Frontal Sinus

INTRODUCTION:
  • The frontal sinuses are located between the inner and outer tables of the skull, posterior to the glabella; they rarely become aerated before age 6.
  • It is the Most superior sinus in the face is Frontal sinus.
  • The frontal sinuses usually are separated by a septum, which deviates from one side to the other or may be absent entirely, resulting in a single cavity.
  • Frontal sinus drain into the hiatus semilunaris in the middle meatus Middle meatus.


X-RAY VIEWS INDICATED FOR FRONTAL SINUS:
LATERAL VIEW:
  • Lateral side of the skull lies against the film and x-ray beam is projected perpendicular from the other side. 
  1. Center CR to a point midway between outer canthus and EAM.:
  2. To visualize air-fluid levels, an erect position with a horizontal beam is required.
  3. Fluid within the paranasal sinus cavities is thick and gelatin-like, causing it to cling to the cavity walls. 
  • To visualize this fluid, allow a short time (at least 5 minutes) for the fluid to settle after a patient's position has been changed (i.e., from recumbent to erect).


CALDWELL VIEW:
  1. Also Known as OCCIPITOFRONTAL VIEW OR NOSE FOREHEAD POSITION
  2. Caldwell view is the best method to see frontal sinus in patients with recurrent frontal sinusitis
  3. Part Position 
  • Place patient's nose and forehead against upright table with neck extended to elevate the OML 15° from horizontal. 
  • A radiolucent support between forehead and upright Bucky or table may be used to maintain this position. 
  • CR remains horizontal. (alternate method if Bucky can be tilted 15°.)
  • Center X-RAY to CR and to nasion, ensuring no rotation.
  • Align CR horizontal, parallel to floor.


WATER’S VIEW
  1. IT IS TAKEN IN SUCH A WAY THAT NOSE AND CHIN OF THE PATIENT TOUCH THE FILM WHILE X-RAY BEAM IS PROJECTED FROM BEHIND.
  2. Part Position
  • Extend neck, placing chin and nose against table/film.
  • Adjust head until MML is perpendicular to film; OML will form a 37° angle with the plane of the film.
  • Ensure that no rotation or tilt exists.
  • Center film to CR and to acanthion.


Exam Question
  • Caldwell view is the best method to see frontal sinus in patients with recurrent frontal sinusitis
  • Frontal sinus drain into Middle meatus
  • Most superior sinus in the face is Frontal sinus

Don't Forget to Solve all the previous Year Question asked on Frontal Sinus