Monday, July 29, 2013

垢多誤採耳驚變弱聽

十多年來的弱聽竟可復元?弱聽也能痊瘉?所指的是傳導性弱聽。這個真實個案是因錯誤採耳,把耳垢愈推愈入,令耳道受堵塞引致聽力下降,經醫生清潔耳道後,聽力自然恢復。不過,常言毋須清除耳垢,以免傷及耳道,究竟怎樣做才正確?
 

林先生現年二十四歲,約七、八歲時進行身體檢查,醫護人員指其左耳的聽覺較一般人為弱,可能受先天因素影響,於是他便認定自己是弱聽患者。一直以來,他亦有用棉花棒清潔耳朵的習慣。「我覺得最近兩、三年,聽力變得愈來愈弱,日常生活上也受到困擾,例如開會、工作時難以聽到同事說話,也試過於地鐵櫃位向工作人員購票增值時,隔着玻璃要靠對方口形辨識語句,或甚至在咀嚼時,完全聽不到同桌人的說話。前陣子再做聽力測試,醫生為我做了『頭骨震動』測試,發現聽覺神經沒問題,於是為我檢查耳道。醫生指我的弱聽是由於耳垢太多而造成,但我一直有定期用棉花棒清潔耳朵的習慣,醫生告訴我,正正是這個原因,把耳垢愈推愈深、愈積愈多。之後醫生為我清除了耳垢,感覺上聽力像強了十倍,現時弱聽已經完全康復。」



引致傳導性弱聽

  耳鼻喉專科醫生指,林先生這病例頗為常見。一般來說,弱聽分為兩種,一為「傳導性弱聽」, 另一是「神經性弱聽」 ,因耳垢而造成的弱聽屬於前者。何謂傳導性弱聽?耳朵主要分外耳、中耳及內耳三個部分,互相連接經過聽神經至大腦,構成人類的聽覺系統。聲音由外耳耳殼進入外耳道後,震動耳膜及中耳腔內三塊聽小骨,最後傳入內耳。內耳包括聽覺神經細胞、神經 及身體平衡神經組織。凡是因外耳及中耳出現問題,即聲音傳導受阻,如涉及內耳而與神經有關,即屬神經性弱聽。耳垢因積聚於外耳道,阻礙聲音傳送,所以屬於傳導性弱聽。檢驗傳導性或神經性弱聽,可通過空氣傳導和頭骨傳導兩種方法,進行純音頻率測試作檢定,若頭骨傳導聽力較空氣傳導聽力為強,即屬傳導性弱聽;要是兩者同等下降,即是神經性弱聽。白醫生指患傳導性弱聽人士,大部分都是因耳垢阻塞所致。



棉花棒愈推愈入
  林先生的情況由七、八歲開始,到二十四歲才發現真正原因,時間較長,但白醫生指這亦不足為奇。原因是一般來說耳垢不會影響聽力,患者未必察覺。耳垢是耳道內的分泌物,內含油脂與防菌酵素,能保護耳道皮膚。耳垢分泌腺集中在耳道入口附近,常積聚於耳道外圍。正常情況下,耳垢隨身體新陳代謝、又或者藉說話、咀嚼時的動作推送出來,不會輕易積聚在外耳道內。不過,由於林先生經常用棉花棒清潔耳垢,弄巧反拙地,將耳垢愈推愈入,經多年後耳垢積壓,阻塞耳道,令聲音傳導失效。

  由於耳垢積聚徵狀並不明顯,患者或長久以來適應了聽覺差的感覺,直至幾年至十幾年弱聽變得更嚴重時才發現。正常人能聽得清楚約十分貝的聲音,但假如患者約需要三十至四十分貝才開始聽到,便屬於輕度至中度弱聽,屆時亦會對日常生活造成影響,要於清除耳垢後聽力才可恢復。耳垢積聚過多或會引起其他問題:若皮膚屬油性,有較大機會造成慢性外耳道發炎,又或者入水後容易被細菌感染導致皮膚發炎,嚴重可致骨枯現象。如出現此情況,患者在清除耳垢後,要再經藥物治療,聽覺才會完全恢復。

