Page:Journal of ophthalmology, otology and laryngology (IA journalofophthal2319amer).pdf/19



S to the title of the article, the question “What can we Learn from Radiography of the Nasal Accessory Sinuses" might better be written “What do we Learn and What Could We Learn?" There is no item dealing with our specially where there is more pretense at understanding than there is in this X-Ray work. We have a case we wish “pictured.” hoping thereby to have a little more light shown upon the condition-——and what do we get—a plate of the skull is shown us and the suspected sinus or sinuses pointed out to us amidst a maze of lines. Shadows are seen and (after we have given the information as to the sinus suspected) we are told that “there is the sinus and it exhibits a shadow, just as you suspected.” I have seen many plates so under- or over-exposed, or plates in which the skull was placed in such a bizarre position—that only an omniscient power could decipher them.

The subject is important enough to demand a more than passive familiarity from us, for we can scarcely expect the average X-Ray man to be sufficiently familiar with the position of the sinuses to give us good pictures. A word first about the positions of the head for taking plates of these cells. Lateral pictures are the least likely to confuse, but give us little of the information we usually desire—for, in this position the sinuses in pairs are thrown superimposed. There is no possibility of (contrasting) sinuses of opposite sides. However. the depth of the frontals can be seen, and conditions about the sella turcica, especially in its relation to the sphenoid, can be noted. “The position should be directly lateral with the median ray from the tube passing through the External Auditory Meatus. Comparing the horizontal Rami of the jaws gives an idea as to the exactness of the lateral position. ‘They should superimpose.