Professional Documents
Culture Documents
SCHULLER/PFEIFFER METHOD/SUBMENTOVERTICAL
PROJECTION
➢ PP: Supine or Seated-upright (more comfortable); IOML //
TOWNE/ALTSCHUL/GRASHEY/CHAMBERLAINE
to IR; MSP ┴ to IR; head rested on vertex; neck
METHOD/ AP AXIAL PROJECTION
hyperextended
➢ PP: Lateral decubitus; OML/IOML & MSP ┴ to IR
➢ RP: ¾ in. anterior to EAM (sella turcica)
➢ RP: 2.5-3 in. above glabella
➢ CR: ┴ to IOML; MSP of throat b/n gonion (entrance)
➢ CR: 30° caudad (OML ┴); 37° caudad (IOML ┴)
➢ SS: Cranial base
➢ SS: Same as above
✓ Foramen ovale & spinosum (best demonstrated)
➢ ER: For patient w/ pathologic condition, trauma or
✓ Symmetric petrosae
deformity (strongly accentuated dorsal kyphosis)
✓ Mastoid processes
✓ Carotid canals
✓ Sphenoidal & ethmoidal sinuses
✓ Mandible
✓ Bony nasal septum
✓ Dens of axis
✓ Occipital bone
✓ Maxillary sinus superimposed over the mandible
✓ Zygomatic arches (well demonstrated if exposure
factors are decreased)
✓ Axial tomography of orbits, optic canals, ethmoid
bone, maxillary sinuses & mastoid processes
VOGT-BONE-FREE POSITION
➢ Taken to detect small or low density foreign particles
located in the anterior segment of the eyeball/eyelids
➢ 2 Projections: lateral & superoinferior
➢ 2 Movements: WATERS METHOD/PARIETO-ACANTHIAL PROJECTION
✓ Vertical: 2 exposures (for lateral) ➢ PP: Prone; MSP & MML ┴ to IR; OML 37° to IR; nose ¾
▪ Look up as far as possible in. (1.9 cm) away from IR
▪ Look down as far as possible ➢ RP: Acanthion (exit)
✓ Horizontal: 2 exposures (for superoinferior) ➢ CR: ┴
▪ Look to extreme right ➢ SS: Orbits, maxillae & zygomatic
▪ Look to extreme left arches
✓ Petrous ridges below
the maxillae
✓ Best projection for
facial bones
✓ Blow out fractures
MODIFIED WATERS
➢ PP: Prone; MSP & MML ┴ to IR; OML 55° to IR
PARALLAX METHOD ➢ RP: Acanthion (exit)
➢ First described by Richards ➢ CR: ┴
➢ It determines whether the foreign body is located within the ➢ SS: Facial bones w/ less axial angulation
eyeball requires no special apparatus ✓ Petrous ridges below the inferior border of orbits
➢ Not considered as precision localization procedure
➢ Widely used as preliminary check only
➢ 2 Projections:
✓ Lateral: 2 exposures
✓ PA: 2 exposures
TANGENTIAL PROJECTION
➢ PP:
✓ Extraoral Film (Cassette): prone; chin rested on
sandbags; chin fully extended; MSP & GAL ┴ to
IR
✓ Intraoral Film (Occlusal Film): supine; head
elevated; MSP ┴ to sponge; GAL // to sponge &
┴ to film
➢ RP: Glabelloalveolar line
REVERSE WATERS METHOD/ AP AXIAL PROJECTION
➢ CR: ┴
➢ PP: Supine; MSP & MML ┴ to IR; OML 37° to IR; chin up
➢ SS: Nasal bones with minimal superimposition
➢ RP: Acanthion (exit)
➢ ER: For demonstration of any medial or lateral
➢ CR: ┴
displacement of fragments in fractures
➢ SS: Superior facial bones; same as True/Original Waters,
➢ Contraindications:
but the image is MAGNIFIED
✓ Children or adults who have very short nasal
➢ ER: For patient who cannot be placed in the prone position
bones, concave face or protruding upper teeth
PA PROJECTION
➢ PP: Prone; nose & chin against IR; AML & MSP ┴ to IR SCHULLER METHOD/ VERTICOSUBMENTAL
➢ RP: Level of lips PROJECTION
➢ CR: ┴ ➢ PP: Prone; chin fully hyperextended; IR against throat;
