2012年10月26日 星期五

Mouth Sores(Part 3)







What are other types of oral lesions to be concerned about?

Leukoplakia—A thick, whitish-color patch that forms on the inside of the cheeks, gums, or tongue. These patches are caused by excess cell growth and are common among tobacco users. They can result from irritations such as ill-fitting dentures or the habit of chewing on the inside of the cheek. Leukoplakia can progress to cancer.


Candidiasis—A fungal infection (also called moniliasis or oral thrush) that occurs when yeast reproduce in large numbers. It is common among denture wearers and most often occurs in people who are very young, elderly, debilitated by disease, or who have a problem with their immune system. People who have dry mouth syndrome are very susceptible to candidiasis. Candida may flourish after antibiotic treatment, which can decrease normal bacteria in the mouth.


Hairy tongue—A relatively rare condition caused by the elongation of the taste buds. It can be caused by poor oral hygiene, chronic oral irritation, or smoking.

 

Torus palatinus—A hard bony growth in the center of the roof of the mouth (palate). It commonly occurs in females over the age of 30 and rarely needs treatment. A torus palatinus is often seen in patients who suffer from tooth grinding. Occasionally it is removed for the proper fitting of dentures.


Oral cancer—It may appear as a white or red patch of tissue in the mouth, or a small ulcer that looks like a common canker sore. Other than the lips, the most common areas for oral cancer to develop are on the tongue and the floor of the mouth. Other symptoms include a lump or mass that can be felt inside the mouth or neck; pain or difficulty in swallowing, speaking, or chewing; any wart-like mass; hoarseness that lasts for more than two weeks; or any numbness in the oral/facial region.



Tips to prevent mouth sores


• Stop smoking.

• Reduce stress.

• Avoid injury to the mouth caused by hard tooth brushing, hard foods, braces, or dentures.

• Chew slowly.

• Practice good dental hygiene, including regular visits to the dentist.

• Eat a well-balanced diet.

• Identify and eliminate food sensitivities.

• Drink plenty of water.

• Avoid very hot food or beverages.

• Follow nutritional guidelines for multivitamin supplements.


Reference information: http://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.

Mouth Sores(Part 2)


 

What are canker sores?

Canker sores (also called aphthous ulcers) are different than fever blisters. They are small, red or white, shallow ulcers occurring on the tongue, soft palate, or inside the lips and cheeks; they do not occur in the roof of the mouth or the gums. They are quite painful, and usually last 5-10 days.

 

 

Who is most likely to get canker sores, and what causes them?

Eighty percent of the U.S. population between the ages of 10 to 20, most often women, get canker sores. The best available evidence suggests that canker sores result from an altered local immune response associated with stress, trauma, or irritation. Acidic foods (e.g., tomatoes, citrus fruits, and some nuts) are known to cause irritation in some patients.

 

 

Are canker sores contagious? How are they treated?

Because they are not caused by bacteria or viral agents, they are not contagious and cannot be spread locally or to anyone else. Treatment is directed toward relieving discomfort and guarding against infection. A topical corticosteroid preparation such as triamcinolone dental paste (Kenalog in Orabase 0.1%®) is helpful.

 

When should a physician be consulted?

Consider consulting a physician if a mouth sore has not healed within two weeks. Mouth sores offer an easy way for germs and viruses to get into the body, so it is easy for infections to develop.

 

People who consume alcohol, smokers, smokeless tobacco users, chemotherapy or radiation patients, bone marrow or stem cell recipients, or patients with weak immune systems should also consider having regular oral screenings by a physician. The first sign of oral cancer is a mouth sore that does not heal.

 

What kind of screenings are performed?

The physician will most likely examine the head, face, neck, lips, gums, and high-risk areas inside the mouth, such as the floor of the mouth, the area under the tongue, the front and sides of the tongue, and the roof of the mouth or soft palate. If a suspicious lesion is found, the physician may recommend collecting and testing soft tissue from the oral cavity.

 

Reference information: http://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.


2012年10月23日 星期二

Mouth Sores(Part 1)



Oral lesions (mouth sores) make it painful to eat and talk. Two of the most common recurrent oral lesions are fever blisters (also known as cold sores) and canker sores. Though similar, fever blisters and canker sores have important differences.

 

What are fever blisters?

Fever blisters are fluid-filled blisters that commonly occur on the lips. They also can occur on the gums and roof of the mouth (hard palate), but this is rare. Fever blisters are usually painful; pain may precede the appearance of the lesion by a few days. The blisters rupture within hours, then crust over. They last about seven to ten days.

 

 

Why do fever blisters reoccur?

Fever blisters result from a herpes simplex virus that becomes active. This virus is latent (dormant) in afflicted people, but can be activated by conditions such as stress, fever, trauma, hormonal changes, and exposure to sunlight. When lesions reappear, they tend to form in the same location.

 

Are fever blisters contagious?

Yes, the time from blister rupture until the sore is completely healed is the time of greatest risk for spread of infection. The virus can spread to the afflicted person’s eyes and genitalia, as well as to other people.

 

How are fever blisters treated?

Treatment consists of coating the lesions with a protective barrier ointment containing an antiviral agent, for example 5% acyclovir ointment. While there is no cure now, scientists are trying to develop one, so hopefully fever blisters will be a curable disorder in the future.

 

Tips to prevent spreading fever blisters

 

• Avoid mucous membrane contact when a lesion is present.

• Do not squeeze, pinch, or pick the blisters.

• Wash hands carefully before touching eyes, genital area, or another person.

Note: Despite all caution, it is possible to transmit herpes virus even when no blisters are present.

 

 
 
Reference information: http://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.