  另外,白醫生再三提醒大家日常千萬別採耳,更加不要進行耳燭,因很易傷害耳道或耳膜,洗頭或游泳而令水入耳後,切勿用棉花棒採耳,應以毛巾吸乾水分,讓耳垢自然排出即可。另外,如弱聽來得非常突然,而非逐漸形成,有可能是突發性神經耳聾,應盡快求醫,以免病情加劇而導致永久影響聽力。



耳垢過多不適徵狀

  •早上起牀時感覺聽力特別差,過後又會回復平日的聽力。
  •游水或洗頭後,水浸入外耳道,耳垢吸水後膨脹致堵塞耳道,患者可能突然覺得聽力減弱,並出現耳痛或耳鳴,待乾爽後才回復正常。
  •通常為單一耳朵聽力有問題,較少為兩耳同時出現問題。
  •感覺聽力持續地差,而且愈來愈弱。
  






使用軟化劑

  醫生一般會為患者先以耳窺鏡檢查耳道,如發現是耳垢所致,專科醫生就會為病人以真空吸管吸走耳垢,若是普通科,或會用溫水將耳垢沖走。如較難處理,可用耳垢軟化劑幫手。軟化劑屬鹼性能將耳垢軟化,但白醫生提醒滴後千萬不要用耳挖來採耳,以免將耳垢推入或挖傷耳膜,讓耳垢自然排出即可。至於橄欖油,白醫生認為作用不大,使用軟化劑更為見效。

  1. 先清潔雙手,用藥棉清潔外耳。
  2. 把藥瓶握於手中數分鐘,使耳垢軟化劑接近體溫。
  3. 側臥在 上,將需要治療的耳朵向上。
  4. 將耳朵輕輕地向上及向後拉,將耳道拉直,按醫生指定的分量(約三至四滴),
                將耳垢軟化劑滴進耳道。
  5. 滴藥後將耳道入口的三角形軟骨按下,然後輕輕按摩約兩分鐘,
                再用毛巾按 耳朵然後慢慢起身。


  ■耳垢軟化劑一般可由醫生處方,或藥房有售。
  ■如小孩常嚷着游水後耳仔痛,有可能是耳垢太多之故。
  ■耳燭能否排毒,暫無科學根據。
  ■傳導性失聰患者,即使只為一塊玻璃之隔,已足以影響其聽力。
  ■耳朵分為外耳、中耳及內耳三個主要部分。
  ■弱聽檢查可通過空氣傳導和頭骨傳導兩種方法,進行純音頻率測試。







新聞來源:the-sun.on.cc/
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。

Monday, July 22, 2013

What is a rhinoplasty?






Rhinoplasty is an operation to improve both shape and function of your nose. The goal of the procedure is to make you happy with the way you can breathe through your nose and to make your nose look more pleasing and less conspicuous.

Should I, Should I not?
If you are unhappy about the shape or function of your nose, you may choose a surgeon from [link find a surgeon] for a consultation. The following points may help you to feel better prepared.

Is Rhinoplasty an operation to be afraid of?
No, life-threatening complications almost never occurr during a rhinoplasty. Surprisingly, in most patients a rhinoplasty causes very little pain after the operation. Of course you should be prepared for more or less swelling around the eyes for up to a week or so and breathing may not be optimal during this time. These inconveniences largely depend on the way your body reacts to the procedure and of course on the technique used by the surgeon and his or her skill. However, rhinoplasty is considered to be the most difficult of all plastic operations in the face and the risk of a result that is less than ideal is therefore higher than with other procedures.

How do I find the best surgeon?
An excellent result in a happy patient of course speaks for a good surgeon and you may rely on word of mouth advertisement. In addition, you should discuss your wishes in great detail and expicitely ask the surgeon about the chances of precisely obtaining the desired outcome. Don’t hesitate to ask how often the surgeon finds another operation necessary to obtain a satisfying result and what the conditions would be, should the need for a second procedure arise.

