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Roentgenographic Examination of the Sphenoid Sinuses

1926; Radiological Society of North America; Volume: 6; Issue: 1 Linguagem: Inglês

10.1148/6.1.23

1527-1315

Amédée Granger,

Medical and Biological Sciences

THE reasons for writing this paper are: 1. To present in concrete form the result of our experimental and clinical study of the sphenoid sinuses with the roentgen rays during the past three years. 2. To demonstrate the necessity for a rigid adherence to our technic. 3. To answer constructive criticisms. 4. And lastly, to prove the superior diagnostic value of our method. As the logical development of the nasofrontal and naso-mental positions and while attempting to obtain greater uniformity and better duplication when making roentgenographs of the sphenoid, we devised the head rest or sinus mask, without which the alveola-glabella position of the head would be impossible. In a former communication (1) we showed the uniformity obtainable with the use of the alveola-glabella position when making roentgenographs of different heads, and the duplication possible with the same head. We recommended a 107° angle inclination of the head and the use of a vertical ray for the best unobstructed view of the sphenoid sinus, and showed constant and clearly visible landmarks for the upper boundaries of the sphenoid and ethmoids (2). In a later communication (3), we proved what anatomical structures produced these landmarks and emphasized the diagnostic importance of the curved sphenoid line, or Granger line, and of the sphenoid region included between that line and one lower down which forms the upper border of the ethmoids. (See key plate, Fig. 1.) This region represents the upper anterior portion of the sphenoid sinuses projected through the frontal sinuses. This view is best obtained (as shown in Fig. 2) by placing the cassette covered with the sinus board or mask on a 17° angle block arranged so as to give to the sagittal plane of the head a 107° inclination. The nose must be inserted in the aperture in the sinus mask, and the upper jaw (alveola) and a line uniting the eyebrows (glabella) must rest firmly on it. The central ray is directed vertically through the head on a line just below the external auditory meatus. We cannot insist too strongly upon the fact that the head must rest and bear firmly and evenly on the alveola and the glabella, and that the angle block must have an angle of exactly 17°. If this is done, the roentgenographs will resemble the key plate, Figure 1, and B of Figure 3. It will be noted that in both these roentgenographs the shadow of the petrous bone is situated in about the center of the orbit and does not extend beyond the upper or lower borders of the latter.