ENT Assessment & Clinical Examination
Build a focused ear, nose and throat assessment while identifying airway and neurological emergencies.
Quick revision ↓ Medical Dictionary
01Triage before detail
Begin with physiological stability and airway safety. Stridor, drooling with inability to swallow, rapidly enlarging neck swelling or major bleeding needs urgent help. Sudden hearing loss and new focal neurological signs also change urgency. A detailed routine examination must not delay resuscitation or referral when the presentation suggests a time-critical problem.
02A focused history
Clarify the main symptom, onset, side, duration and progression. Ask about pain, hearing, discharge, dizziness, nasal obstruction, bleeding, voice change and swallowing as relevant. Include previous operations, medicines, anticoagulants, diabetes, immune status and tobacco exposure. A concise symptom timeline helps distinguish an acute infection from a persistent structural or malignant process.
03Ear examination
Inspect the pinna, canal opening and surrounding skin before otoscopy. Use appropriate illumination, a suitable speculum and gentle positioning with the examining hand supported against the head. Record what is actually visible, including the tympanic membrane when adequately seen. Wax or swelling that blocks the view is a limitation, not evidence of a normal middle ear.
04Nose, mouth and neck
Examine the nose, oral cavity, oropharynx and neck according to the complaint, with consent and appropriate infection precautions. Note asymmetry, ulcers, masses and cranial nerve findings where relevant. Specialist endoscopy may be needed to assess hidden areas. Do not provoke a distressed patient with suspected airway obstruction through repeated forceful throat examinations.
05Make a useful plan
Summarise the likely site, urgency and differential. Arrange investigations that answer a clinical question and record examination limitations. Explain treatment, warning signs and who will review pending findings. Urgent referral requires a confirmed receiving pathway and practical access; a completed form alone does not ensure that the patient receives timely care.
High-Yield Revision
- Airway safety comes before a complete routine examination.
- Record laterality and examination limitations.
- Persistent unilateral symptoms deserve attention.
Common Pitfalls
- Calling an obscured tympanic membrane normal.
- Delaying emergency help to finish the checklist.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.