X-RAY OF FACE

X-RAY OF FACE

X-ray Facial Bone P/A View

Facial Bone PA 15˚ (Caldwell)

Region: facial bone, orbital rim, zygomatic bone, nasal septum

Pathology: fracture of facial bone, deformation, tumor, Paget's disease

SID: 100 cm (40 inches)

Central Ray: beam directed at the nasion with 15˚ caudal angulation

Respiration:suspended

Position:

1. The patient is in an erect position, in a sitting position or in a prone position.

2. Align the midsagittal plane (MSP) of head to the vertical axis crossing the center of the image receptor (IR).
3. Flex the cervical vertebrae enough to align the orbitomeatal line (OML) perpendicular to the IR.
4. Lean forehead and nose gently on the IR to place the nasion at the center of the IR.

Collimation: Include the entire structure of facial bone between parietal region and maxilla

Evaluation:

1. Petrous ridge is projected in lower 1/3 of orbits above inferior orbital margin.
2. Bilateral petrous ridges should be symmetric and the skull should not be rotated.
3. Structures including frontal bone, nasal septum, zygomatic bone, and orbit should be clearly observable.

kVp:75, mAs:25

Tip:

1. For prone position, if assistance instruments are used like pillow under the chest, it is easy to bend cervical vertebrae so that orbitomeatal line (OML) can be perpendicular to image receptor (IR).
2. For patient who is uncomfortable with bending cervical vertebrae, adjust skull to make Inferior OrbitoMeatal line (IOML) be perpendicular to IR and project 8° caudad to nasion.
3. It is hard to maintain the pose for patient; the inspection must be done in a short time.

X-ray Facial Bone Lateral View

Facial Bone Lateral

Region: facial bone, greater wing of sphenoid, orbital roof, zygomatic bone, mandible

Pathology: fracture of facial bone, deformation, tumor

SID: 100 cm (40 inches)

Central Ray: perpendicular beam directed to the zygomatic bone between the outer canthus and the external auditory meatus (EAM)

Respiration: suspended

Position: 1. The patient is placed either in an erect position or in a semi-prone position.

2. Align the Inferior orbitomeatal line (IOML) parallel to the horizontal axis of image receptor (IR).
3. Align the Interpapillary Line (IPL) perpendicular to the IR and adjust the head to align the midsagittal plane (MSP) parallel to the IR.
4. Place zygomatic bone at the center of IR.
5. Maintain the true lateral position by placing the patient's ear tightly on the IR.

Collimation:Include the entire structures of facial bone between parietal region, mandible, and mandibular condyle.

Evaluation:

1. The superimposition of the sella turcica with anterior clinoid process, greater wing of sphenoid, mandibular rami, extra auditory meatus and temporomandibular joint should be observed without the rotation
2. Zygomatic bone should be observed at the center of the image.
3. The sella turcica should not be rotated, and the floor of sella turcica should be shown as a line not a plane.
4. The superimposition of superior orbital margins should be observed without tilting

kVp-75, mAs-25

Tip:

1. When patient cannot pose semi-prone position, place patient in supine position and lean temporal bone on image receptor (IR) to make true lateral position. In this case, projecting horizontally is considered.
2. Semi-prone position is an uncomfortable position; it helps the position to use assistance instruments like pillow or sponge to support cervical region.
3. It is hard to maintain the pose for patient; the inspection must be done in a short time.