Remember that you may not require the most experienced surgeon if a simple procedure will satisfy your needs. Also note that even the most outstanding expert may have to redo an operation now and then. You will have found the right surgeon, if all your questions have been answered in a pleasant atmosphere of mutual understanding, if the surgeon precisely knows what you expect and you are well informed about the chances of getting the result you want.


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 specialist for diagnosis and treatment.
Reference information: www.eafps.org

Tuesday, July 16, 2013

Hearing aids

Reference information: www.entific.com.hk


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.






Reference information: www.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.

Tuesday, July 9, 2013

肥胖可損低頻聽力






肥胖不單導致糖尿病或心血管病,亦會影響聽力。美國哥倫比亞大學研究發現,肥胖年輕人血漿內可防炎症的蛋白質脂聯素水平低,導致內耳因發炎而受損,他們聽不到各種頻率聲音的比率較高,其中一邊耳朵聽不到低頻率的比率,是體重正常同輩的兩倍。聽力受損會影響他們對別人說話的理解力,情況令人擔心。


內耳受損所致
哥倫比亞大學耳鼻喉及頭頸外科對一千五百名十二至十九歲青少年進行研究,參加者需接受家訪,提供他們近期健康狀況和家族的醫療史、服藥情況、家人吸煙情況、社交生活和生活環境是否嘈雜等因素。

一般而言,聽不到二千赫茲(Hz)或以下的聲音,屬於低頻率聽力受損。肥胖青少年因內耳受損,失去感音神經性聽力,一般人聽到的聲音,他們都聽不到。研究發現,百分之十五肥胖青少年聽不到低頻率聲音,而體重正常青少年出現同類問題的比率只有百分之八。研究指出,不少肥胖人士能明白別人說話的意思,但在嘈雜或多人在交談的環境中,他們就難聽得清楚。

該項研究仍然繼續,直至參加者成年。負責研究的哥倫比亞大學教授建議將「肥胖損害聽力」加入肥胖對健康負面影響的名單中,促使各年齡組別人士控制體重。此外,日後的研究也需要從社交生活、學術表現、行為及認知能力等方面,了解年青人因肥胖影響聽力所帶來的影響。



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。
新聞來源: orientaldaily.on.cc/

Monday, July 1, 2013

骨固定式助聽器(BAHA)的嶄新應用




成功將骨固定式助聽器應用在受放射性治療影響的鼻咽癌患者

研究人員表示:裝置能提高患者的滿足感,改善生活質素,且帶來社會經濟效益
香港威爾斯親王醫院的醫生正進行一項試驗,將骨固定式助聽器直接、永久地植入耳朵後方的頭骨。結果顯示因併發症而導致聽力障礙的鼻咽癌患者,不但聽力明顯有改善,他們亦十分滿意助聽器的效果。

威爾斯親王醫院作為香港中文大學醫學院的教學醫院,自1996年便開始用骨固定式助聽器來幫助其他有聽力障礙的病人。但此乃首次將骨固定式助聽器應用在鼻咽癌患者身上,改善他們的聽力。眾所周知,鼻咽癌是南中國一帶常見的疾病。
骨固定式助聽器利用鈦金屬螺絲固定在耳後方的頭骨,助聽器擴音機放大的聲音經由鈦金屬螺絲及頭骨直接傳到耳蝸,不像傳統空氣傳導式助聽器般,聲音要經過外耳道,再透過鼓膜傳音傳至耳蝸。

負責是項臨床研究、隸屬威爾斯親王醫院耳鼻喉科的蘇明順醫生表示:「雖然研究證明放射性治療可有效地治療鼻咽癌,但也經常帶來一些副作用,如破壞耳朵一些脆弱的組織,導致不同種類的聽力障礙。」

蘇醫生續說:「放射性治療可能令一些鼻咽癌的康復者有耳流膿、耳道潰瘍或其他併發症,使配帶傳統空氣傳導式助聽器變得困難,甚至不能配帶。至今,配帶骨固定式助聽器的鼻咽癌患者均滿意其聽力效果。我們現正分析有關應用此裝置而得以改善生活質素的數據。」

參考資料: www.cuhk.edu.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。