耳鼻喉, 睡眠窒息, 鼻鼾, 香港耳鼻喉教育博客

2011年12月20日星期二

Treatment for obstructive sleep apnea

Life style adjustment is important. Obstructive sleep apnea patients are usually over-weight. Weight reduction, by diet and regular exercises, is utmost important. Improve sleep hygiene with regular sleep, avoid alcohol and sleeping pills will improve the sleep quality.

Positive airway pressure machines (CPAP) are the gold standard of the management of the sleep apnea. By applying positive pressure ventilation, the airway is splinted. Airway vibration and collapse are prevented and sleep quality improved. The compliance is the major problem. Lots of people refuse the idea of using CPAP and many find wearing a mask to sleep intolerable. It needs time for patients to get use to the CPAP machine and most of them will find it useful.

Surgery is reserved for those who cannot tolerate CPAP machine. Different kinds of surgery, aim at different level of obstruction, are available. The aim of the surgery is to enlarge and stiffen the airway. Success rate varies from 40% to 80%, depending on the individual. Sometime multilevel surgery is required for optimal results. Minimal invasive techniques such as radiofrequency ablations can be used to relieve obstruction at different level.

Dental appliances are another option for the treatment of sleep apnea. It is usually tailor made by dentists and wearing them during bedtime, may control the snoring and sleep apnea.

Reference information: 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.

2011年12月16日星期五

Radiofrequency of inferior turbinate

It is a minimal invasive procedure for Nasal obstruction caused by inferior turbinate hypertrophy. A special designed applicator is used to apply the radiofrequency to the submucosal tissue of the inferior turbinate. With a controlled increase in temperature, volume reduction is achieved through the scaring and later resorption of the submucosal tissue. The whole procedure is performed under local anaesthesia in outpatient basis. No hospital stay is required. The pain or discomfort will be minimal and easily controlled by analgesic.

Inferior turbinectomy

Nasal obstruction can be caused by the mucosa hypertrophy of the inferior turbinate. Under general anaesthesia, the inferior turbinate will be removed. A dramatic relieve of Nasal obstruction will be expected.

Septoplasty

Nasal obstruction can be caused by a deviated nasal septum. By removing the deformed bone or cartilage and repositioning of the septum, the septum can be straightened. Symmetric patent nasal air flow can then be restored. The operation is performed under general anaesthesia.

Reference information: ent-hk.com

2011年12月14日星期三

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.

Reference information: ent-hk.com

2011年12月10日星期六

Allergic Rhinitis Treatment

Allergens Avoidance

House dust mites feed on human skin danders. Warm and humid condition facilitates their growth. Bed mattress, pillows, carpet, upholstered furniture and fluffy toys should be cleaned regularly.

Animal danders are present in high amounts in domestic dust, upholstered furnishings and mattress. Avoid keeping pets if possible.

Pollens that cause most common allergies are grasses, weeds and trees. Wearing mask for outdoor activity during the pollen seasons is recommended.

Medication

The most common prescribed medication is antihistamine. Both sedating and non-sedating antihistamine are available.

The other type of medication is Vasoconstrictor which can be administered as oral or local via nasal spray. Vasoconstrictor is useful for relieving nasal obstruction. Oral Vasoconstrictor may cause systemic side effects while local Vasoconstrictor should not be used continuously for more than a week.

Steroid nasal spray is useful for all nasal symptoms including nasal obstruction. It is more effective than the oral medication.

Reference information:

2011年12月8日星期四

Allergic rhinitis

Allergic rhinitis is a global health problem affecting 10% to 20% of the population. It represents an immunoglobulin E (IgE)-mediated inflammation of the nasal mucosa.

The symptoms of Allergic rhinitis include sneezing, nasal discharge, postnasal dribbling, nasal obstruction and nasal itchiness. It affects social life, sleep, work and school. Serious Allergic rhinitis may lead to sinusitis, asthma, etc.

Allergic rhinitis can be seasonal or perennial. Outdoor allergens (e.g. pollen) appear to constitute a greater risk for seasonal rhinitis than indoor allergens and indoor allergens (e.g. house dust mite) a greater risk for perennial rhinitis.

Reference information: