Mastoid Bone X-Ray: Imaging the Mastoid Process for Diagnosis and Evaluation

Introduction

A radiographic imaging examination called a mastoid bone X-ray is used to see the bones of the mastoid process, a bony protrusion situated behind the ear. The mastoid process, a portion of the temporal bone, has air cells known as sinuses, called mastoid spaces. The middle ear is related to these air cells, which can develop an infection and lead to mastoiditis. Numerous vital organs, including the brain, meninges, blood arteries, and several vital nerves, are located close to the mastoid bone. Therefore, a sickness that affects the mastoid ear has a high chance of spreading to other organs. In addition, the mastoid bone plays a crucial role in hearing.

What Is an X-Ray of Mastoid Bone?

Schuller X-ray is another name for the mastoid X-ray. The temporomandibular position is used to take the X-ray in this method. The center X-ray beam is 25 degrees caudad to the radiography plate and travels from one side of the head. Images of two mastoid bones cannot overlap because of this angulation. Each mastoid's radiograph is obtained independently. When imaging technicians image patients, they frequently adopt this posture, which is the most prevalent.

Mastoiditis pictures on the mastoid X-ray film (Schiller's position) can show lesions that have lost their wall and turned into widespread inflammation, as well as hollows in the mastoid bone that are thick and opaque owing to the death of cell groups in the mastoid bone. Additionally, in some cases of head traumas involving the mastoid, a mastoid X-ray may be necessary.

How Is an X-Ray of Mastoid Bone Performed?

1. Preparation: The patient will be asked to remove any jewelry or other metal objects that can obstruct the X-ray and, if required, to put on a gown. Additionally, the patient will be positioned so that the X-ray machine faces the side of the head that has to be checked.

2. Positioning: The patient is positioned with the right hand on torso and the left hand in front while lying on the imaging table. Adjust the patient's position gradually such that they are lying on their side with their head parallel to the film, their top border of the film is parallel to the Virchow plane, and their lateral atrium is in the middle of the film. Set the lamp head to be 25 to 300 degrees from the foot, choose a location 1.97 inches above and 1.97 inches beyond the outer ear canal distal to the film, and direct the beam through the imaging atrium. Press the X-ray generator button while keeping an eye on the patient through the control room's lead glass. View the convenient technical picture.

3. Radiation Exposure: The X-ray equipment emits a tiny quantity of radiation. This radiation passes through the mastoid bone and creates a picture on a particular film or digital detector. The exposure period is normally short only a few seconds at most.

4. Interpretation: Depending on the requirements of the exam, the X-ray technician may capture one or several pictures of the mastoid bone. A radiologist will examine the X-ray pictures and search for any indications of fluid, infection, or other abnormalities in the mastoid bone. The referring doctor will then get the radiologist's findings report.

The full mastoid bone X-ray process is normally finished in less than 30 minutes, and patients frequently find it safe and well-tolerated. Most of the time, no extra preparation is needed, and patients can resume their regular activities immediately after the examination.

Why Is an X-Ray of the Mastoid Bone Done?

1. To recognize a mastoid air passage infection (mastoiditis).

2. To identify any potential issues, including cholesteatoma and middle ear infections (abnormal skin growth in the middle ear behind the eardrum).

3. To identify any suspected malignancy near the mastoid bone.

4. To check the mastoid bones for any suspected fracture or damage.

A mastoid bone X-ray may answer the following questions-

1. Do mastoids have cells, or are they acellular? If yes, how are they disseminated, and do they reach the typical anatomical limitations if they are cells? Is the mastoid process diploetic or sclerotic if it is acellular?

2. How dense or thin is the cortical bone?

3. Are the two mastoid processes equal in size? A condition that interferes with the normal anatomical expansion of the antrum's mucosa early in development typically causes asymmetry.

4. Are there any indications of bone loss?

5. Is the mastoid cavity still there?

6. Is it possible to see the sinus and dural plates in their natural positions?

7. Cholesteatoma formation—is there any?

What Are the Radiological Findings of Different Pathological Conditions of Mastoids?

The mastoid processes are typically bilaterally cellular in 80 percent of the population and bilaterally acellular in the remaining 20 percent. The following discoveries are the most significant ones related to common mastoid diseases:

1. Acute Suppurative Mastoiditis: Clouding or generalized haziness is visible in the mastoid air cell system. Loss of the typical trabecular pattern signifies that the intercellular septa have been destroyed. The prominence of the lateral sinus plate is also related to acute mastoid inflammation.

2. Chronic mastoiditis: A conspicuous preantral triangle and widespread sclerotic alterations to the mastoid air cell system are symptoms of chronic mastoiditis.

3. Cholesteatoma: As they are radiolucent, cholesteatomas can only be identified radiologically when the disease process results in bone erosion. A transparent region within a sclerotic mastoid can be seen as a result of erosion of the antrum of the mastoid process. Normally, the edge of a cholesteatoma cavity is smooth. This has to be distinguished from a granulation cavity, which typically looks like a hairline.

4. Fistulas: In chronic suppurative otitis media, the external auditory canal's apex is often where the infection enters the internal ear. Radiological films of the mastoid process can be used to see this.

5. Zygomatic Mastoiditis: This condition develops when an infectious process in the mastoid process spreads to the zygomatic bone. Radiologically, this can be seen as an extension of pneumatization into the zygomatic bone.

6. Apical Petrositis: It is characterized by identifiable bone cell development.

7. Operating Mastoid Cavity: It is typically shown as a cavity with an uneven edge and no sclerosis.

Conclusion

In summary, Any bone alterations or anomalies in the mastoid process can be seen using the X-ray, as well as the presence of fluid or infection in the mastoid air cells. A radiologist evaluates the X-ray results and gives the ordering physician a report after evaluating the photos. The underlying issue is diagnosed using this report, and a suitable treatment strategy is created. X-rays are a crucial tool in diagnosing and treating many medical diseases and are generally considered safe. While radiation exposure during pregnancy may be hazardous to the growing fetus, women who are pregnant or believe they may be pregnant should contact their doctor before receiving an X-ray.