
- CR exits through the nasion.

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Caldwell projection

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Caldwell projection

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Radiopositioning of the paranasal sinuses

Radiopositioning Anatomic structures

Waters projection Maxillary, frontal, & ethmoid sinuses
Caldwell projection Frontal & anterior ethmoid sinuses
Lateral projection Frontal, ethmoid, sphenoid, & maxillary sinuses

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Radiological appearances of normal
paranasal sinuses

Paranasal sinuses:
Shape, size:
• Frontal sinus: height = ca. 1.5-2.0 cm
• Ethmoid cells
• Sphenoid sinus: width = 0.9-1.4 cm
• Maxillary sinuses: width and height = ca. 2.0 cm

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Contours:
• Smooth and sharp, no contour defects,
no circumscribed cortical thinning or
thickening, no expansion

Pneumatization :
• Radiololucency
• No sinus clouding
• No air-fluid levels

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Nasal cavity:
symmetry, nasal septum centered

Other bony structures :

• Facial skeleton, orbits, petrous ridges:
- shape, structure, contours

Soft tissues :
• No foreign bodies or calcifications
• No swelling

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