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).
- Skin and mucous membranes
- Auscultation of the lungs
- Inspection (viewing).
- ENT medical examination – including nasal endoscopy (nasal endoscopy; nasal cavity mirroring) or endoscopy (mirroring) of the nasal cavity and nasopharynx incl. inspection (viewing) of the olfactory fissure and the skull base (eg, to exclude a mechanical obstruction of the olfactory fissure) possibly with biopsy (tissue sampling) [due todifferential diagnoses:
- Chronic recurrent rhinosinusitis (RS; simultaneous inflammation of the nasal mucosa (“rhinitis”) and the mucosa of the paranasal sinuses).
- Chronic sinusitis (sinusitis).
- Polyposis nasi – occurrence of multiple nasal polyps.
- Septum deviation (deviation of the nasal septum).
- Neurological examination – including examination of motor function, sensitivity, coordination, and cranial nerve function [due todifferential diagnoses:
- Familial dysautonomia (Riley-Day syndrome) – genetic disorder leading to autonomic nervous system dysfunction.
- Alzheimer’s disease
- Parkinson’s disease (shaking palsy)
- Multiple sclerosis (MS)
- Neoplasms in the area of the brain
- Progressive paralysis – manifestation of neurosyphilis, which proceeds as psychosis with neurological deficits]
- Psychiatric examination [due todifferential diagnoses:
- Depression
- Psychosis]
- Health Check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
