A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; furthermore:
- Inspection (viewing).
- Mouth/throat
- Throat
- Palpation (palpation) of the entire neck area [thyroid enlargement (e.g. goiter/ goiter), lymph nodes].
- Inspection (viewing).
- ENT examination – including inspection of the larynx[due todifferential diagnoses:
- Chronic inflammation of the throat, pharynx (pharynx), larynx (larynx).
- Chronic injuries in the area of the throat, pharynx (pharynx), larynx (larynx).
- Disease of the salivary glands
- Malformations in the area of the neck, pharynx (throat), larynx (larynx).
- Foreign body aspiration (inhalation of foreign bodies).
- Contact granulomas – may be localized in the posterior part of the vocal folds
- Laryngeal hypersensitivity (hypersensitivity in the area of the larynx).
- Scarring changes after procedures on the upper swallowing tract, e.g., after tonsillectomy (tonsillectomy)
- Polyps of the larynx
- Spasmodic dysphonia (vocal cord spasm).
- Tonsillitis (tonsillitis) with swollen lymph nodes.
- Tumors of the soft tissues of the throat
- Enlarged gum tonsils
- Enlargement of the tongue base (tongue base tonsil).
- Cysts in the in the neck, pharynx (throat), larynx (larynx) – often in the hypopharynx; cysts originating from the larynx can become very large]
- Internal examination[Differential diagnoses:
- Esophageal muscle dysfunction.
- Functional changes of the esophagus in the upper third.
- Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
- Motility disorders of the esophagus.
- Opening disorder of the esophageal sphincter
- Zenker’s diverticulum – protrusions of the esophagus (esophagus) into the soft tissues of the throat; after a few bites, food intake is limited
- Orthopedic examination[due todifferential diagnoses:
- Fibromyalgia (fibromyalgia syndrome) – syndrome that can lead to chronic pain (at least 3 months) in several regions of the body.
- Osseous (bony) changes in the cervical spine that extend into the swallowing tract]
- Psychiatric examination[due todifferential diagnoses:
- Anxiety
- Depression
- Hypochondriacal disorder
- Stress]
- Orthodontic examination of the neck area – if there is evidence of musculoskeletal disorders.
