Lawrence Chow / ENT Doctor
Physical and Mental Preparations for a Tonsillectomy
Tonsillectomy is a common procedure wherein the tonsils are removed through surgery. Keep in mind that as a surgical procedure, it isn’t to be undertaken without careful discussions between you and your ENT doctor. You will be considered a suitable candidate for a tonsillectomy if your tonsils are large, or if you have trouble breathing at night, or if you’re experiencing frequent throat infections.
Due to the fairly invasive nature of a tonsillectomy, you should be well-prepared for it physically and mentally. You will be put under general anesthesia, a slightly scary thing in itself, followed by the surgeon removing either both the tonsils or just the affected tonsil tissue.
Physical Preparations
Even if tonsillectomy is a fairly routine procedure, you must be relatively healthy for the surgery. Your surgeon will ask for physical and laboratory exams to be performed, which can take a day or two. These exams can include blood tests, such as a complete blood count, clotting factors and electrolytes, and checks for blood pressure and glucose levels.
Be honest about your medical history and other possible risk factors. If you have a bleeding disorder, your doctor may evaluate your suitability for a tonsillectomy, for example.
Depending on your response to the surgery, you may be sent home on the same day or spend a night at the hospital. In either case, you have to make arrangements for a family member or a friend to drive you home from the hospital.
A few more important things to consider as part of your physical preparations.
- Wear loose-fitting clothes before showing up to the hospital on your scheduled day for surgery. You should be able to change from your street clothes to a hospital gown easily. Don’t wear your jewelry and makeup but do take a shower.
- Stop eating and drinking at the recommended time, usually about 8 hours before the operation. For example, if your operation is at 8 a.m., you will be asked to fast starting at 12 midnight.
- Stop taking medications according to your doctor’s recommendations. These can include ibuprofen, warfarin and naproxen, which increases bleeding.
Your ENT doctor will give instructions on what to do before your surgery – follow them for best results.
Mental Preparations
Be honest about your mental health, too. This is because people with major mental health issues have to be further evaluated before surgery so as to decrease the risk of side effects and complications. People with depression and anxiety disorders, for example, are closely monitored, especially during the recovery period.
If you have concerns and questions about your scheduled tonsillectomy, you should discuss them with your surgeon. You will likely get the right answers, perhaps even be reassured about the safety of the procedure, and have your concerns addressed.
In the end, a tonsillectomy is an elective procedure. You may or may not choose to go through with it but it’s a decision best discussed with your ENT doctor.
For more details of the tonsillectomy, please consult HK ENT specialist (the professional ENT clinic centre).
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
What You Need to Know About Dupixent
Chronic sinusitis is a challenging medical condition that will require patience combined with prompt and proper medical intervention to completely resolve. The presence of nasal polyps aggravates the symptoms and, thus, make it even more challenging for your ENT doctor to treat.
Fortunately, there’s hope for people who suffer from chronic sinusitis with nasal polyps! Here are a few things that you should know about it.
Approved in 2019
The U.S. Food and Drug Administration (FDA) approved Dupixent (dupilumab) only on 26 June 2019. It was considered as the first treatment for chronic sinusitis with nasal polyps, particularly for adult patients. It’s used for inadequately controlled cases of the condition and, as such, can be prescribed along with other medical interventions.
But Dupixent isn’t a new medication per se. In fact, it was originally approved by the FDA in 2017 as treatment for inadequately controlled eczema in patients 12 years old and above. It was also approved in 2018 as an add-on drug for patients 12 years old and up who have been diagnosed with either oral corticosteroid-dependent asthma or severe eosinophilic asthma.
The approval for Dupixent’s use was granted to Regeneron Pharmaceuticals.
Decreases the Need for Oral Steroids and Surgery
By the way, chronic sinusitis refers to the prolonged inflammation of the sinuses and the nasal cavity. Nasal polyps are abnormal growths on the sinuses’ inner lining. In some cases, patients with nasal polyps may undergo surgery to remove them; nasal polyps can also result in loss of the sense of smell.
But surgery may not be necessary since Dupixent works by decreasing the size of the nasal polyps and lessening the nasal congestion. The medication may also reduce the need for taking oral and intranasal steroids, thus, relieving the symptoms.
In two studies about the safety and efficacy of Dupixent, patients who received it experienced significant reductions in the size of their nasal polyps and the severity of their nasal congestion. They also reported better smell ability as well as reduced need for oral steroids and surgery.
Dupixent isn’t an over-the-counter medication that can be taken orally. Your ENT doctor will inject it into your body, a mode of administration that increases its efficacy.
