What are the causes of hoarseness? (1)

Acute Laryngitis: The most common cause is acute laryngitis—swelling of the vocal folds that occurs during a common cold, upper respiratory tract viral infection, or from voice strain. Serious injury to the vocal folds can result from strenuous voice use during an episode of acute laryngitis.

Voice Misuse:

l   Speaking in noisy situations

l   Excessive use

l   Telephone use with the handset cradled to the shoulder

l   Using inappropriate pitch (too high or too low) when speaking

l   Not using amplification when public speaking

Benign Vocal Cord Lesions: Prolonged hoarseness can occur when you use your voice too much, or too loudly for extended periods of time. These habits can lead to nodules, polyps, and cysts. Vocal nodules (singers’ nodes) are callus-like growths of the vocal folds. Vocal fold polyps and cysts also occur in those who misuse their voice, but can also occur in those who do not.

Vocal Hemorrhage: If you experience a sudden loss of voice following a yell or other strenuous vocal use, you may have developed a vocal fold hemorrhage. Vocal fold hemorrhage occurs when one of the blood vessels on the surface of the vocal folds ruptures and the soft tissues fill with blood. It is considered a vocal emergency and should be treated with absolute voice rest and examination by an otolaryngologist (ear, nose, and throat doctor).

Gastroesophageal Reflux (GERD): A possible cause of hoarseness is gastro-esophageal reflux, when stomach acid comes up the swallowing tube (esophagus) and irritates the vocal folds. Other typical symptoms of GERD include heartburn and regurgitation. Usually, the voice is worse in the morning and improves during the day. These people may have a sensation of a lump or mucus in their throat and have an excessive desire to clear it.

Reference information: www.entnet.org/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Hoarseness

Abnormal changes in the voice are called “hoarseness.” When hoarse, the voice may sound breathy, raspy, strained, or show changes in volume or pitch (depending on how high or low the voice is). Voice changes are related to disorders in the sound-producing parts (vocal folds) of the voice box (larynx). While breathing, the vocal folds remain apart. When speaking or singing, they come together and, as air leaves the lungs, they vibrate, producing sound. Swelling or lumps on the vocal folds hinder vibration, altering voice quality, volume, and pitch.

Reference information: www.entnet.org/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Indicators for hearing loss (2)

Response to the environment

(speech and language development)
Newborn (Birth to 6 Months)
 •Does not startle, move, cry or react in any way to unexpected loud noises.
•Does not awaken to loud noises.
•Does not freely imitate sound.
•Cannot be soothed by voice alone.
•Does not turn his/her head in the direction of
 your voice.
•Does not point to familiar persons or objects
 when asked.
•Does not babble, or babbling has stopped.
•By 12 months does not understand simple phrases by listening alone, such as “wave bye-bye,” or “clap hands.”





Infant (3 months to 2 years)

 •Does not accurately turn in the direction of a soft voice on the first call.
•Is not alert to environmental sounds.
•Does not respond on first call.
•Does not respond to sounds or does not locate where sound is coming from.
•Does not begin to imitate and use simple words for familiar people and things around the home.
•Does not sound like or use speech like other
 children of similar age.
•Does not listen to TV at a normal volume.
•Does not show consistent growth in the understanding and the use of words.

Reference information: www.entnet.org/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Indicators for hearing loss(1)

During pregnancy
 •Mother had German measles, a viral infection or flu.
•Mother drank alcoholic beverages.



Newborn (birth to 28 days of age)
 •Weighed less than 3.5 pounds at birth.
•Has an unusual appearance of the face or ears.
•Was jaundiced (yellow skin) at birth and had an exchange blood transfusion.
•Was in neonatal intensive care unit (NICU) for more than five days.
•Received an antibiotic medication given through a needle in a vein.
•Had meningitis.
•Failed newborn hearing screening test.


Family
 •Has one or more individuals with permanent or progressive hearing loss that was present or developed early in life.



Infant (29 days to 2 years)
 •Received an antibiotic medication given through a needle in a vein.
•Had meningitis.
•Has a neurological disorder.
•Had a severe injury with a fracture of the skull with or without bleeding from the ear.
•Has recurring ear infections with fluid in ears for more than three months.

Reference information: www.entnet.org/

 

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

How the Voice Works(2)

The Vibrator: The larynx (or voice box) sits on top of the windpipe. It contains two vocal folds (also known as vocal cords) that open during breathing and close during swallowing and voice production. When we produce voice, the airstream passes between the two vocal folds that have come together. These folds are soft and are set into vibration by the passing airstream. They vibrate very fast – from 100 to 1000 times per second, depending on the pitch of the sound we make. Pitch is determined by the length and tension of the vocal folds, which are controlled by muscles in the larynx.

