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Facial X-Ray

Test Overview

A facial X-ray is a series of pictures of the bones in the face. One type of facial X-ray (called a paranasal sinus X-ray series) looks at the air-filled cavities (sinuses) around the nose and eyes.

X-rays are a form of radiation, like light or radio waves, that are focused into a beam, much like a flashlight beam. X-rays can pass through most objects, including the human body. X-rays make a picture by striking a detector that either exposes a film or sends the picture to a computer. Dense tissues in the body, such as bones, block (absorb) many of the X-rays and look white on an X-ray picture. Less dense tissues, such as muscles and organs, block fewer of the X-rays (more of the X-rays pass through) and look like shades of gray on an X-ray. X-rays that pass only through air, such as through the lungs, look black on the picture.

A facial X-ray helps find bone fractures, tumors, foreign objects, infections, and abnormal growths or changes in bone structure or size. An X-ray of the eye (orbital cavity) may be taken if the eye has been injured. A computed tomography (CT) scan may be needed to check any problems seen on X-ray.

Why It Is Done

A facial or sinus X-ray may be done to:

  • Find problems of the sinuses of the face and nose, such as sinusitis or abnormal growths (polyps or tumors).
  • Find fractures of the facial bones and nose.
  • Check the bones around the eye (orbital cavity).
  • Check the sinuses before surgery.
  • Check for metal objects around the eyes before a magnetic resonance imaging (MRI) test.
  • Look for the cause of pain in the face.

How To Prepare

Before the X-ray test, tell your doctor if you are or might be pregnant. Pregnancy and the risk of radiation exposure to your unborn baby (fetus) must be considered. The risk of damage from the X-rays is usually very low compared with the potential benefits of the test. If a facial X-ray is absolutely necessary, a lead apron will be placed over your abdomen to shield your baby from exposure to the X-rays.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information formmedical test information form(What is a PDF document?).

You don't need to do anything else before you have this test.

How It Is Done

A facial X-ray is taken by a radiology technologist. The X-ray pictures are usually read by a doctor who specializes in interpreting X-rays (radiologist), but other doctors may also review the films.

You will need to remove any jewelry that may be in the way of the X-ray picture. You will also need to remove glasses or dentures.

You may be asked to lie on an X-ray table or sit in a chair. Several views (a series) of X-ray pictures are needed for clear pictures of the face. Your head may need to be repositioned for each view. You should hold your head completely still while the pictures are being taken. A padded brace, foam pads, a headband, or sandbags may be used to hold your head in place while the pictures are taken.

If pictures of the orbital cavities or sinuses are needed, you will usually sit up while they are taken. A padded brace may be used to hold your head still while the pictures are taken.

Facial X-rays usually take about 10 to 20 minutes. You will wait about 5 minutes until the X-rays are processed in case repeat pictures need to be taken. In some clinics and hospitals, X-ray pictures can be shown immediately on a computer screen (digitally).

How It Feels

You will feel no discomfort from the X-rays. The X-ray table may feel hard and the room may be cool. You may find that the positions you need to hold are uncomfortable or painful, especially if you have an injury.

Risks

There is always a slight risk of damage to cells or tissue from being exposed to any radiation, including the low levels of radiation used for this test. But the risk of damage from the X-rays is usually very low compared with the potential benefits of the test.

For example, the radiation exposure from a chest X-ray is about equal to the natural radiation exposure received during a round-trip airline flight from Boston to Los Angeles (Montreal to Vancouver) or 10 days in the Rocky Mountains (Denver, Colorado).

Results

A facial X-ray is a series of pictures of the bones in your face. A facial X-ray helps find bone fractures, tumors, foreign objects, infections, and abnormal growths or changes in bone structure or size. In an emergency, the doctor can see the initial results of a facial X-ray in a few minutes. Otherwise, a radiologist usually has the official X-ray report ready the next day.

Facial X-ray
Normal:

The bones of the face and orbital cavity are normal in size and shape.

No foreign objects or abnormal growths are present.

No broken bones are present.

The sinuses are clear. No inflammation or infection is present.

Abnormal:

Foreign objects, such as fragments of metal or glass, may be present.

Broken bones, such as the nasal bones or bones around the eye (orbital cavity), may be present.

Signs of a disease that affects the bones of the face or orbital cavity may be present.

Abnormal growths (tumors) are present.

Signs of sinusitis, such as fluid in the sinuses or a thick tissues lining the sinuses, may be present.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • If you can't remain still during the test. The pictures may not be clear.
  • If you have a possible neck injury. In this case, it may not be possible to do a complete series of facial X-rays.
  • If you have a false eye (prosthetic eye) or other artificial or metal objects around the face. These can make a shadow on the X-ray picture that hides part of the bones.

What To Think About

  • A computed tomography (CT) scan may be needed to check any problems found on a facial X-ray. CT scans are better than X-rays for some problems, such as severe facial trauma or sinusitis. CT scans are more expensive than facial X-rays and may not be available in some areas. Facial and sinus X-rays may be done if a CT scan is not available. To learn more, see the topic Computed Tomography (CT) Scan of the Head and Face.
  • Your X-ray results may be different from earlier test results because you were tested at a different medical center or you had a different kind of test.

References

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer Howard Schaff, MD - Diagnostic Radiology
Current as of June 4, 2014

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