➢ SS: Mandibular body MSP ┴ to IR
➢ RP: Level just posterior to outer canthi
➢ CR: ┴ to IOML or occlusal plane
➢ SS: Condyle & neck of condylar processes are better shown
(CR ┴ occlusal plane)
PANORAMIC TOMOGRAHY/
PANTOMOGRAPHY/ROTATIONAL TOMOGRAPHY
➢ technique employed to produced tomograms of curved
surfaces
➢ Provides panoramic image of the entire mandible, TMJ,
dental arches
➢ Provides distortion-free lateral image of the entire mandible
➢ Patients who sustained severe mandibular or TMJ trauma
➢ Useful for general survey studies of dental abnormalities
➢ Adjuvant for pre-bone marrow transplant SCHULLER METHOD/ AXIOLATERAL
OBLIQUE/LATERAL TRANSCRANIAL/AXIAL
TRANSCRANIAL PROJECTION
➢ PP: Semi-prone; MSP rotated 15° toward the IR; AML // to
transverse axis of IR;
➢ RP: 1.5 in. superior to upside EAM
➢ CR: 15° caudad; TMJ of sidedown (exit)
➢ SS: Condyles & neck of the mandible
✓ Closed-mouth: fracture of the neck & condyle of
ramus
✓ Opened-mouth: mandibular fossa; inferior &
anterior excursion of the condyle
TEMPOROMANDIBULAR JOINTS
TOWNE METHOD/AP AXIAL PROJECTION
➢ PP: Supine; MSP & OML ┴ to IR
✓ Closed-mouth Position: posterior teeth in contact
not incisors
▪ Rationale: prevents mandibular
protrusion & condyles to be carried out
of mandibular fossae INFEROSUPERIOR TRANSFACIAL POSITION
✓ Opened-mouth Position: open as wide as possible ➢ PP: Semi-prone; head in true lateral; IPL 10-15° from┴;
▪ Mandible not protruded (jutted MSP 15 from IR
forward) ➢ RP: Uppermost gonion
▪ Not perform in trauma patients ➢ CR: 30° cephalad
➢ RP: 3 in. above nasion ➢ SS: TMJ
➢ CR: 35° caudad ALBERS-SCHONBERG METHOD/ LATERAL
➢ SS: Mandibular condyles & mandibular fossae of temporal TRANSFACIAL POSITION
bones ➢ PP: Semi-prone; head in true lateral; IPL ┴ to IR; MSP // to
✓ Closed-mouth: condyle lying in mandibular fossa IR; IOML // to transverse axis of IR
✓ Opened-mouth: condyles lying inferior to ➢ RP: TMJ closes to IR (exit)
articular tubercle ➢ CR: 20° cephalad
➢ SS: TMJ
ZANELLI METHOD/ LATERAL TRANSFACIAL POSITION
➢ PP: Lateral recumbent; head in true lateral; head resting on
parietal region; MSP 30° to IR
➢ RP: Uppermost gonion (entrance)
➢ CR: ┴
➢ SS: TMJ
SINUSES
AXIOLATERAL PROJECTION CROSS & FLECKER
➢ PP: Semiprone; head in lateral position; IPL ┴ to IR; MSP ➢ pointed out the value of erect position
// to IR; closed-mouth & opened-mouth position ➢ To demonstrate presence or absence of fluid
➢ RP: 0.5 in. anterior & 2 in. superior to upside EAM ➢ To differentiate between shadows caused by fluid & those
➢ CR: 25-30° caudad caused by pathology
➢ SS: TMJ anterior to EAM LATERAL PROJECTION
✓ Closed-mouth: condyle lying in mandibular fossa ➢ PP: Upright RAO/LAO or dorsal decubitus (can’t assume
✓ Opened-mouth: condyles lying inferior to upright); head in true lateral; MSP parallel to IR; IPL ┴ to
articular tubercle IR; IOML // to transverse axis of IR;
➢ RP: 0.5-1 in. posterior to outer canthus ➢ CR: Horizontal
➢ CR: ┴ ➢ SS: Sphenoidal sinuses
➢ SS: All paranasal sinuses projected through open
mouth
✓ Petrous pyramids
inferior to floor of
maxillary sinus
➢ ER: For the patients who
cannot be placed in position
PA PROJECTION for SMV
