隆鼻手術，鼻矯形

面部整形日漸普及，大眾對整形的接受程度也越來越高。改善鼻形手術除了功能及外觀上的改善外，東方人更相信矯正鼻形可以改善面相，從而改善自己的運氣。

隆鼻可分為手術性及非手術性兩種

隆鼻 - 非手術性 ：
主要是透過注射來達至鼻矯形效果。常用物質包括透明質酸(Hyaluronic Acid, 又稱玻尿酸), 微晶瓷 (Calcium Hydroxyapatite) 等。

透明質酸是人體本身物質，常用於注射面部，下巴，鼻部等。好處是簡單而需時較短，一般二十分鐘左右可完成。但是，由於注射透明質酸只可輕微改善鼻形，所以不是所有人也適合。例如，鼻翼左右不平衡，鼻子過大或比較嚴重之鼻部畸形，就需要選擇手術性修復。透明質酸隆鼻通常能維持半年至九個月，需要重覆注射，方可維持效果。

但是，注射性隆鼻並非完全沒有風險，如注射位置紅腫，瘀傷，甚至發炎等。此外，於同一位置多次注射，會有機會影響該位置的血液循環，嚴重甚至會造成皮膚創傷。

隆鼻 - 手術性 ：
隆鼻手術或鼻矯形手術，適合比較嚴重之鼻部畸形，鼻子過大，或有功能上問題如鼻塞之人仕。隆鼻手術之植入物，可分為自體移植和異物植入兩種類型。自體移植的植入物是來自患者身體的其他部份。例如鼻中隔軟骨，耳朵軟骨或肋骨等。好處是副作用如排斥或發炎等，較異物植入為低。

異物植入的植入物一般是人工物質，例如矽膠或合成的聚合物，如Goretex等。異物植入的好處是手術時間較短，而亦不需在病者其他部份造成傷口。

一般來說，單純隆鼻的手術時間較短，大約三十分鐘左右。鼻矯形或鼻雕 ，手術則需時兩至三小時。

每一個患者的需要和狀況也不同，在決定隆鼻手術前，請先諮詢耳鼻喉專科醫生平衡隆鼻手術風險。

資料來源：www.entific.com.hk

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。

止鼻血方法

 

流鼻血是一種常貝症狀，以兒童及老年人發病較多，一旦發生以上情况，發現者應保持鎮定，因為若病者精神緊張，血壓升高，出血會較難停止，對病者不利，以下是一般較簡易的應救措施：

 

l   先讓病者坐下，頭向前傾，解除頸部及胸部衣服的束縛，應保持鎮定，
並安撫病者。

l   指示病人用口呼吸，並揘住鼻翼(鼻子的柔軟部份) 大約十分鐘，
可以達到止血效果。

l   同時利用冰袋敷鼻樑及前額，可以收縮血管，幫助止血。

l   部份鼻血可能會流至口腔，應指導病者不應嚥下，及給予器皿盛載。

l   十分鐘後放鬆壓力，如果仍未止血，再壓十分鐘，此時病者仍不可把頭抬高。

l   不可用紙屑塞進鼻腔內。

l   出血情況停止後，叮囑病者避免身體過份用力，至少四小時內不要擤鼻涕，以免引致再流鼻血。

l   如急劇流鼻血或三十分鐘內仍未止血，應延醫治理。

 

 

 

資料來源：www.entific.com.hk

 

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。

 

Hearing Loss (Part Two)

 

Hearing loss treatment

The treatments vary depending on the type, site/s and severity of hearing loss. This is best assessed and diagnosed by an Ear, Nose & Throat Specialist.

The appropriate treatment may be conservative observation, hearing aiding and /or ear surgery. For children with persisting “glue ear” especially when in both ears with notable signs of language and /or attention problems, a ventilation tube (grommet) can be placed into the eardrum by surgery. For patients with a perforated eardrum, this can be repaired by surgery.

For patients with bilateral complete deafness, a cochlear implant sound processor should be considered. This re-stimulates the deaf ear using an electrode array and some very clever speech software processing. The new sound that is heard will indeed be different. Speech and hearing rehabilitation exercises to re-learn these sounds would be required. Children do better than adults with these cochlear implants. Studies have shown that a child’s brain has a higher neuro-plasticity than an adult, and therefore a greater capacity to adapt to new sounds and learning development.

 

Hearing aids

Hearing aids are often the first consideration for patients with hearing disabilities. These aids can be similarly considered like glasses for visual problems. They do not require surgery and the advanced technology is relatively inexpensive. Patients can used them when they want and remove them as necessary.

