2020年6月18日 星期四

如何治療打鼻鼾 ?

打鼻鼾成因
打鼻鼾是由於睡覺時,患者的肌肉完全放鬆,其舌頭和吊鐘部位會向後墮或咽喉組織過多,而引致空氣不能順利通過,造成氣管阻塞,要用力呼吸才可以通過障礙物,形成鼻鼾。患者通常是過胖,其中以中年男士居多。打鼻鼾是睡眠窒息症的先兆,不容忽視。
 


射頻手術 - 治療打鼻鼾

現今醫學昌明,打鼻鼾已可以透過微創射頻手術治療,耳鼻喉專科醫生會利用射頻以65至80度的熱力把阻塞咽喉的軟組織去除。射頻手術會於局部麻醉下進行,過程大約十五分鐘,可減輕打鼻鼾和睡眠窒息症的症狀。微創手術後,大約4至6個星期後會出現效果,幾個月後效果會越見明顯。手術功效可維持1至2年,直至軟組織重新生長。



射頻手術後處理

耳鼻喉專科醫生會處方血管收縮素噴劑、消炎藥等藥物,以減輕手術後的不適和發炎機會。每一項手術也有其風險,射頻治療有機會出現流血、發炎和黏膜潰瘍等併發症,出現併發症的機率少於1%。

射頻療程過程快捷,只有少量不適,手術後毋需住院,但病狀有復發的可能。

 
 
 
 
 
 

 


 














資料來源: 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。

2020年6月4日 星期四

Sinusitis


Rhinosinusitis


Rhinosinusitis is defined as inflammation of the nose and the paranasal sinuses. The symptoms include nasal blockage, loss of smell, nasal discharge, postnasal drip and facial pain. It is defined as acute sinusitis if complete resolution of symptoms is achieved within 12 weeks. If the symptoms persist more than 12 weeks, it is defined as chronic sinusitis.


Examination for sinusitis must include nasoendoscopy. This procedure is performed by ENT specialists under local anaesthesia. The abnormalities include mucopurulent nasal discharge, the mucosal edema with total obliteration of the sinus outlet and nasal polyps will be detected. Besides, the anatomy of the nasal cavity and sinus outlet can also be seen.


CT scan of the paranasal sinuses is useful for assessment of sinusitis. It can detect mucosal changes within ostiomeatal complex and/or sinuses and also opacity of the sinuses and delineate the anatomy of the sinuses.


Treatment of Acute Sinusitis


Symptomatic therapy


Normal saline lavage is used to remove secretions and promote nasal mucosal healing. Oral and topical decongestants can reduce mucosa congestion and improve drainage. Mucolytic is used to thin mucus secretions, reduce mucus stasis, and promote clearing. Antihistamine can decrease mucus production and diminish nasal discharge. Intranasal corticosteroid is also used to reduce inflammation and improve associated symptoms.



Antibiotic


Antibiotics are a common prescription for acute rhinosinusitis. However, only 0.2%-2% of viral upper respiratory tract infections are complicated by bacterial rhinosinusitis and around 40% of acute bacterial infections resolve spontaneously. That means 85%-98% of patients with acute rhinosinusitis are needlessly prescribed an antibiotic



Early treatment of rhinosinusitis should be focused on control inflammation to allow sinus drainage and prevent bacterial infection. Antibiotic should be reserved for persistent moderate to severe disease and complications.



Treatment of Chronic Sinusitis


A careful history taking and past medical records review are important. A thorough physical examination including fiberoptic nasoendosocpy is necessary to delineate the patient's anatomy. CT scan of paranasal sinus will help document the extent of disease and clarify any other anatomic abnormalities.


An optimal medical treatment consists of antibiotic, nasal saline irrigation, intranasal steroid spray should be given. The patient should then be re-evaluated and restaged in 1 month. If the patent is not responsive to the treatment, surgical intervention should be considered.


Endoscopic Sinus Surgery


The surgery is done under general anaesthesia. The sinus opening will be widened with all the obstruction removed. The sinuses will be cleansed with the mucopus drained. The normal mucus clearance mechanism will be restored. The operation is performed inside the nose under endoscopic control with no external surgical scar. In certain situation, it will combine with other nasal surgeries (such as septoplasty or polypectomy) to improve the access of the surgical field and the ventilation of the sinuses.



Postoperatively, the nose will be packed with dressing for hemostasis. The dressing will be removed in 1 to 2 days. Nasal saline irrigation should be started after the removal of nasal packing.


The complications include bleeding and infection which is not common. Rare complications include brain and eye injury.




Reference: http://www.ent-hk.com/
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your ENT doctor for diagnosis and treatment.