Summary – Head, Eyes, Ears, Nose and Throat System

Disorders of the ears, eyes, nose, and throat are extremely common in the primary care setting making proficiency in HEENT assessment and history taking paramount. During the assessment, it is helpful to use a sequential pattern of inspection, palpation, and auscultation while considering the many structures involved and their general physiology and pathophysiology.

Eye disorders can be age, trauma, or inflammatory in nature. The most common age-related eye disorders that affect vision such as hyperopia (far-sightedness), macular degeneration, and cataract formation. Inflammatory conditions can be related to irritation, allergies, infection, corneal abrasions, or foreign bodies. The effect or symptoms of an eye disorder is usually what patients are most concerned about; common symptoms include vision disturbances, eye pain, discharge, and eyelid problems.

Common chief complaints of the ear are pain, discharge, changes in hearing, and tinnitus. Hearing changes can be age-related, tinnitus can be related to medication use or overuse, and ear pain and discharge are often infectious or inflammation.

Mouth conditions that cause sores or pain such as herpes simplex 1 (cold sores), aphthous ulcers, and oral thrush commonly have a bacterial, viral, or fungal origin. Pharyngitis of multiple aetiologies such as viral mononucleosis, tonsillitis, or strep throat is more common during the winter months and flu season.

Common nasal symptoms include epistaxis (nosebleed), and causes can be environmental, traumatic, or inflammatory. Upper respiratory conditions and allergies commonly cause nasal congestion and rhinitis.