➢ PP: Upright; forehead & nose against IR; MSP & OML ┴ SCHULLER METHOD/SUBMENTOVERTICAL
to IR PROJECTION
➢ RP: Nasion (┴); glabella (10° cephalad); midregion of ➢ PP: Upright; IOML // to IR;
maxillary sinuses (┴) MSP ┴ to IR; head rested on
➢ CR: ┴; 10°cephalad vertex; neck hyperextended
➢ SS: ➢ RP: ¾ in. anterior to EAM
✓ Posterior ethmoid sinuses inferior to cranial (sella turcica)
bones & superior to anterior ethmoid sinuses (┴) ➢ CR: ┴ to IOML; MSP of throat
✓ Sphenoidal sinuses through frontal bone & b/n gonion (entrance)
superior to frontal & ethmoid sinuses ➢ SS: Sphenoidal & ethmoidal
✓ Maxillary sinuses inferior to cranial base sinuses
CALDWELL METHOD/ PA AXIAL PROJECTION ✓ portion of the base of
➢ PP: Upright the skull
✓ Angle grid technique: nose & forehead against SCHULLER METHOD/VERTICOSUBMENTAL
IR; IR tilted 15°; MSP & OML ┴to IR PROJECTION
✓ Vertical grip technique: nose against IR; OML ➢ PP: Seated-erect; chin fully hyperextended; MSP ┴to IR
15° from IR; sponge b/n forehead & IR; MSP ┴ ➢ RP: ¾ in. anterior to EAM (sella turcica)
to IR ➢ CR: ┴ to IOML; MSP of throat b/n gonion (entrance)
➢ RP: Nasion ➢ SS: Sphenoidal
➢ CR: Horizontal sinuses
➢ SS: Frontal sinuses & anterior ethmoidal sinuses ✓ Posterior
ethmoidal
sinuses
✓ Maxillary
sinuses
✓ Nasal fossae
PIRIE METHOD/ AXIAL TRANSORAL POSITION
➢ PP: Upright (prone; nose & chin against IR; mouth wide
open; MSP ┴ to IR; phonate “ah” during exposure
WATERS METHOD/ PARIETOACANTHIAL PROJECTION
➢ RP: ¾ in. anterior to EAM (sella turcica)
➢ PP: Upright; neck hyperextended & rested against IR;
➢ CR: ┴
OML 37° to IR; MML ┴ to IR
➢ SS: Sphenoidal sinuses projected through open mouth
➢ RP: Acanthion
✓ Maxillary sinuses
➢ CR: Horizontal
✓ Nasal fossae
➢ SS: Maxillary sinuses
RHESE METHOD/ PA OBLIQUE POSITION
✓ Petrous pyramids inferior to floor of maxillary
➢ PP: Seated-erect; zygoma, nose & chin against IR; AML ┴
sinus
to IR; MSP 53° from IR
✓ Foramen rotundum
➢ RP: Upper parietal region
✓ Distorted frontal & ethmoidal sinuses
➢ CR: ┴
➢ SS: Oblique image of posterior & anterior ethmoidal
sinuses
✓ Frontal & sphenoidal sinuses
✓ Profile image of the optic canal
LAW METHOD/ PA OBLIQUE POSITION
➢ PP: Seated-erect; zygoma, nose & chin against IR; neck
fully extended
➢ RP: Uppermost gonion
➢ CR: 25-30° cephalad
➢ SS: Relationship of teeth to maxillary sinuses
OPEN-MOUTH WATERS METHOD/ PARIETOACANTHIAL MASTOID
PROJECTION LAW METHOD/ AXIOLATERAL POSITION
➢ PP: Upright; neck hyperextended & rested against IR; DOUBLE ANGULATION METHOD
OML 37° to IR; MML ┴to IR; mouth wide open ➢ PP: Prone; head in true lateral; tape auricle forward; MSP
➢ RP: Acanthion & IOML // to IR; IPL ┴ to IR
➢ RP: 2 in. posterior & 2 in. superior to uppermost EAM ✓ Mastoid cells, mastoid antrum, IAM & EAM &
➢ CR: 15° caudad & 15° anterior tegmen tympani (Henschen)
➢ Lange Recommendations: ✓ Tumors of the acoustic nerve (Cushing)
✓ 25° caudad & 20° anterior ✓ Pneumatic structures of mastoid process, mastoid
✓ Auricles taped forward antrum, tegmen tympani, IAM & EAM, sinus &
SINGLE ANGULATION METHOD dural plates & mastoid emissary when present
➢ PP: Prone; tape auricle (Schuller)
forward; MSP rotated ✓ Mastoid cells, matoid antrum, IAM & EAM,