The Resonator: By themselves, the vocal folds produce a noise that sounds like simple buzzing, much like the mouthpiece on a trumpet. All of the structure above the folds, including the throat, nose, and mouth, are part of the resonator system. We can compare these structures to those of a horn or trumpet. The buzzing sound created by vocal fold vibration is changed by the shape of the resonator tract to produce our unique human sound.

When our voices are healthy, the three main parts work in harmony to provide effortless voice during speech and singing.

Reference information: www.entnet.org/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

How the Voice Works(1)

We rely on our voices every day to interact with others, and a healthy voice is critical for clear communication. But just as we walk without thinking about it, we usually speak without thinking how our body makes it happen. However, knowing how we make sound is useful to maintaining the health and effectiveness of our voices. So this year on World Voice Day, April 16, take a minute to learn how your voice works. The following overview describes the body parts that work together to produce the sounds we make when we speak and sing.

The main parts of voice production:

• The Power Source: Your Lungs

• The Vibrator: Your Voice Box

• The Resonator: Your Throat, Nose, Mouth, and Sinuses

The Power Source: The power for your voice comes from air that you exhale. When we inhale, the diaphragm lowers and the rib cage expands, drawing air into the lungs. As we exhale, the process reverses and air exits the lungs, creating an airstream in the trachea. This airstream provides the energy for the vocal folds in the voice box to produce sound. The stronger the airstream, the stronger the voice. Give your voice good breath support to create a steady strong airstream that helps you make clear sounds.

Reference information: www.entnet.org/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

耳咽管功能失調

耳咽管是一條連接中耳和鼻咽的管道。功用是調節中耳的壓力，以減低外在壓力改變時引起的耳力問題，甚至耳膜損傷。籍著吞嚥或呵欠時肌肉的運動，耳咽管都會張開，讓空氣進出，以調節中耳的壓力。常見的情況如乘搭飛機或攀上高山時，雙耳有著塞著的感覺，需要吞嚥數下來調節。

 

如耳咽管功能失調，中耳壓力便不能調節到與大氣壓相同，影響聲音傳入。病徵包括耳塞，迴音耳朵不適及耳鳴。

 

耳咽管失調的成因很多，包括鼻敏感，上呼吸道感染，增殖體肥大，壓力和疲倦，荷爾蒙改變，體重顯著下降，藥物影響，如口服避孕藥，鼻咽癌及電療的後遺症，先天性顎裂。簡單的處理方法包括吞口水，打呵欠，或夾著鼻子及緊閉雙唇吹氣。
如情況持續，需要找耳鼻喉醫生作詳細檢查，找出原因，再作處理。

 

 

 

 

 

 

 

參考資料: http://www.ent-hk.com/

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。

腮腺發大

 

口水腺是分泌唾液的腺体。主要的口水腺有三对,分别是腮腺,颌下腺及舌下腺。 腮腺发大有很多原因,包括:

炎症性腫大
急性炎症包括流行性腮腺炎(即生炸腮),急性化膿性腮腺炎,又或是腮腺淋巴發炎。亦可以是慢性炎症,如結核性腮腺炎。

腮腺管結石
結石可導致腮腺管阻塞,導致腮腺發大甚至發炎。

腮腺腫瘤
腫瘤可分為良性及惡性。良性腫瘤包括多形腺瘤,腺淋巴瘤或肌上皮瘤;惡性腫瘤包括原發性腮腺癌及轉移癌。口水腺腫瘤的發生率佔頭頸腫瘤的3％，而腮腺腫瘤佔口水腺腫瘤的80─85％。大多數的腮腺腫瘤以良性的多形腺瘤居多，生長緩慢，病程可長達數年或十數年。另外一些瘤樣病變如第一腮裂囊腫,亦可導致腮腺脹大。

其他
部份藥物亦可導致腮腺脤大。另外,一些免疫性疾病,如舍格倫綜合症,亦可導致腮腺肥大。 腮腺肥大,會影響臉部外觀,嚴重的如影響吞嚥,甚至呼吸。如屬急性炎症,會有發熱,疼痛甚至發燒等病徵。

腮腺惡性腫瘤不易與良性腫瘤分辨。如腮腺惡性腫瘤快速長大,疼痛或出現臉癱,屬惡性腫瘤的機會便大大提高。應盡快找醫生診治,作進一步檢查及化驗。

 

參考資料: http://www.ent-hk.com/

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。

Otitis Externa (a.k.a. External Otitis or Swimmer’s ears)

 Otitis externa is the inflammation of the skin of the ear canal.