There are many different types of hearing aids available. They vary in size, quality, performance and therefore, price. Hearing aids should always be tailored to the different needs and hearing disability of the user. Hearing aids are however, not without their own problems. Patients may well find them uncomfortable or conspicuous to wear. This perhaps more so if the benefit offered is insufficient to meet the patients’ expectation and needs.

Conventional hearing aids require a sound leak proof occlusion of the ear canal by the ear mold in order to work well. Patients may find the fitting ear mold a little uncomfortable to use. Also, slight movement could alter its position easily and this can create feedback whistling sound, when the amplified sound leaks out of the ear canal, and re-enters the microphone of the same hearing device. This is similar to the whining feedback during karaoke sessions when the sound is picked up by the same microphone in a reverberating circuit.

When properly prescribed and fitted, conventional hearing aids are a good option to rehabilitate most hearing problems.

 

Baha (Bone Anchored Hearing Aid)

The baha, as its abbreviation suggests, works by direct bone conduction of sound to the cochlea via a sound processor and titanium implant on the skull. As the sound conduction is entirely via bone conduction to the cochlea, the external pinna, external ear canal and middle ear bones are not required. In fact they are completely bypassed. Hence the baha is suitable for those without an outer ear and occluded ear canal (microtia and congenital aural atresia) and those with poor middle ear conduction problems (mastoidectomy, loss of ossicles, otosclerosis).

The baha is especially ideal for patients with one-sided complete hearing loss, aka single-sided deafness (SSD). These SSD patients experience a poor perception of sound on one side especially on the phone, during meetings and dinners, and in noisy environments. The baha “captures” sound from the deaf side, and transmits it to the only working ear on the opposite side through bone conduction through the skull. The patient is then able to appreciate sounds and conversation on the deaf side, and finds themselves once again, enjoying their sound rich social environment.

One of the greatest advantage of the baha is that it is the only implantable hearing processor that allows people “to try before they buy”. By using a soft band applicator as a connection to the skull, the baha can be tried without surgery required. If the user likes the baha, they can choose to continue using the softband approach, or undertake a more securely applied baha via a surgical titanium implant to the skull, just behind the ear. Certainly, for the surgical installed baha, as there will be no intervening soft tissue unlike the softband trial, the sound heard will be clearer after the BAHA is implanted.

The surgery is a single-stage surgery, done with a minimal invasive implantation, maximizing the preservations of tissues. It takes around 15 minutes to complete the whole procedure and can be done within a clinical setting.

 

Summary

Hearing loss should be identified early especially with children for their speech and language development. Timely treatment by medication, surgery or hearing aiding can then be advocated.

Hearing aids and sound processors like the baha and cochlea implant, allow sounds to be heard. The sound may not be as rich as the normal ear, but the improvement beyond the hearing disability improves our patients’ social and professional interaction and enjoyment significantly.

 

 

Reference information: entific.com.hk

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.

Hearing Loss (Part One)

 

 

Causes of hearing loss

Hearing loss, is the loss of sound sensation and discrimination ability. It can be sudden or gradual. This loss can also be divided into two categories as either congenital (inborn from birth) or acquired hearing loss.

Congenital hearing loss is an hearing deficit since birth.

Acquired hearing loss happens later after birth. Some of the commoner causes are aging, trauma, long term exposure to loud noise, surgery of the ear/brain, infections in the middle or inner ear, and ototoxic drugs.

 

Hearing loss in children

Hearing loss in children is more commonly seen than in adults. This is because acute suppurative otitis media, which is an infection of the middle ear cavity, is the commonest infection of childhood. It occurs after an upper respiratory infection. The majority of these infections subside completely but it is not uncommon that some persists as a collection of a straw-colored fluid in the middle ear. This fluid has the consistency of “glue”, and when present, prevents the eardrum from moving normally. Hence children with acquired “glue-ear” will have a reduction in their hearing similar to water getting into their ear/s after a shower. This condition can exist in one or both ears.

In children, hearing losses should be investigated and treated as early as possible. This is especially true for children aged up to 7 years old as our speech and language development occurs in the first seven years of life. It is accepted that speech and language rehabilitation becomes more difficult and less successful, the later the hearing loss is diagnosed, and after optimal treatment.

