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BMJ Case Reports 2013; doi:10.1136/bcr-2013-008651

Using the tongue to palpate a lesion in the postnasal space: a unique case of self-diagnosis

  1. Robert Nash2
  1. 1Department of ENT, Lister Hospital, Stevenage, UK
  2. 2Department of ENT, Royal National Throat Nose and Ear Hospital, London, UK
  1. Correspondence to Nora Haloob, nora.haloob{at}nhs.net

Description

This 64-year-old lady presented to ear, nose and throat department with a history of left-sided nasal blockage and a lesion in her postnasal space which was palpable by her tongue. In figure 1, the patient demonstrates how she was able to self-diagnose the cause of her symptoms, and therefore prompting a general practitioner referral, by manoeuvring the tip of her tongue to fit into the postnasal space. Flexible nasal-endoscopy and CT confirmed a large antrochoanal polyp in her left nostril extending to the postnasal space. She went on to have functional endoscopic sinus surgery and polypectomy.

Figure 1

Oropharynx showing the tongue reflected behind the soft palate in the postnasal space.

Learning points

  • Clinicians should never underestimate the value of a patient's input in formulating a diagnosis.

  • An unusual method for the human body to self-diagnose an anatomically discreet lesion.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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