ABSTRACT
Rhinology is an increasingly broad sub-speciality in which outpatient assessment is adjusted to suit each individual case. This chapter explores basic rhinologic history taking, clinical examination, nasendoscopy and the use of patient reported outcome measures (PROMs). The aim of an outpatient assessment is to reach a diagnosis in order to guide management. In many patients this may be clear from the history alone. History taking is best initiated by characterizing the index nasal symptom(s), noting duration, periodicity, nocturnal variation, seasonal effects, laterality, association with trauma or prior surgery, and whether there is any alleviating or provoking factors. Nasal patency is assessed through anterior rhinoscopy – examination of the anterior nose using a Thudicum's speculum and head light illumination. Nasendoscopy is a necessary investigation for all patients referred for a specialist investigation of nasal or paranasal sinus disease. It is best performed after the application of decongestant.
