Palpation & Percussion: Sinuses


Required Instrument 

  • Head light.

Examination Technique

  • For all examinations of the nose, the patient sits on a chair which provides adequate back support.
  • Sit on a height-adjustable stool beside or in front of the patient.
  • Your eyes should be at the same height as the patient’s nose.


Procedure

  • For the examination of the maxillary sinus, place your thumb on the cheekbone.
  • Subsequently, move your thumb to just below the cheekbone and apply pressure [Figure 25].
  • Ask the patient if this is painful and whether any existing pain becomes worse.

Figure 25


  • For palpation of the ethmoidal sinus, place your index finger in the medial angle of the eye against the roof of the eye socket [Figure 26] and apply pressure.
  • Ask the patient if this is painful or whether any existing pain becomes worse.

Figure 26


  • Percuss the frontal sinuses by tapping with the index or middle finger on the area above the medial angle of the eyes [Figure 27].
  • Again, ask the patient if this is painful or whether any existing pain becomes worse.

Figure 27


  • Start with the least painful side and examine the (more) painful side in the same manner.

 

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