Skull X-Ray Positioning Techniques
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Joeriz BartolomeSkull X-Ray Positioning Techniques
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Powered by AIThe TAYLOR METHOD (used for the mastoid processes, IAM, EAM, and inferior petrosal sinuses) involves an SMV projection with the patient sitting and the OM line vertical, and centering to the midline 2.5cm anterior to the level of the EAM at an upward angle of 20 degrees . By contrast, the JUG HANDLE VIEW, also an SMV projection, primarily demonstrates the zygomatic arches, with patients positioned similarly but often requiring adjustment to target those specific facial structures .
The MAY View achieves visualization of the zygomatic arch by positioning the head in PA with the chin raised and rotated 15 degrees away from the side being examined. The central ray is angled toward the feet to be at right angles to the radiographic baseline . The TITTERINGTON method uses the routine OM 30 view for the zygoma, typically involving cephalometric alignment that may vary but generally maintains an open mouth position to aid better visualization . While both techniques aim to visualize the zygomatic arch, the MAY View provides a more angled approach assisting in differentiating the arch's dimensions compared to the frontal approach of TITTERINGTON.
The HAAS method demonstrates multiple structures including the petrous temporal region, foramen magnum, and dorsum sellae by positioning the head in a PA position and angling the central ray 25 degrees cranially . It provides a comprehensive visualization of the posterior cranial structures. In contrast, the MAY View specifically focuses on demonstrating the zygomatic arch by positioning the head PA and rotating it 15 degrees away from the side examined, offering targeted visualization with the tube angled towards the feet . The HAAS method is more suitable for detailed studies involving the cranial base, whereas the MAY View is ideal for targeting specific facial features.
The ERASO METHOD involves positioning the patient as for an AP skull, then raising the chin. The central ray is angled upwards to make a 65-degree angle to the outer canthus of the ocular margin (OM) line, and the center is to the midline at the level of the EAM .
The ALBERS-SCHONBERG method is used to demonstrate the temporomandibular joints (TMJs). Key positioning details include placing the head in the lateral position and then rotating it 20 degrees towards the film. The central ray is directed to the TMJ that is in contact with the film, and the tube is angled 20 degrees upwards .
The SCHULLER method for imaging the petrous temporal region involves a lateral view with positioning to accurately reflect the anatomical area of interest. The STENVER View, as an oblique view of the petrous temporal region, requires specific oblique positioning of the head, typically involving head lateralization and tilting for optimal differentiation of the skull’s temporal anatomy . The SCHULLER method provides a straightforward lateral image, while the STENVER adds complexity through angled perspectives, offering a more comprehensive view but requiring careful positioning to avoid distortion.
The LAW technique is used specifically to demonstrate the petrous temporal region, involving positioning the head in the lateral position and rotating it 15 degrees towards the film, centering 5cm above and 5cm behind the EAM with the tube angled 15 degrees towards the feet . On the other hand, the LAW METHOD (FACIAL BONES) is used to demonstrate the floor and posterior wall of the antrum, with the patient sitting PA, fully extending the head so that the chin, zygoma, and nose of interest are in contact with the cassette, and the central ray angled upwards 30 degrees from the horizontal centered to the lower antrum .
The Modified FUCHS Method is theoretically used for projecting the temporal styloid process, suggesting a focus on detailed skull base anatomy. Although specific technique details are not available, modern imaging could apply principles such as precise angulation and meticulous patient head positioning to optimize visualization of the temporal styloid area. Its benefits lie in potentially improving diagnostic clarity when assessing disorders involving the styloid process, such as elongation or fractures, by engendering a targeted imaging approach despite lack of procedural specifics .
The ALEXANDER METHOD provides a view of the optic canal in cross-section, with the patient sat with the back of the head against the skull table. The upper border of the skull table is angled backward 15 degrees, and the head is positioned so that the midsagittal plane makes a 40-degree angle to the plane of the bucky. The head is extended so that the acanthomeatal line is perpendicular to the bucky plane, and the central ray is directed to the lower outer margin of the orbit away from the film .
The CHAUSSE II method for an oblique transoral view of the foramen jugulare involves positioning the patient as for an AP skull, with the mouth wide open. The head is rotated 10 degrees away from the side in question, and the central ray is directed up through the open mouth, creating a 35-degree angle with a line joining the superior border of the EAM and the anterior nasal spine . This view can be particularly useful for assessing the foramen jugulare’s patency or for detecting masses or lesions that may affect the structures passing through this crucial skull base aperture, such as jugular vein abnormalities or tumors.