The art and science of oral examination

Abstract

Performing an accurate oral examination is an integral part of a complete dermatological evaluation. As dermatologists, we are frequently asked to assess and treat numerous oral pathologies, which include, but are not limited to, normal variants, infections, ulcers, granulomas, lymphomas, as well as primary and metastatic tumors of the mouth and lips. The oral mucosa can be the window through which one can see and make numerous systemic diagnoses. Some clinicians are apprehensive about performing this evaluation, or feel that this examination is outside of their realm of expertise. These concerns may reflect limited exposure and education during training. Therefore, this article aimed to educate the readers on how to complete an oral examination, demonstrate normal variants, and highlight potential pitfalls and limitations of performing oral biopsies.

Diseases of the lips

“…The history and examination findings should dictate further laboratory and/or histologic assessment. 1…”

“…These papules represent normal accessory (minor salivary glands) which secrete myxoid saliva directly onto the labial mucosa. 1 To visualize the myxoid saliva, the clinician should gently dry off the mucosa using a piece of gauze as the lip is everted. Within 2-3 minutes, clear myxoid saliva pools on the surface of the lips.…”

Oral Mukoza Muayenesi ve Psödopatolojileri

“…İntraoral resim almak amacıyla tasarlanmış geleneksel 35 mm ya da dijital kameraların kullanımı, fotoğrafik belgeleme ve tıbbi kayıt için önemlidir 1 . Sağlıklı bir oral muayene, ekstraoral muayene ile başlar.…”

“…İntraoral muayene, dudaklar, vestibül, diş etleri, yanak mukozası, yumuşak ve sert damaklar, dorsal ve ventral dil, majör ve minör tükrük bezleri, ağız tabanı ve orofarinksi içine alır 1 . Hasta yatarak muayene edilecekse ortalama 45 derece açıyla uzanmalı, başın sağa sola, yukarı aşağı oynamayacak şekilde stabil olması sağlanmalıdır.…”

“…Lenf bezi muayenesinde palpasyon her zaman sistematik bir yol izlenerek yapılır (Superiordan inferiora ya da inferiordan superiora). Servikal lenf nodları zinciri; preaurikuler, postaurikuler, oksipital, superior servikal, posterior servikal, submaksiller, submental, inferior derin servikal ve supraklavikuler nodlar şeklinde dizilim gösterir 1,2 . Supraklavikuler lenf bezlerindeki büyüme, valsalva manevrası ile intratorasik basıncın artırılması yardımıyla daha kolay saptanabilir.…”