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Axiolateral oblique (Modified Law) Axiolateral oblique (Stenvers) AP Axial (Town) Axiolateral (Schuller) Axiolateral oblique (Arcelin - reverse Stenvers) Axiolateral Oblique (Mayer method and Owen modification)

Special :

1. Axiolateral oblique projection (Modified Law Method)

Kelainan yang ditampakkan : proyeksi ini menampakkan beberapa kelainan pada processus mastoideus.o

kedua sisi diperiksa sebagai perbandingan.

Posisi pasien : Erect atau prone . Tekuk daun telinga pada mastoid yang diperiksa untuk mengurangi superimposisi dengan mastoid. Posisi obyek :o

letakkan sisi lateral kepala menempel meja/permukaan bucky dengan bagian yang akan dperiksa berada dekat dengan IR. Tubuh dioblique kan untuk membuat pasien bisa senyaman mungkin. atur MSP pararel dengan bidang permukaan meja/bucky. Dari posisi lateral, obliqkan wajah 15 derajat terhadap IR. Hindari tilting dengan mengatur Interpupilary line tegak lurus permukaan meja/bucky. atur dagu agar IOML tegak lurus pada tepi depan IR

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CR : 15 derajat ke caudad CP : 1 inchi posterior dan 1 inchi superior MAE yang jauh dari IR. FFD : 100 cm Struktur yang ditampakkan : tampak gambaran mastoid air cell dan struktur tulang yang dekat dengan IR Kelainan yang ditampakkan :o

2. Axiolateral Oblique (Stenver's Method)

Proyeksi ini menampakkan beberapa kelainan pada tulang temporal (spt acoustic neuroma), yang menyebabkan IACs (Internal acoustic canals) tampak asimetris. Dibuat foto perbandingan kanan dan kiri.

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Posisi Pasien : Prone atau erect Posisi Obyek :o o o

Atur dagu sehingga IOML tegak lurus terhadap IR Rotasikan kepala 45 derajat dan bagian yag diperiksa berada dekat dengan IR. Atur mastoid bagian bawah berada pada pertengahan IR.

Central Ray (CR) : 12 derajat ke cephalad CP : 3 hingga 4 inchi (7 hingga 10 cm) posterior, dan inchi (1,25 cm) inferior permukaan

MAE, menuju ke mastoid process yang dekat dengan IR.

FFD : 100 cm (40 inchi) Struktur yang ditampakkan :o

Petrous pyramid, labirynth tulang, cavity tympany, internal auditory canal, dan mastoid air cells ( dengan mastoid tips) tidak superposisi dengan tulang temporal. Posisi yang benar akan menampakkan condylus mandibular mengalami superimposisi dengan tulang cervical, internal acousticus canal, cochlea, dan semicircularncanals (bony labyrithm) tampak dibawah petrous ridge, processus mastoideus tampak berada di bawah cranial margin, posterior margin dari ramus mandibula superimposisi dengan bagian posterior tulang cervical.

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3. Axiolateral oblique-Anterior profile /Arcelin method (reverse stevers method)

Kelainan yang ditampakkan :patologi yang ditampakkan pada daerah temporal seperti acoustic neuroma. Proyeksi ini diperuntukkan bagi pasien yang tidak dapat diposisikan prone seperti pada proyeksi PA oblique (Stenvers). Selalu dilakukan foto perbandingan. Posisi Pasien : erect atau supine Posisi Obyek :o

Rotasikan kepala 45 derajat dengan bagian yang diperiksa jauh dari kaset (sisi yang dielevasi adalah sisi yang akan ditampakkan). Atur dagu, sehingga IOML tegak lurus permukaan meja/bucky. Atur daerah mastoid agar berada pada pertengahan IR

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CR : 10 derajat ke caudad CP : 1 inchi (2,5 cm) anterior dan inchi (2cm) superior dari permukaan MAE yang dielevasi. FFD : 100 cm (40 inchi) Struktur yang ditampakkan :o

Sisi petrous ridge yang dielevasi tampak karena posisi ini pararel terhadap IR. TMJ yang dielevasi akan tampak di sisi anterior mastoid air cell yang ditampakkan.

4. Axiolateral oblique (Mayers method dan Owen modification)

Patologi yang ditampakkan : Kelainan daerah mastoid (OMSK). Posisi Pasien : erect atau supine Posisi Obyek :

Atur dagu, sehingga IOML tegak lurus terhadap IR Rotasikan kepala 45 derajat dengan daerah yang duperiksa dekat dengan IR. Atur mastoid yang dekat dengan film berada pada pertengahan permukaan meja/bucky. CR : 45 derajat ke caudad CP : 3 inchi (7,5 cm) diatas superciliary arch, menuju setinggi 1 inci (2,5cm) anterior tepi bawah MAE. FFD : 40 inchi (100cm)o

Alternatif Owen modification :

pada proyeksi ini rotasi kepala berkisar antara 30-40 derajat dari sisi lateral dan CR berkisar 30-40 derajat ke caudad.

Struktur yang ditampakkan :o

Tampak bagian tepi bawah petrous ridge, yang mencakup tepi bawah mastoid air cell dan struktur tulang labyrinth.