Facial Bone : Lateral Projection

Sunday, February 23, 2014

Radiography of a lateral view of facial bone demonstrates the following:
  • Fracture and neoplastic/inflammatory processes of the facial bones, orbits, and mandible are shown.
  • The facial bone routine commonly includes a single lateral, whereas the skull routine may include bilateral positions.

Technical Factors:
  • IR size - 18 x 24 cm (8 x 10 inches), lengthwise
  • Moving or stationary grid
  • 65 to 80 kV range
  • Small focal spot
  • mAs 8

Patient Position:
  • Remove all metallic or plastic objects from head and neck. Patient is erect or semiprone.

Part Position:
  • Rest lateral aspect of head against table or upright Bucky surface, with side of interest closest to IR.
  • Adjust head into a true lateral position and oblique body as needed for patient's comfort. (palpate the external occipital protuberance posteriorly and the nasion or glabella anteriorly to ensure that these two points are equidistant from the tabletop)
  • Place support sponge under chin if needed.
  • Align midsagittal plane (MSP) parallel to IR.
  • Align interpupillary line (IPL) perpendicular to IR.
  • Adjust chin to bring the IOML perpendicular to front edge of IR.

Central Ray:
  • Align CR perpendicular to IR.
  • Center CR to zygoma (prominence of the cheek), midway between outer canthus and EAM.
  • Center IR to CR.
  • Minimum SID is 40 inches (100 cm).

Collimation:
  • Collimate on all side to within 1 inch (2.5 cm) of facial bones.

Respiration:
  • Suspend respiration.

Note: Use radiolucent support under head if needed to bring IPL perpendicular to tabletop on large-chested patients.

Radiographic Criteria:

Structure Shown:
  • Superimposed facial bones, greater wings of the sphenoid, orbital roofs, sella turcica, zygoma, and mandible.

Position:
  • An accurate positioned lateral image of the facial bones demonstrates no rotation of vertical structures such as mandibular rami and no tilt of horizontal structures such as orbital roofs, which normally are superimposed in this position.

Collimation and CR:
  • Superimposed zygomatic bones should be in the center of the image, with EAMs and orbital roofs included within the collimated field.

Exposure Criteria:
  • Contrast and density are sufficient to visualized the maxillary region.
  • Sharp bony margins indicate no motion.

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