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X-ray of the nasal cavity and paranasal sinuses
Last reviewed: 05.07.2025
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X-ray examination (X-ray) of the nasal cavity and paranasal sinuses, larynx, auditory organ, as well as the eye and eye socket, gained full recognition in the clinic already in the first years after the discovery of X-ray radiation. This is even more obvious today, when such radiation methods as sonography, computer and magnetic resonance tomography, scintigraphy have "come into their own". Radiation diagnostics has become a necessary component of clinical examination of patients in otolaryngology and ophthalmology clinics.
Nasal cavity and paranasal sinuses
The nasal cavity occupies a central position in the facial skull. It is divided in half by a septum formed by the vertical plate of the ethmoid bone and the vomer. The posterior opening of the nasal cavity is divided by the vomer into two parts - the choanae. The anterior opening of the nasal cavity - the so-called piriform opening - is formed by the bones of the upper jaw and is closed at the top by the nasal bones. Paired paranasal, or accessory, sinuses are located around the nasal cavity. They communicate with the nasal cavity by means of passages, or canals, are lined with a mucous membrane and under normal conditions are filled with air, as a result of which they are clearly visible on radiographs as light and clearly defined formations.
X-ray anatomy of the nasal cavity and paranasal sinuses
Diseases of the nose and paranasal sinuses
Sinus injuries are associated with fractures of the bones that surround them. The fracture gap and displacement of fragments are determined by X-rays or tomograms. Hemorrhage into the damaged sinus is accompanied by its darkening. If air from the sinus penetrates through a crack in its bone wall into the surrounding tissues, then light gas bubbles can be seen on the X-rays against the background of these tissues. The most common fractures are those of the nasal bones, which are characterized by displacement of fragments backwards and downwards. The task of the radiologist is not so much to identify the fracture line, but to establish the degree of deformation of the bony part of the nose before and after reduction of the fragments.
Any replacement of air in the sinus with other tissue (exudate, blood, granulation, tumor) leads to a decrease or disappearance of its lumen and, consequently, to its darkening in the images.