Zygomatic bone x-ray is a method of radiographic visualization of this bone structure with obtaining images on paper or special film. It is assigned to study the structure of the zygomatic bone, determine its location, internal structure and density. It is used in the process of diagnosing fractures of the zygomatic and adjacent bones (part of the maxillary sinus and eye socket), is used to identify inflammatory, dysplastic processes and assess bone density relative to the age norm. In case of combined injuries of the skull bones, the examination is supplemented by other types of radiography to study the necessary structures.
Indications
The doctor may prescribe an zygomatic bone x-ray to the patient in case of a fracture or suspicion of it. It happens after a blow or injury. Sometimes such pathology may not have vivid symptoms. Also, an zygomatic bone x-ray in various layouts will be useful for detecting structural anomalies. Such a defect is usually congenital in nature. X-rays can also be performed to confirm or refute such bone pathologies as osteomyelitis.
What shows
The pictures show the outlines of the bone, you can estimate its size, symmetry (since it is a paired bone), structure. You can also consider the places where the zygomatic bone interfaces with other bones of the skull, for example, with the frontal, temporal. X-rays allow you to see a fracture of the zygomatic bone, as well as determine whether there is a displacement. If a patient has inflammatory bone diseases, such as osteomyelitis, an X-ray will show lesions if they are located on the zygomatic bone.
Zygomatic bone x-ray in case of fracture
In case of a fracture, thin, elongated darkening will be visualized on the zygomatic bone x-ray. These are fractures or cracks. Also, a fracture of the zygomatic bone is characterized by deformation and sinking in a certain area. A vivid sign of a fracture will be a visualized “step” in the lower ocular part and the area of the zygomatic arch. Symptoms of a fracture in this case may be pain when opening the mouth or making lateral movements of the lower jaw. Fractures of the cheekbones can also be accompanied by hemorrhages in the retina of the eye. The patient may feel a loss of eye sensitivity, which is associated with damage to the suborbital nerve.
It is important to assess the size of fractures, find out the exact number, understand whether the fracture is comminuted, whether the fragments touch the bones of the nose, jaw, eye sockets, soft tissues and sinus walls adjacent to the cheekbone.
Preparation
Zygomatic bone x-ray does not require special training, diets, preliminary laboratory tests, and so on. The patient should come to the procedure in a calm state, take off all jewelry, glasses, if there is a denture. To protect the body below the neck level, a special lead apron is put on the patient.
Method of conducting
Zygomatic bone x-ray with fractures or other pathologies can be performed in different layouts, which help to take pictures in the right projections. To obtain a transverse projection, the patient is placed on his stomach. He stretches his arms along his torso. The examined side of the head is in contact with the soundboard of the table with the upper ocular edge, the zygomatic bone and in some cases the tip of the nose. The zygomatic bone of interest is located in the center of the layout of the table deck. Before turning on the high voltage on the X-ray tube, the patient needs to hold his breath and not move. Radiographic examination of the zygomatic bones and zygomatic arches is recommended to be performed both on the right and on the left side (for further comparison).
To obtain an X-ray of the zygomatic arches in the oblique anterior projection, the patient is also placed on his stomach, arms are stretched along the trunk. The head is turned so that the examined side of it is removed from the cassette. The chin is brought to the front of the neck.
To obtain a picture of the zygomatic bone in a tangential projection, the patient is also placed on his stomach, and the head is turned to the side so that its median sagittal plane forms a 60° angle with the cassette, open posteriorly. The plane of the physiological horizontal in this case should be perpendicular to the cassette. The 13×18 cm cassette is installed in the longitudinal position. The radiation beam is directed relative to the studied zygomatic bone.
Contraindications
X-ray examination may be canceled or postponed if the patient is in a serious condition. Also, you can not do an X-ray of the cheekbones for pregnant women, children under 15 years old.
Interpretation
The decoding of the image is performed by a radiologist. It is also possible to involve other specialists, such as a surgeon. The size of the zygomatic bone, its location, connection with other bones of the skull is estimated. It is also important to evaluate the structure, the clarity of the boundaries.
Normal X-ray readings
The zygomatic bone has three planes: lateral, orbital and temporal. The orbital area of the bone should be smooth, it participates in the formation of some orbital sections. On its plane is the orbital-zygomatic opening. The orbital plane faces the inner side, which, interacting with the temporal bone, forms a temporal fossa. There is a temporal-zygomatic opening on it. The lateral part of the bone has a slightly convex shape.
