Modified tangential Peeyush's technique: A simplified radiographic technique to visualize zygomatic arch fracture

Abstract

Introduction: Zygomatic arch (ZA) fractures are common in facial trauma. The imaging techniques for the ZA include submentovertex (SMV) and jug handle (a variation of the SMV view) views. These radiographic techniques require neck hyperextension to make the canthomeatal line parallel to the film receptor. Most of the time, these patients will be having cervical injuries also which makes these imaging techniques challenging. Aims and Objectives: This observational study aimed to estimate the efficacy of modified tangential Peeyush's technique (MTP technique) as an alternative to SMV view in patients with ZA fracture along with neck pain. Materials and Methods: A digital panoramic radiography machine and other standard equipment for radiography were used. Twenty patients with clinically diagnosed ZA fracture were selected and imaged using two different techniques, i.e., technique A (canthomeatal line to be about 30°–45° in relation to image receptor) and technique B (MTP technique). Images obtained with both techniques were evaluated for the presence of ZA fracture. The results were tabulated and compared. Results: Technique A showed partial visualization of ZA in 55% of the cases, whereas ZAs were not visualized in 45% of cases. ZA was evident in 100% of the sample selected in technique B (MTP technique). Conclusion: Modified Peeyush's tangential technique can be applied in patients having ZA fracture with neck pain.

Keywords

• jug handle view
• tangential techniques
• zygomatic arch