 

2012年10月17日 星期三

兒童聲沙


 
兒童聲沙
兒童的聲音應該是清脆甜美的。然而兒童都不懂保護自己的聲音,喜歡大聲的叫喊,唱歌,又或是長時間的哭鬧,容易造成聲音沙啞。

 
聲沙原因
此外,在呼吸道感染時,鼻塞引起張口呼吸,鼻涕倒流引致喉部刺激,加上長時間咳嗽,亦會造成聲帶水腫 充血,甚至是聲帶小結或息肉。 兒童聲沙 也可能是聲帶乳頭狀瘤。乳頭狀瘤一般需以外科手術切除。兒童乳頭狀瘤有多發性傾向,可能需要定期作手術切除。隨著年齡增長,復發的情況會逐漸減少。

另外,許多先天性的病情,包括聲帶麻痺,亦可引致聲沙。



聲沙診斷
聲沙問題的診斷一般要作內窺鏡喉部檢查。把一條幼小的喉管從鼻孔放到喉部作詳細檢查。


治療聲沙
治療聲沙,主要是讓孩子減少說話,讓聲帶得到休息,但這是很困難做到的。言語治療師可教導孩子正確的發聲方法。糾正用聲不當及防止用聲過度。

如聲沙是因急性喉炎引起,便要先以耳鼻喉醫生處方藥物, 處理發炎情況。
如果控制不當,並出現聲帶息肉,可能需要接受喉部手術治療。

 

 
 
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。

2012年10月15日 星期一

聲帶息肉


 

聲帶息肉是常見的聲帶問題。聲帶息肉是因用聲不當 ,如持續大聲嘶叫, 又或是長期 過度用聲,以至 勞損有關。

由於聲帶有了息肉, 聲帶活動及閉合受到阻礙,聲帶的震動頻率 亦會受到影響。病人的聲音會變得低沉, 嚴重的會有聲沙,甚至發聲困難。如果息肉太大會阻塞呼吸道, 甚至造成呼吸困難。

 

聲帶檢查
聲帶息肉由耳鼻喉醫生作內窺鏡檢查 ,檢測聲帶發聲功能及分辨是普通息肉或是惡性腫瘤。


聲帶息肉手術
聲帶息肉與聲帶結節不同 ,大部份都需要以手術切除。病人需要 接受言語治療, 包括用聲,呼吸方法及調整音調等, 解決發聲問題。如能改善發聲方法,聲沙情況會得到改善。但如果聲音沙啞情況嚴重, 或有呼吸困難,便要進行聲帶息肉手術。手術名為顯微喉鏡, 以全身麻醉形成進行。聲帶息肉手術後需休息一至兩週。跟著便要遵 照言語治療師的發聲方法保護聲帶, 否則, 會有復發可能。


 
 
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。

 

 

2012年10月12日 星期五

鼻鼾與睡眠窒息症 (Part 2)



診斷方法
睡眠窒息需由睡眠測試診斷。患者可選擇到醫院留醫一晚或由睡眠測試公司上門為患者進行測試。

阻塞性睡眠窒息的治療
日常生活中,患者需注意飲食,定時運動,減輕體重。另外,作息要定時,避免煙酒。安眠藥,鎮靜劑會增加阻塞的情況,應盡量避免。

正氣壓呼吸機是最安全及簡單的方法治療睡眠窒息。每晚睡覺時只需戴上呼吸機,不單窒息情況可以控制,鼻鼾聲亦可大大減少。唯部份病人未能適應睡覺時戴着面罩,需作另外治療。

睡眠手術針對不同的阻塞部位,以外科手術或射頻消融術把阻塞清除。成功率由40%80%,需視乎不同個案而定。如阻塞部位不止一處, 可能要接受多於一次手術,手術後並有復發可能。

牙膠是套在上下牙齒的儀器,由牙科醫生為患者製造,於睡覺時戴上,可把下顎拉前,減少呼吸道阻塞。

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。

2012年10月8日 星期一

鼻鼾與睡眠窒症 (Part 1)


鼻鼾十分普遍,無論成人或小童,很多人都會有這種問題。
鼻鼾是由於上呼吸道組織因睡眠時放鬆和收窄,在呼吸時引起振動所致。阻塞越嚴重,振動越大,鼾聲亦越大,但當到達完全全阻塞時,呼吸聲和鼻鼾聲都會停止,造成阻塞性睡眠窒息。

鼻鼾除了影響患者家人的睡眠,亦會對患者造成壓力,在工作會議或課堂中造成尷尬。甚至有患者為了減少與別人同房的機會而減少了旅遊或工幹的機會。

睡眠窒息
香港大約有4%的男性及2%的女性患上睡眠窒症。顧名思義,睡眠窒息症就是睡眠時停止了呼吸。根據國際診斷標準,睡眠中每小時多於五次超過十秒的呼吸停止,就是睡眠窒息症。 睡眠窒息症可分為阻塞性,中樞性及混合性三種。

阻塞性如上文所述是因阻塞而導致窒息,是最常見的一種。

中樞性睡眠窒息症較為少見,代表中樞神經於睡眠時不能維持正常呼吸,成因可能是先天性,又或是中風或藥物引致。

部份患者可能同時有阻塞性及中樞性睡眠窒息,便是混合性睡眠窒息症。

睡眠窒息的病徵包括鼻鼾,呼吸間歇停止,早上不願起床,頭痛,口乾,日間疲倦,很容易打瞌睡,難以集中精神,影響學業或工作表現。如病情嚴重,更會於工作時入睡,如在駕駛或操作機械時發生,更可能引致意外或人命傷亡。另外睡眠窒息亦可導致脾氣改變,記憶力及性功能衰退。 除以上病徵,睡眠窒息亦可引致不同的併發症,包括高血壓,心臟病,中風等。嚴重的甚至引致夢中猝死,切不可輕視。(續)


參考資料: 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。