1 Dr Sujan Chhetri MS (ENT)X-Rays in ENT Dr Sujan Chhetri MS (ENT)

2 How to read X-ray Plain or contrastRegion: Nose and PNS, mastoid, soft-tissue neck View: AP, lateral Important anatomical landmarks Pathological findings Diagnosis

3 X-ray nose & paranasal sinus

4 Types of X-Rays Occipito-mental (Water) viewOccipito-mental view with mouth open (Pierre) AP or fronto-occipital (Caldwell) view Lateral view Lateral oblique of orbit (Rhese) view Submento-vertical (base skull) view

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6 Best views Maxillary: occipito-mental (Water’s) viewFrontal: antero-posterior (Caldwell) view Ethmoid: lateral oblique (Rhese’s) view Sphenoid: submento-vertical (base skull) view

7 Water’s view

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9 Water’s view with mouth open (Pierre view)

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11 Lateral view

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13 Pathologies

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26 X-ray mastoid

27 Why do mastoid x-ray? Type of pneumatization: cellular, sclerotic, diploetic Position of dural plate Position of sinus plate Presence of bone destruction Presence of mastoid cavity Presence of cholesteatoma

28 Types of mastoid x-ray Towne’s view: b/l antero-posterior view showing both mastoids & internal auditory canals Law’s view: 150 lateral oblique view Schuller’s view: 300 lateral oblique view

29 Towne’s view

30 Cellular Mastoid

31 Sclerotic Mastoid

32 Diploetic Mastoid

33 Cholesteatoma erosion

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35 Mastoid cavity Cholesteatoma Post-mastoidectomy cavityMastoid abscess in coalescent mastoiditis Tympano-mastoid malignancy Eosinophilic granuloma Mega-antrum

36 X-ray soft tissue neck antero-posterior & lateral view

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38 Coin in esophagus

39 Coin in bronchus

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41 Acute retropharyngeal abscess

42 Chronic retropharyngeal abscess

43 FB bronchus

44 Acute epiglotitis

45 Croup

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47 Thank You