Schuller's view

Radiographic view used in otolaryngology

Schuller's view is a specialized radiographic projection used primarily in the field of otolaryngology to evaluate the temporal bone and the mastoid air cells. This view is particularly useful in assessing conditions such as mastoiditis, cholesteatoma, and other pathologies affecting the middle ear and surrounding structures.

Technique

The Schuller's view is an oblique lateral projection of the skull. The patient is positioned with the head turned so that the side of interest is closest to the X-ray film or detector. The central ray is directed perpendicular to the film, typically at an angle of 25 degrees caudally, to best visualize the mastoid region.

Diagram illustrating Schuller's view

The patient is usually seated or standing, with the head tilted slightly forward and the chin tucked. This positioning allows for optimal visualization of the mastoid air cells and the bony structures of the temporal bone. The opposite side of the head is elevated to prevent superimposition of the structures.

Clinical Applications

Schuller's view is primarily used to assess the mastoid process and the middle ear structures. It is particularly useful in diagnosing:

• Mastoiditis: Inflammation of the mastoid air cells, often secondary to otitis media. Schuller's view can reveal clouding or opacification of the mastoid air cells, indicating infection or fluid accumulation.
• Cholesteatoma: An abnormal skin growth in the middle ear behind the eardrum. This view helps in identifying erosion of the bony structures and the extent of the lesion.
• Temporal bone fractures: Schuller's view can help in identifying fractures of the temporal bone, which may affect hearing and balance.

Advantages and Limitations

The primary advantage of Schuller's view is its ability to provide detailed images of the mastoid air cells and the temporal bone structures. It is a relatively simple and quick procedure that can be performed in most radiology departments.

However, Schuller's view has limitations. It provides a two-dimensional image, which may not fully capture the complexity of the three-dimensional structures. Computed tomography (CT) scans are often preferred for more detailed evaluation, especially in complex cases or when surgical intervention is considered.

Related pages

• Mastoiditis
• Cholesteatoma
• Temporal bone
• Otitis media
• Radiography