A comprehensive clinical examination is the basis for selecting further diagnostic and therapeutic steps.
Extraoral examination
- Inspection
- Facial asymmetries
- Soft tissue swelling
- Fistulas
- Skin florescences
- Palpation
- Bimanual (symmetry comparison)
- Lymph node
- Nerves, nerve exit points
Oral cavity
- Floor of mouth
- Bimanual (“with both hands”): from intraoral (“inside the oral cavity“) with counterpalpation from extraoral (“outside the oral cavity”) [salivary stones palpable in the submandibular duct or hilus of the submandibular gland/mandibular gland].
- Cheek soft tissues
- [in slender patients may be palpable indurations]
- [Stenon duct of the parotid gland/parotid gland often swollen in inflammatory change]
- [Papilla of Stenon’s duct often reddened during inflammatory change]
- Palpation dolence/painfulness on palpation [dolent/painful in acute purulent sialadenitis]
- Saliva
- Spontaneous flow [impaired in obstruction (complete occlusion)/sialolith]
- Quantity [decreased]
- Consistency
- [flaky: undissolved constituents: concretions]
- [cloudy, bloody: acute bacterial superinfection]
- Probing the excretory ducts [obstruction].
Square brackets [ ] indicate possible pathologic (pathological) physical findings.