17.1. METHODS OF DIAGNOSTIC RADIOLOGY
Imaging study is, in most cases necessary in the diagnosis of diseases and injuries of the ENT organs, as well as in assessing the results of treatment.
17.1.1. Radiological method
In otorhinolaryngology, the following methods are most often used in clinical practice.
► X-ray of the nose and sinuses (Fig. 17.1):
• in the mental positioning;
• in a straight anterior positioning of the head (petrous parts of the temporal bone in the view of the orbits);
• in the lateral view of the head;
• orthopantomography at the level of the maxillary sinuses.
► Spot X-ray of the temporal bone, which is the visualization of the pyramid and its structures in the main and additional views. The optimal views for visualization of the pyramids are the posterior survey, posterior occipital, as well as the special views, which are performed by a narrow tube. The images in these views require patient positioning of a particular accuracy:
• oblique X-ray image of the pyramid according to Schuller;
• transverse image of the pyramid according to Stenvers;
• a longitudinal image of the pyramid, according to Mayer (see Fig. 14.2).
► Linear tomography of the facial skeleton (Fig. 17.2) and of the larynx.
► Contrast maxillary sinus radiography (X-ray or CT), which is performed according to the indications.
Normal X-ray examination of ENT organs. On X-ray images of the paranasal sinuses, the nasal cavity has the form of a triangular lucent area, divided by a bone septum into two symmetrical halves. On the background of each half, the shadows of the nasal conchae are noticeable, and between them, there are narrow light gaps corresponding to the nasal passages. On the sides of the nasal cavity maxillary sinuses in the form of lucent area of a triangular shape with clear boundaries are visualized. The ethmoid bone is visualized between the orbits and the nasal cavity in the form of cells delimited by thin partitions. On the X-ray in the mental positioning, the ethmoid bone is projected at an angle to the image receiver. As a result, on the image, the anterior cells of the ethmoid bone are defined above, and the posterior cells are defined below. In the