TY - JOUR
AU - Herpel, Frederick K.
AB - Roentgenologic Examination of the Nasal Accessory Sinuses in Infants and Children 1 Frederick K. Herpel , M.D., F.A.C.P. , Roentgenologist Good Samaritan Hospital, West Palm Beach, Florida ↵ 1 Read by title before the Radiological Society of North America, at the Seventeenth Annual Meeting, at St. Louis, Nov. 30–Dec. 4. 1931. Excerpt IN the newborn, one sees well formed maxillary sinuses and a varying number of ethmoid cells. Seldom are the frontal and sphenoid sinuses materially developed at birth, or in early infancy. During infancy and early childhood, one sees the early development of the frontal sinuses into the vertical and horizontal plates of the frontal bone, from the ethmoid cells. The sphenoids are also noted then, developing first in the anterior part of the body of the sphenoid bone. One expects to see well developed frontal sinuses at the age of four or five years, and a well developed sphenoid at a slightly later age. The presence of an infection in the ethmoid cells and the maxillary sinuses may materially retard the development of the frontal and sphenoid sinuses. A certain percentage of adults have no frontal sinus development into the vertical plate, while others have only one frontal sinus. There are many variations in size, shape, and position of the sinuses, calling for individual interpretation in most instances. In infants and children, there are technical difficulties in the roentgenologic examination of the sinuses which necessitate a modification in routine adult technic. Nowhere are patience and painstaking attention to detail more richly rewarded than in this type of roentgenography. The confidence of the child must be obtained if we are to obtain roentgenograms of maximum value. I need not stress the necessity, in many instances, of separating the child from its over-anxious parents before its confidence can be obtained and its fears allayed. With infants, one must be content with roentgenograms in the postero-anterior and lateral projections. Rapid technic is possible with modern equipment, and, in most instances, satisfactory diagnostic roentgenograms can be obtained. If the head is held firmly by a nurse or assistant, one can often obtain a good roentgenogram even if the patient is crying. The x-ray switch must be controlled, and the exposure made by someone who can observe every motion of the infant, and who is thereby able to determine the proper time for making the exposure. It is very difficult to obtain satisfactory roentgenograms if the exposure is controlled from some distance behind a screen. I know that this is contrary to the usual principles of safety to the operator, but, if one wishes to obtain roentgenograms of good qualitv, the exposure must be controlled from a point close to the patient. With children who are able to co-operate, and generally this includes children of three years or more, the adult technic can usually be followed in detail. Films are made without the use of the Bucky diaphragm. No special apparatus is used other than that found in any well equipped laboratory. A small cone, 11 inches in length, is used, with a 2.75-inch aperture. Cone pressure against the head is used for immobilization. This gives an average target-head distance of 16 inches. Copyrighted by The Radiological Society of North America, Inc.
TI - Roentgenologic Examination of the Nasal Accessory Sinuses in Infants and Children
JO - Radiology
DO - 10.1148/20.3.181
DA - 1933-03-01
UR - https://www.deepdyve.com/lp/radiological-society-of-north-america-inc/roentgenologic-examination-of-the-nasal-accessory-sinuses-in-infants-YHC5IA68oC
SP - 181
VL - 20
IS - 3
DP - DeepDyve
ER -