Side Effects Are Possible
Like most medications, Dupixent can cause serious allergic reactions in susceptible individuals. These side effects include:
- Redness
- Itching
- Pain
- Changes in vision
- Conjunctivitis, or inflammation of the eye
- Keratis, of inflammation of the cornea
- Inflammation of the eyelids, which may or may not be accompanied by itching, swelling and redness
If you experience any of these symptoms, you should immediately consult with your doctor and/or your ophthalmologist.
Extremely Important: If you receive Dupixent, you shouldn’t receive live vaccines.
Lastly, Dupixent isn’t the be-all and end-all of treatment for chronic sinusitis with nasal polyps. Your doctor may also prescribe other medications like antibiotics and antihistamines.
For more details of chronic sinusitis with nasal polyps and their treatment, please consult our ENT doctor.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
The Stages of Nasopharyngeal Cancer and Their Treatment Options
Nasopharyngeal cancer (NPC) can be cured but, as with all types of cancer, early detection and treatment are key to excellent prognosis. The types of treatment will vary depending on the stage of cancer; stage refers to the extent of cancer in the affected area and its spread to the surrounding areas. Emphasis must also be made that oncologists typically treat NPC in children and adults in nearly the same manner.
If you have NPC, you and your ENT doctor will discuss the best treatment protocol for your case. Your treatment protocol will likely be unique because your age, physical condition and medical history, among other factors, will be considered.
For Stages 0 and I
At these stages, the cancerous cells haven’t metastasized or spread to the lymph nodes. The typical treatment for Stages 0 and I is radiation therapy specifically targeting the tumor.
But even as the cancer hasn’t spread to the healthy lymph nodes around it, these lymph nodes in the neck will likely be subjected to radiation therapy. Known as preventive radiation, it’s necessary to remove undetected cancer cells in the lymph nodes. Otherwise, these cancer cells can grow and spread to the surrounding tissues.
For Stages II, III, IVA, and IVB
At these stages, the tumor cells have spread beyond the nasopharynx possibly in the lymph nodes either above the collarbone or in the neck. This means more aggressive treatments to kill the cancer cells while, hopefully, keeping the surrounding healthy tissues as healthy as possible.
The typical treatment protocol at these stages include:
- Chemoradiation, or chemotherapy combined with radiation therapy, aimed at the nasopharynx and affected lymph nodes. Cisplatin is the common drug used and it’s sometimes combined with another drug.
- Chemotherapy comes next, usually a combination of cisplatin and 5-FU.
Unfortunately, chemoradiation and chemotherapy may kill the cancer cells but these are aggressive treatments with side effects. You should discuss these side effects with your ENT doctor as there are interventions to decrease their impact on your quality of life.
Your ENT doctor may also consider other treatment protocols. These include induction chemotherapy and chemoradiation in tandem, immunotherapy either on its own or with chemotherapy, or chemoradiation after the chemotherapy with cisplatin and 5-FU.
If deemed necessary, you may also undergo surgery to remove the affected lymph nodes after these treatments have been performed.
For Stage IVC
With Stage IVC NPC, the cancer can be harder to treat. The treatment protocol will depend on your doctor’s professional judgment, but it can be a combination of chemotherapy, radiation therapy and immunotherapy.
Cancer in any form isn’t easy but with modern medical treatments and technology, there’s hope for a remission. It’s vital to know your treatment options, discuss them with your doctor, and adopt healthy lifestyle habits – the healthier you are even with cancer, the better your prognosis.
For more details of diagnosing nasopharyngeal cancer and their treatment, please consult our ENT doctor.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
The Difference In Symptoms Between Allergies and Coronavirus
2020 hasn’t been good so far and the Covid-19 pandemic is undoubtedly the foremost reason for it. For people who suffer from allergies, it can be more stressful for many reasons. The symptoms of allergies and coronavirus may seem similar while people with allergies have higher risk for contracting respiratory illnesses because of their compromised health.
But there’s little reason to worry because the symptoms of allergies and coronavirus are different! Of course, it’s vital to protect yourself and your family and friends against contracting the coronavirus. These protection measures include frequent hand washing, using a face mask in public, and covering your nose and mouth when you sneeze or cough.
Common Symptoms of Allergies
According to the American College of Allergy, Asthma, and Immunology, allergies usually occur when a susceptible person’s immune system overreacts to things that are harmless for others. These things, known as allergens, include ragweed, pollen and grass, thus, the increase in allergy attacks.
The immune system’s overreaction results in the following symptoms of allergy:
- Stuffy nose, runny nose and/or sneezing
- Dry cough
- Shortness of breath or wheezing
- Fatigue
- Rashes
- Headache
- Puffy, watery and/or itchy eyes
- Itchy throat, nose and ears
Many people with allergies will understandably be worried since many of these symptoms have also been identified as coronavirus symptoms.
