Overview

The Waters projection images the maxillary sinuses and anterior ethmoid air cells with the chin elevated. It is useful for detecting sinusitis fluid levels and facial fractures. Proper head extension optimizes sinus visualization.

Technique

Position the patient with the chin extended so the orbitomeatal line forms a 37 degree angle to the detector. Center the detector to the maxillary sinuses and use appropriate exposure. Immobilize the head to reduce motion artifact.

Clinical Indications

Waters sinus view is indicated for sinusitis facial trauma and suspected maxillary sinus disease. It helps detect air fluid levels and mucosal thickening. CT is preferred for detailed sinus and orbital assessment when needed.

Image Assessment

Evaluate maxillary sinus aeration fluid levels and bony integrity. Inspect for orbital floor fractures and foreign bodies. Recommend CT for complex disease or surgical planning.