 

Causes of Otitis Externa

•During swimming, water can get into the ear cannel and cause infection.

 •Ear picking with cotton wool bud may cause trauma to the ear canal and may result in infection.

•Abuse of the antibiotic ear drop result in the extinguishing of normal flora in the external ear, leading to fungal otitis externa.

 •Immunocompromised patient, such as diabetes, are more prone to otitis externa.

 •The inflammation of the skin of ear canal may be secondary to eczema.

 

 

Treatment for Otitis Externa

To prevent otitis externa, we should keep our ear dry. Avoid swimming in polluted water. Avoid inserting anything into the ear canal. The use of cotton buds or swabs is the most common event leading to acute otitis externa.

 

Consult an ENT doctor when you get otitis externa. Ear cleaning under microscope will be performed to remove dirt, wax and discharge from the ear canal. Antibiotic ear drop (or antifungal ear drop in case of fungal infection) will be prescribed.

For recurrent infection, investigation including blood test for diabetes will be conducted.

 

 

 

 

 

Reference information: www.ent-hk.com/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

Tonsillitis

Tonsil is the lymphoid tissue at the oropharynx. It can be seen in the back of the throat. It is the guard of our upper respiratory tract. Tonsillitis is the inflammation of the tonsils, which is commonly caused by bacteria or virus.

 

Symptoms of Tonsillitis
Fever, sore throat, pain on swallowing are the common symptom of tonsillitis.

 

Treatment of Tonsillitis
Treatment includes symptomatic treatment with medications to reduce the pain and the fever. Antibiotic will be prescribed in case of bacterial tonsillitis.

 

Tonsillectomy
Tonsillectomy is the removal of tonsil. The procedure is performed under general anaesthesia. The indications of the operation include repeated episodes of tonsillitis, recurrent peritonsillar abscess, sleep apnea. The morbidity rate associated with tonsillectomy is 2% to 4% due to post-operative bleeding. Patients need to stay in the hospital for one or two days after surgery. Sore throat will persist for around two weeks after the operation, and analgesic will be prescribed. Proper hydration is very important, as dehydration can increase throat pain, leading to a vicious circle of poor fluid intake. Recovery can take from 7 to 10 days, and patients are good to resume daily activities.

Removal of the tonsils does not reduce the immunity of the body in any significant way. There are many other lymphoid tissues that also perform the same function. There is enough scientific evidence to show that the immunity of the body does not reduce after a tonsillectomy.

 

 

 

 

 

 

Reference information: www.ent-hk.com/

The information aims to provide educational purpose only. Anyone reading it should consult ENT Specialists before considering treatment and should not rely on the information above.

流鼻血, 鼻水, 鼻涕與鼻塞

流鼻血的成因有很多,如鼻中隔骨彎曲,天氣乾燥,創傷,或挖鼻亦可以。但在香港,成人流鼻血最擔心的是鼻咽癌。除了鼻血,會有鼻塞,頸部淋巴漲大,及聽力減退等情況出現

除此之外,一些全身性的疾病, 如高血壓,血友病,白血病,亦可引起鼻血。另外,一些藥物,如薄血丸,亦會引起容易流鼻血。流鼻血是一個令人警惕的病徵,應盡快找耳鼻喉科醫生檢查。

鼻塞與鼻痕, 都是鼻敏感的徵象。

日常應注意,環境衛生,減少致敏原(如塵埃螨)的接觸。床單,被鋪應憑勤換,空調的隔塵網應定時清潔。植物,寵物,毛公仔亦可引起敏感,應盡量避免。

每天用鹽水清洗鼻腔,可減少徵狀。

如情況持續,可使用藥物治療,一般鼻敏感藥(抗組織胺劑)都可以控制情況。另外,消炎噴劑亦是很有效的治療方法,雖然含有類固醇,但劑量少及吸收量低,很少有副作用。另外,一些含偽麻黃素的噴劑,雖然通鼻能力很好,但只能作短期的治療,一般不能使用超過一星期,否則會有後遺症。

現時,一些微創技術,如射頻術,在診所內以局部麻醉進行,亦可有效治療鼻塞。如鼻塞嚴重,有可能需要外科手術,包括鼻中隔成形術及下鼻甲切除術,把鼻塞徹底治療。

參考資料: http://www.ent-hk.com/

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的耳鼻喉專科醫生查詢，而不應單倚賴以上提供的資料。