. Roentgen interpretation; a manual for students and practitioners . ich usually obliterates the sinus completely. Their shadows areidentical in every respect, so that it is usually impossible to tell POLYPI 89 ^Yhich one we are dealing with from the roentgen plate alone. Whenthere is a fluid exudate in a sinus it is often possible to make out afluid level in the suspected cavity upon a plate taken with the patientupright. However, the absence of a fluid level does not rule out of the sinuses will ordinarily give some evidence of theirnature by erosion or invasion of the walls or ad
. Roentgen interpretation; a manual for students and practitioners . ich usually obliterates the sinus completely. Their shadows areidentical in every respect, so that it is usually impossible to tell POLYPI 89 ^Yhich one we are dealing with from the roentgen plate alone. Whenthere is a fluid exudate in a sinus it is often possible to make out afluid level in the suspected cavity upon a plate taken with the patientupright. However, the absence of a fluid level does not rule out of the sinuses will ordinarily give some evidence of theirnature by erosion or invasion of the walls or adjacent bones, ^eryrarely a sinus or portion of the orbit will be occupied by a denseosteoma. Absence of frontal sinuses is fairly common and must bedifferentiated from thickening which has obscu-ed the margins andobliterated the outline of a well-developed sinus. A lateral viewwill show no evidence of a sinus and no room for it at the base ofthe frontal. Careful inspection of the anteroposterior view shouldshow the presence of bone structure in the suspected Fig. 64.—Sclerosed and normal It must not be forgotten that a sinus may be found filled withmucoid material at operation and yet cast no abnormal shadow onthe plate. In fact, mucoceles by erosion of the bone overlying themoften appear as areas of diminished density. Polypi.—Polypi can sometimes be visualized in the frontals andantra as romided areas of slightly increased density. The entiresinus will usually appear somewhat hazy as a result of the thickenedmembrane. Burnham has called attention to the occurrence of a densefusiform shadow OAerlapping the septum in a case of gumma ofthe septum. 90 SKULL The patency and course of nasal ducts may be determined fromroentgenograms made with opaque probes in situ. Mastoids.—Plates of both sides should always be taken as aroutine for purposes of comparison. Normally the cells are brightand clear with sharply outlined walls. The broad grooves of thelateral sin
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