15° toward IR tegmen tympani, labyrinthine area & carotid
➢ RP: 2 in. posterior & 2 canal (Lysholm/Runstrom II)
in. superior to ➢ Runstrom Recommendation:
uppermost EAM ✓ Exposure made with
➢ CR: 15° caudad open mouth
PART ANGULATION METHOD ✓ For visualization of
➢ PP: Prone; head rested on flat surface of cheek; tape auricle petrous apex
forward; MSP rotated 15° towards IR; IPL 15° from between anterior
vertical wall of EAM &
➢ RP: 2 in. posterior & 2 in. superior to uppermost EAM mandibular condyle
➢ CR: 15° caudad & 15° anterior
➢ SS: Mastoid cells PETROUS PORTION
✓ Sigmoid sinus TOWNE METHOD/AP AXIAL PROJECTION
✓ Lateral portion of pars petrosa ➢ PP: Supine; OML/IOML & MSP ┴ to IR;
✓ Tegmen tymphani ➢ RP: MSP b/n EAMs
✓ Superimposed internal & external auditory ➢ CR: 30° caudad (OML ┴); 37° caudad (IOML ┴)
meatuses ➢ SS: Petrosae above base of the skull
✓ Mastoid emissary vessel (when present) ✓ IAM
MODIFIED HICKEY METHOD/ AP TANGENTIAL ✓ Arcuate eminences
POSITION ✓ Labyrinths
➢ PP: Supine; tape auricles forward; face rotated away from ✓ Mastoid antrum
side of interest; MSP 55° from IR or 35° from vertical; ✓ Middle ears
IOML ┴ to IR; IR caudally inclined 15° ✓ Dorsum sellae w/in shadow of foramen magnum
➢ RP: 1 in. superior to tip of mastoid process HAAS METHOD/PA AXIAL PROJECTION
➢ CR: 15° caudad ➢ PP: Prone; MSP & OML┴ to IR; forehead & nose against
➢ SS: Mastoid process free of superimposition the table; IR center 1 in. to nasion
✓ Projected below the shadow of occipital bone ➢ RP: Nasion
PA TANGENTIAL POSITION ➢ CR: 25° cephalad
➢ PP: Prone; IR cranially inclined 15°; tape auricles forward; ➢ SS: Symmetric axial frontal image of petrous portions
cheek against IR; face rotated away from side of interest; projected above the base of the skull
MSP 55° from IR or 35° from vertical; IOML ┴to IR ✓ IAM
➢ RP: 1 in. superior to tip of mastoid process ✓ Labyrinths
➢ CR: 15° cephalad ✓ Mastoid antrums
➢ SS: Mastoid process free of superimposition ✓ Middle ears
✓ Projected below the shadow of occipital bone ✓ Dorsum sellae & posterior clinoid processes w/in
TOWNE METHOD/AP AXIAL PROJECTION shadow of foramen magnum
➢ PP: Supine; OML/IOML & MSP ┴ to IR; ➢ ER: For patients who cannot assume AP axial position
➢ RP: 2 in. above glabella or 2.5 in. above nasion VALDINI METHOD/PA AXIAL PROJECTION
➢ CR: 30° caudad (OML ┴); 37° caudad (IOML ┴) ➢ PP: Recumbent or seated-erect (more comfortable); upper
➢ SS: frontal region of skull against IR; MSP ┴ to IR; head
✓ Internal auditory canal acutely flexed; IOML 50°/OML 50°; line extending from
✓ Petrous portion of temporal bone inion to 0.5 cm distal to nasion form 28 to CR
✓ Labyrinths ➢ RP: 0.5 cm distal to nasion (dorsum sellae); foramen
✓ Mastoid antrum magnum at or slightly above level of EAM (petrosae)
✓ Middle ears ➢ CR: ┴; inion (entrance); 0.5 cm distal to nasion (exit)
✓ Dorsum sellae w/in foramen magnum ➢ SS:
HENSCHEN, SCHULLER, & LYSHOLM METHODS/ ✓ DILA (IOML 50°): Dorsum sellae; Internal
AXIOLATERAL POSITIONS Auditory Meatus (IAM); LAbyrinth
➢ PP: Semiprone; head in true lateral; MSP // to IR; IPL ┴ to ✓ ETB “EaT Bulaga” (OML 50°): External