 

Hearing loss in adults

Hearing loss may be acquired later in life. Causes include the long term sequelae of childhood ear infections like a perforated eardrum or cholesteatoma and hearing loss secondary to aging, ototoxic drugs application, noise-induced loss, barotrauma, occupation related noise exposure, ear surgery or intracranial brain surgery, intracranial tumours, unexplained sudden hearing loss, etc.

 

Hearing loss in one or both ears

Hearing loss can happen in either one (unilateral) or both ears (bilateral). Different hearing problems may co-exist in the same ear or in both ears. The severity of the hearing loss for each ear may vary from a mild loss (cannot hear someone whispering into your ear) to a profound hearing loss (cannot hear someone shouting into your ear) and anything in between.

Patients with a unilateral hearing loss, normal hearing ability may exist on the other side. These sufferers tend to hear only in one ear, and therefore fail to be able to stereo-localise sounds as other normal individuals i.e. they cannot tell the direction of sounds. They also particularly have problems in any noisy environment, such as in a meeting, restaurant, bar, etc. Here the voice of the speaker they are trying to listen to, competes with the noise of the background, which drowns it out. Hence it is hard for them to concentrate on one sound source and listen clearly. Certain adaptations in lifestyles are essential like cocking their heads to one side so the better hearing ear hears what is being said, walking always with friends / family standing on the side of their good ear, attending meeting early to sit in a position that would be advantageous to hearing better in the meeting, etc.

For patients with bilateral hearing loss, usually caused by noisy working environment over time and aging, they require a louder volume of sound stimulus in order to hear better. Turning the television, hifi, or radio up louder appears to do the trick but their family, friends and neighbours may, and do, find it disturbing.

 

 

 

 

 

 

 

 

Reference information: entific.com.hk

 

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.

 

失聰治療 (Part3)

 

骨固定式助聽器, Baha (Bone Anchored Hearing Aid )
骨固定式助聽器是透過一個聲音處理器及一個鈦金屬鏍絲，通過頭骨傳遞聲音到耳蝸。由於聲音的傳遞全透過頭骨，可以不需依靠外耳、耳道和耳骨。所以骨固定式助聽器適合沒有外耳或耳道閉塞的病人(小耳畸形和先天性外耳道閉塞) 及中耳的聲音傳遞有問題的病人(乳突骨手術後、失去耳骨和耳骨硬化症)。

骨固定式助聽器很適合單耳失聰的人。這類病人於聽電話，開會和在宴會或其他嘈吵的地方時，很難集中處理聲音。而骨固定式助聽器可以於失聰的耳那邊”捕捉”聲音，再透過頭骨傳送聲音到正常的耳朵，令病人可以再一次聽到立體的聲音。

而骨固定式助聽器另一項好處，就是可以讓病人先試用再考慮安裝。透過一條軟帶戴上頭部，便可試用骨固定式助聽器而不需任何手術。如覺得合適，可以繼續以接觸器傳遞聲音，或接受植入手術，將一個鈦金屬的固定器植入頭骨近耳背的位置。相比前者，後者免除了軟組織的阻隔，可以更直接地傳遞聲音。

植入手術是微創手術，手術時間需要約十五分鐘，可於一般耳鼻喉診所進行。

 

 

總結

失聰需盡快診斷，尤其是正處於言語發展階段的兒童。診斷後，耳鼻喉醫生便可針對不同失聰成因，利用藥物，手術或助聽器作出及時治療。

助聽器例如骨固定式助聽器、耳蝸植入手術，可以讓病人再次聽到聲音。雖然聲音未必如正常人一樣豐富，但已可改善生活質素，回復正常的工作及社交生活。

 

 

 

 

資料來源：　http://entific.com.hk/

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。

失聰治療 (Part2)

助聽器, hearing aid
失聰人士通常會選用助聽器，正如有近視或散光要用眼鏡矯正視力一樣。助聽器安裝不需施手術，而且所需價格相對便宜。病人可以按個人需要隨時配戴或移除。

巿面上有不同種類的助聽器，有不同的大小、品質、價錢等等。助聽器應為不同程度的聽力問題及不同需要的病人而度身定造。不過助聽器也有本身的問題，例如病人可能會覺得不舒適或儀器太明顯。尢其當助聽器有時帶來的好處不大明顯的時候。

傳統的助聽器要靠耳模密封耳道才有最佳效果，亦有病人會因此感到不舒服。而且任何微細的動作都會令助聽器移位，以致聲音漏出，再進入助聲器而變成回音。這種聲音跟唱卡啦ok時咪高風引發的回音很相似。

