Sinus Waters (Parietoacanthial)
Position the Patient
- Upright only (horizontal beam required)
- Chin against IR
- Chin firmly on IR (MML perpendicular)
- Nose slightly away from IR
- Head straight, no rotation or tilt
- (MSP perpendicular)
- Center acanthion to IR
Words That Work
“Stand facing the board and rest your chin gently against it. Lift your chin until your nose is slightly away from the board—like looking just above the horizon. Keep your head straight without turning or tilting. This position moves the dense bones at the base of your skull below your sinuses so we can see them more clearly. Stay upright so any fluid can settle and show on the image. Close your mouth and hold still.”
Waters (parietoacanthial) positioning
Set Up the Shot
- Center here
- Central ray
- Exit at acanthion
- Include this in the field
- Collimation
- Sinus region
- Set the distance
- SID
- 40"
- Check the technique
- Technique
- 70-80 kVp
- Follow facility protocols
Common Pitfalls
- •Not upright (horizontal beam required)
- •Chin not firmly on IR
- •Petrous ridges not below maxillary sinuses
Evaluate the Image
What should be visible?
- Maxillary sinuses
- Frontal sinuses
- Ethmoid sinuses
- Open maxillary ostia
Does the image pass?
- ✓Horizontal beam maintained
- ✓No rotation or tilt
- ✓Petrous ridges below maxillary sinuses
- ✓Clear visualization of maxillary sinus floors