Common Symptoms of the Coronavirus
Take note that scientists are still finding out new information about the coronavirus and Covid-19. But they know that these are the three main symptoms of Covid-19. (The U.S. Centers for Disease Control and Prevention also pointed out these symptoms)
- Fever
- Dry cough
- Shortness of breath
According to the World Health Organization (WHO), there are also less common coronavirus symptoms that doctors and individuals should be aware of. These include nasal congestion, body aches and pains, sore throat, diarrhea and/or runny nose.
And this is where the anxiety starts for many allergy sufferers. There are more than a few symptoms shared by allergies and coronavirus infection – dry cough, shortness of breath, and runny nose, for example.
But there’s also something that differentiates seasonal allergies from coronavirus: Fever. Even the worst allergy attack will not bring on the body’s fever reaction but most Covid-19 patients exhibit fever as among their first symptoms.
There are also other major distinctions between the two conditions. First, coronavirus doesn’t bring on itchiness while allergies certainly will cause it. Second, people with allergies are more likely to experience worse nasal issues than people with the coronavirus, although both can experience sneezing.
There’s also the more serious matter of allergies being non-contagious and the coronavirus being extremely contagious. People with allergies can go about their business in public without fear of infecting others but this isn’t the same for Covid-19 patients.
If you would like to learn more of our ENT services, diagnosis, and treatment, please consult our ENT specialist.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Dealing with Allergies in the Time of the Coronavirus
It’s quite unfortunate that allergy season is already in full swing at the same time as Covid-19 continues to take lives. Many people who experience allergies at this time of the year may be more anxious about their symptoms for this reason.
Are you one of them or you know somebody in these shoes? Your anxiety is justified, in a way, because allergies can have an impact on the overall health of your respiratory system. You may even be at greater risk of getting the coronavirus because your respiratory system is more fragile.
But before you succumb to panic, here are a few things that you should know to keep your wits about you.
Keep Your Lungs Healthy From the Start
If you have had allergy attacks at this time of the year before, then you will likely still get them in 2020. You should then start taking precautionary measures now so that your lungs will be remain healthy. You can talk to your ENT doctor about starting early on your medications, perhaps changing them to account for the new threat.
The earlier you start on your anti-allergy medications, the less likely you will experience the symptoms. Your body’s immune system isn’t sent into overdrive fighting the inflammation caused by allergens and, thus, it has less mucus production. The common medications include nasal steroids and antihistamines, which are prescribed as a way to control the symptoms of an allergy attack.
Of course, you should minimize your exposure to the allergens that trigger your symptoms. Since this is the time of Covid-19, you have to adopt the preventive measures recommended by WHO and other medical experts. These include practicing good hygiene including washing your hands frequently and social distancing.
Keep Calm and Carry On
Unless you have been exposed to people carrying the coronavirus or people diagnosed with Covid-19, you have to keep calm if your allergy symptoms seem to have returned. You may or may not have the coronavirus but it’s important to keep calm, seek testing and medical treatment, if needed, and protect others.
There are also cases when an allergy attack happens for the first time in adults. Again, don’t panic as it’s actually common for adults who have never experienced allergies to have them in later life. The adult-onset allergies may likely be due to higher levels of pollution and declining immune system function.
The bottom line: There may be no effective vaccine and treatments yet for Covid-19 but there are treatments that will address your allergies. Get control on what you can and let the medical experts find the solution to the current pandemic.
For details of the ENT services, diagnosis, and treatment, please consult our ENT doctor.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Turn Off the Post-nasal Drip With These Effective Methods
The mucus running down your nose isn’t just inconvenient since it requires constant wiping, but it can also be embarrassing. Plus, it’s another symptom of a cold, or allergies or flu that makes your life less happy, perhaps even add to your anxiety about a more serious illness.
You may have to see your ENT doctor for a medical evaluation in case your post-nasal drip symptoms aren’t resolved in a few days. But in the meantime, you may want to adopt these easy yet effective methods to turn off the tap, so to speak.
Limit Your Allergen Exposure
Allergies are among the more common causes of post-nasal drip. If you have post-nasal drip and a feeling of itchiness, then you’re likely having an allergy attack. This is because the allergy cells in your body release histamine that, in turn, causes itchiness.
- Use HEPA filters and dust mite covers in your home. These will decrease your exposure to allergens floating in the air and on your upholstered furniture including your mattress.
- Wash your bed linens in hot water as frequently as possible.
- Keep your pets outdoors since their hair and dead skin cells can cause allergies.
- Get rid of items in your house that can collect dust, such as carpets and rugs, even old books and magazines.
Watch What You Eat
Gastrointestinal reflux disorder (GERD) can cause post-nasal drip and can be triggered by eating fried and fatty food as well as chocolate, alcohol, coffee, soda and citrus fruits. If your post-nasal drip occurs after eating these food, then you may have to limit, if not stop, eating them.