IR; IOML parallel to transverse axis of IR; auricles taped auditory meatus; Tymphanic cavity; Bony part of
forward Eustachian tube
➢ RP: Dependent EAM closest to IR SCHULLER/PFEIFFER METHOD/ SUBMENTOVERTICAL
➢ CR: 15° caudad (Henschen/Cushing); 25° caudad (SUBBASAL) PROJECTION
(Schuller); 35° caudad (Lysholm/Runstrom II) ➢ PP: Supine or Seated-upright (more comfortable); OML //
➢ SS: Mastoid & petrous portion to IR or CR ┴ to OML; (cannot fully extend the neck) or
supraorbitomeatal line (SOML) parallel to IR; MSP ┴ to ✓ Mastoid antrum
IR; head rested on vertex; neck hyperextended ✓ Area of tympanic
➢ RP: ¾ in. anterior to EAM (sella turcica) cavity
➢ CR: ┴ to OML at midway b/n EAMs or 15-20° anteriorly ✓ Labyrinth
at MSP of throat 1 in. anterior to EAMs ✓ IAM
➢ SS: Symmetric petrosae ✓ Cellular structure
✓ Mastoid processes of petrous apex
✓ EAMs ARCELIN METHOD/ ANTERIOR PROFILE POSITION/
✓ Labyrinths REVERSE STENVERS METHOD
✓ Acoustic/auditory ossicles ➢ PP: Supine; IOML ┴to IR; face rotated away from side of
✓ Tympanic cavities interest; MSP 45° to IR
HIRTZ METHOD ➢ RP: 1 in. anterior & ¾ in. superior to EAM closest to IR
➢ RP: Midway b/n & 1 in. anterior to EAMs (exit)
➢ CR: 5° anteriorly ➢ CR: 10° caudad
MAYER METHOD/AXIOLATERAL OBLIQUE PROJECTION ➢ SS: Magnified pars
➢ PP: Supine; auricles taped forward; outer side of IR petrosa away from IR
elevated (reduces part-film distance); MSP 45 from IR; ➢ ER: Useful with children
chin depressed; IOML //to IR & with adults who cannot
➢ RP: Dependent EAM be position for Stenvers
➢ CR: 45° caudad Method
➢ SS: Axial oblique of petrosa MODIFIED LAW METHOD/ AXIOLATERAL POSITION
✓ Petrosa inferior to mastoid air cells SINGLE ANULATION METHOD
✓ EAM ➢ PP: Prone; taped auricle forward; Head rotated 15° toward
✓ Tympanic cavity & ossicles IR; MSP 15°
✓ Epitympanic recess (attic) ➢ RP: 2 in. posterior & 2 in. superior to uppermost EAM
✓ Aditus ➢ CR: 15° caudad
✓ Mastoid antrum ➢ SS:
OWEN MODIFICATIONS: ✓ Mastoid cells
PENDERGRASS, SCHAEFFER & HODES ✓ Lateral portion of pars petrosa
➢ PP: MSP 40° to IR; IR & head angled 10° caudally ✓ Superimposed IAM & EAM
➢ CR: 28° caudally ✓ Mastoid emissary vessel (when present)
ETTER & CROSS STYLOID PROCESS OF TEMPORAL BONE
➢ PP: MSP 30° to IR PA AXIAL PROJECTION/ CAHOON METHOD
➢ CR: 25-30° caudally ➢ PP: prone; forehead
COMPERE and nose; OML ┴
➢ PP: MSP 30-45° to IR ➢ CR: 25° cephalad
➢ CR: 30° caudally ➢ SS: styloid process of
ZIZMOR temporal bone
➢ PP: MSP 15° to IR
➢ CR: 35° caudally JUGULAR FORAMINA
SUBMENTOVERTICAL AXIAL PROJECTION/ KEMP
HARPER M ETHOD/ ERASO
MODIFICATION
➢ PP: OML is // to IR
➢ CR: 25° caudad
➢ ER: EAM
HYPOGLOSSAL CANAL
AXIOLATERAL OBLIQUE PROJECTION/ MILLER
METHOD
ANTERIOR PROFILE
STENVERS METHOD/ POSTERIOR PROFILE POSITION ➢ PP: supine position; head 45° away from the side being
➢ PP: Prone; forehead, nose & zygoma against IR (3-pt examined; OML // to IR
Upper Landing); IOML // to transverse axis of IR; face ➢ CR: 12° caudad; 1inch inferior of EAM
rotated away from side of interest; MSP 45° to IR ➢ SS: hypoglossal canal
➢ RP: 1 in. anterior to EAM closest to IR (exit)
➢ CR: 12° cephalad
➢ SS: Pars petrosa closest to IR
✓ Petrous ridge
✓ Cellular structure of mastoid process