case presentation parotid swelling.pptx

Case

1. CASE PRESENTATION Presenter DR CHAITRA N

2. NAME : Marudevayya AGE : 58 years SEX : male RELIGION : Hindu OCCUPATION : labour ADDRESS : BANGALORE DOA : 27/06/2023

3. CHIEF COMPLAINTS c/o swelling below the right ear since 1 year

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

12. Pallor Icterus Clubbing Cyanosis absent Lymphadenopathy Edema

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 2/3 rd 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

25. Probable diagnosis Right parotid swelling