如果助聽器安裝妥善而合身，傳統的助聲器對於聽力減弱的人士是個不錯的選擇。

 

 

資料來源：　http://entific.com.hk/

 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。

失聰治療 (Part 1)

治療失聰方法取決於類別，位置及失聰的嚴重程度，需要由耳鼻喉醫生診斷。突發性失聰的治療已於前面介紹。

總括來說失聰治療有保守觀察，助聽器及/或耳部手術。對於有「中耳積水」的小朋友，尤其是影響到兩邊耳，及說話和專注力都有問題的兒童，可以藉着手術放入中耳導管。而患有耳膜破損的人，亦可以以外科手術修補耳膜。

對於雙耳完全失聰的人而言，耳鼻喉醫生會因應個別情況，建議植入人工耳蝸，以智能聲音處理器，配以電流，刺激失去聽力的。不過聲音與一般人聽到的會有所分別，所以他們需接受言語治療，重新學習聽到的聲音。研究指出兒童的腦部發展較成人靈活，因此他們適應新聲音的能力亦較高。

 

 

 

 

資料來源：　http://entific.com.hk/

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。

及早控制鼻敏感 保持生活質素

每逢轉季的時候，張小姐便會出現鼻敏感。通常是剛起床不久即出現鼻癢、流鼻水和打噴嚏，而連續的噴嚏令她感到頭昏腦脹，弄得整個早上提不起精神來。

鼻敏感的對象不分年齡，可分間歇性和持續性兩種。病徵持續出現少於四星期間歇性，多於四星期為持續性。成因多為患者吸入致敏原令鼻腔內的細胞受到刺激而釋出組織胺，引致鼻塞、鼻癢、打噴嚏、流鼻水等病徵持續出現。而致敏源多來自家居與生活環境，如塵蟎、寵物的毛髮皮屑、塵粒和二手煙等。

良好的家居衛生對治療鼻敏感非常有幫助，保持寢具與室內環境清潔可以減少致敏原出現。對於持續性的鼻敏感,第一綫藥物多處方無睡意抗組織胺藥物，再因應患者對藥物的反應與病情，考慮處方類固醇噴鼻劑。醫生亦會了解患者鼻敏感出現的模式，建議患者最佳受藥時間，減少感到需要長期服藥的心理負擔。

 

鼻敏感不是嚴重疾病，然而對學習生活或日常工作會帶來不便，所以，若持續出現鼻敏感病徵需考慮作詳細檢查，以降低學習與工作情緒受影響，或是社交生活裡帶來的尷尬情況。

 

資料來源: 健康動力; 黃德彰 耳鼻喉專科醫生

 

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。

Wrinkle Reduction Treatment (Commonly known as Botox) (Part 2)

Consultation and treatment 

During consultation a detailed medical history is obtained by your surgeon and assessment of the facial wrinkles is carried out to determine the exact areas of muscles that require the injection. An appropriate dose of botulinum toxin is then injected into the muscles using a tiny micro needle. Following the treatment with Botox, the skin over the muscles remains smooth and even. Injected muscles are paralysed in about 2-3 days while untreated areas continue to work as normal. As the needle used is very fine and small quantities are injected, the pain is minimal and therefore no anaesthetic is required. You may experience some discomfort over the treated area immediately after treatment. You may resume normal activities immediately however any strenuous activity and massaging the area should be avoided. You must follow the post injection instructions carefully to avoid any untoward effects. Some patients may experience mild headaches in the first week or so following the injection which resolve spontaneously, and the use of mild painkillers such as paracetamol is recommended to relieve the headaches.  

 

Reference information:  www.eafps.org/botox.html

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.

Wrinkle Reduction Treatment (Commonly known as Botox) (Part 1)

The gradual development of facial wrinkles is inevitable and generally represents the early sign of ageing. The most common areas of wrinkling include the forehead, the brows and the outer corner of the eyes (crow's feet). This is mainly related to muscle activity which can be effectively dampened by the use of botulinum toxin, which is a naturally occurring bacterial toxin. This type of treatment to paralyse muscles selectively and reduce wrinkles is commonly known as 'Botox' treatment. Botox is a trade name, and other similar preparations may also be used for this purpose. Botulinum toxin was initially used in the 1970s for treating patients with hyperactive muscles around the eyes. Currently, it is widely used for cosmetic reasons, such as wrinkle reduction and a wide variety of other medical conditions related to dysfunction of muscles.

 

Reference information:  www.eafps.org/botox.html

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.