External Nose:

• Inspect for deviations in shape. 

• Observe for discharge from the nares, (watery, mucoid, purulent) from one or both sides. 

• A bilateral watery discharge associated with sneezing and nasal congestion indicate an allergy. 

• Mucus discharge is typical of rhinitis while bilateral purulent (pus) discharge is typical of an upper respiratory infection (URI). 

• One-sided purulent, thick greenish and extremely malodorous discharge may indicate a foreign body.

Nasal Cavity:

• To examine the nasal cavity spread the nares by pushing up on the tip of the nose. 

• Using an otoscope with a wide nasal speculum or a hand held nasal speculum inspect the:

  • Nasal mucosa, noting color, swelling or discharge (clear, mucus, purulent)

  • Inferior and middle turnbinates

  • Nasal septum noting any deviation, inflammation or perforation.

  • Nose for polyps (pale masses that usually hang down from the middle turbinate) or other abnormalities.

Examination of the Sinuses:

• To palpate the frontal sinus for tenderness use your thumbs and press up from under the bony brow (right under eyebrows). 

• Avoid pressure on the eyes. 

• Then press up on each maxillary sinus by pressing under the zygomatic processes.

• Next percuss the sinus areas to detect tenderness. 

• Lightly tap directly of each sinus area with your finger. 

• Another method is to transilluminate the sinuses in a dark room. 

  • Place a light under each brow close to the nose. 

  • Shield the light with your hand. 

  • Normally you will see a dim red glow as light is transmitted through the air filled sinus. 

  • Repeat the process with light shinning downward just below the inner aspect of each eye. 

  • Look through the open mouth for the reddish glow. 

  • Absence of the red glow suggest thickened secretions in the sinus.

For further information, read:

Otorhinolaryngology, in The SeaBee Operational Medical and Dental Guide

Aviation Ear Nose and Throat Medicine, in Operational Settings

ENT in Hospital Corpsman Sickcall Screeners Handbook