4. HISTORY OF PRESENTING ILLNESS
Patient was apparently normal 1 year back after which he
developed swelling on right side of face below the ear which was
insidious in onset, gradually progressive in size, initially was size of
peanut which progressed to present size
Patient also noticed the sudden increase in size in last 2 months
The swelling was not associated with pain or discharge
5. No h/o difficulty or pain during swallowing
No h/o restricted mouth opening, facial weakness
No h/o trauma to face
No h/o any other swelling on face
No h/o ear pain
No h/o fever, weight loss
6. PAST HISTORY
No significant history in the past
Not a known case of hypertension, type 2 DM, TB
FAMILY HISTORY
• No significant history in the family
7. PERSONAL HISTORY
Diet : mixed
Sleep : adequate
Appetite : normal
Bowel and bladder : normal and regular
8. h/o smoking cigarettes : 2 to 3/day for 15 years
stopped smoking in last 2 years
h/o consumption of alcohol : 90m;/day for 10years
stopped consumption of alcohol; in last 2 years
9. Treatment history
Not taken any treatment for present condition
No h/o any surgeries in the past
10. Summary
A 58 year old male presented with a painless gradually progressive
swelling in front and below the right ear lobule since 1 year with no
comorbidities
11. GENERAL PHYSICAL EXAMINATION
Patient , moderately built and nourished
Conscious , co operative
Patient is afebrile
Pulse : 80bpm
BP : 110/70mmhg
Spo2 : 98% in room air
13. Head and neck examination
Inspection
Solitary swelling, ovoid in shape
Situated in the right parotid region
Extent : superiorly just above the level of intertragal notch extending 3 cm below the
angle of mandible
posteriorly till anterior border of sternocleidomastoid
Surface : appears smooth
Borders : well defined
No visible pulsations over the swelling
14. Skin over the swelling is normal
Left parotid region appears to be normal
No other swellings noted in the face and neck
15. Palpation
No local rise in temperature
On palpation there is a single swelling in the front, below and behind the right ear lobule
with a size of 8cm (vertically) x 3cm (horizontally)
Skin over the swelling is pinchable
Shape : bilobed shape
Consistency : firm to hard in consistency
Margins : well defined
16. Auscultation
No bruit heard
Lymph node examination
No palpable cervical lymph nodes
Facial nerve examination : normal
17. NOSE EXAMINATION :
External frame work of nose :
root : normal
nasal bridge : normal
Tip: normal
Skin over the nose : normal
Elevation of tip: nasal vestibule normal
18. Anterior rhinoscopy
Right Left
Septum Deviated to left
Mucosa Normal Normal
Inferior turbinate Normal Normal
Inferior meatus Normal Normal
Middle turbinate Normal Normal
Middle meatus Normal Normal
Floor Normal Normal
19. Right Left
Smell sensation Normal Normal
Cold spatula test Decreased fogging
Cottle’s test negative negative
Functional tests
20. Paranasal sinus tenderness
Para nasal sinus Right Left
Frontal Absent Absent
Ethmoidal Absent Absent
Maxillary Absent Absent
21. ORAL CAVITY EXAMINATION
Lips
Buccal mucosa
Hard palate normal
Floor of mouth
Anterior 2/3rd of Tongue
Retromolar trigone
Teeth: nicotine stains present
22. OROPHARYNX EXAMINATION
Uvula : normal
Anterior pillar : normal
Tonsillar area : normal
posterior pillar : not visible
posterior pharyngeal wall : normal
23. LOCAL EXAMINATION
Ear Right Left
Pinna Normal Normal
Pre auricular area Normal Normal
Post auricular area Normal Normal
Tragal tenderness Absent Absent
Mastoid tenderness Absent Absent
EAC Normal Normal
Tympanic membrane Intact Intact
EAR EXAMINATION
24. NECK EXAMINATION
External laryngeal contour: normal
Trachea: midline
Laryngeal crepitus: present
No palpable lymph nodes