You should also consider eating smaller yet more frequent meals, as well as eating more whole grains, lean meats and ginger. You will be healthier for it, too!
You may also benefit from reducing your intake of dairy products. These include cheese, milk and yogurt, although you can still enjoy them in limited amounts.
Rinse Your Sinuses
This works because it removes the allergens and irritants lodged in your nasal passages. The less irritants, the less irritation and the less drip since your body doesn’t have to produce as much mucus to get rid of them.
Rinsing your sinuses is as easy as pie, too! You can either use a homemade rinse or buy pre-packaged saline solutions. For a DIY solution, you can use distilled water, boiled water that has been cooled afterwards, or filtered tap water.
Steaming is also an effective way to rinse out your nasal passages and loosen mucus from your throat. You can fill a pail or large bowl of hot water, add two drops of eucalyptus oil, and place a towel over your head while inhaling the steam. You can do this for 10 minutes at a time, 2-3 times a day.
Your ENT doctor can also recommend medications but these tips will improve your condition, too. Think of it as a wholistic approach to becoming better sans the post-nasal drip.
For details of our ENT services, diagnosis, and treatment, please contact us.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Lost Your Sense of Smell? It May Not Be Coronavirus!
Do you feel like you’ve suddenly lost your sense of smell and you’re now panicking? Perhaps you think that it’s the coronavirus because you’ve read reports on social media about Covid-19 patients losing their sense of smell. Perhaps you believe that you now have Covid-19, thus, the panic.
But don’t jump into conclusions! While there are, indeed, an increasing number of reports about Covid-19 patients losing their sense of smell, known as anosmia, these are just anecdotal evidence. Scientists aren’t sure yet whether there’s a connection between anosmia and Covid-19.
Contrasting Opinions from the Experts
The American Academy of Otolaryngology-Head and Neck Surgery suggested that anosmia can be used for screening new Covid-19 cases. It based its suggestion on reports that Covid-19 patients didn’t have noticeable symptoms but their sense of smell was either significantly reduced or completely lost.
But there are opinions to the contrary from other medical experts. The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC), for instance, haven’t added anosmia to their Covid-19 list of symptoms. These organizations also said that the simple loss of smell isn’t sufficient reason to make a definitive diagnosis of coronavirus.
Common in Viral Infections
It should be noted that in numerous studies, up to 40% of people with the common cold and flu, among other viral infections, experience temporary anosmia. This is also the case among people with allergies, partly because of the runny nose. But it’s usually resolved within a couple of weeks or so.
About 3% to 20% of the general population are known to experience prolonged smell disorders. These disorders are more common among older people because of underlying medical conditions and history. These include severe head trauma, nasal polyps and neurodegenerative diseases.
But it’s too early to tell whether anosmia is, indeed, a Covid-19 symptom. One of the reasons is that the connection is based on anecdotal reports instead of scientific studies conducted over the long-term period. There’s also the matter of people confusing the loss of the sense of smell and taste since these are closely intertwined.
A British study was conducted wherein the researchers used an online app to collect data on Covid-19 symptoms from 579 patients. Their conclusion: Nearly 60% of the surveyed patients reported losing their sense of smell and taste. But about 18% of 1,123 people who tested negative for the coronavirus also reported the same loss!
The bottom line: While we are all concerned about the spread of the coronavirus in the United States and the world, we should keep calm and seek medical attention, when needed. If you lost your sense of smell, it may or may not be a cause for concern and only your ENT doctor can give a definite answer.
Seek medical attention if it continues to be bothersome to you or your family members. Otherwise, you may want to stay home and follow the shelter-in-place order, especially if you don’t have fever, dry cough and shortness of breath.
For details of the ENT services, diagnosis, and treatment, please consult our ENT doctor.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Who’s Likely to Get Throat Cancer?
Throat cancer is a scary ENT disease, not only because it’s the Big C but also because it can take away the capacity to speak! Take note that it occurs in the pharynx (throat) as well as in the larynx (voice box) or in the tonsils, all of which are important in the generation of sound.
Some people have higher risk for getting throat cancer. Let’s take a look at these risk factors as well as the symptoms of this ENT disease to look out for.
Risk Factors
Keep in mind that belonging to one or more of these risk factors doesn’t automatically mean that you will get cancer, 100%. Instead, these factors will increase your risk of getting the Big C because of the accumulated damage inflicted on the throat.
- The use of tobacco products including chewing and smoking tobacco because it has nicotine and other substances that compromise the health of the tissues in the throat.
- The excessive use of alcohol because of its adverse effects on the body, especially over a prolonged period.
- The presence of the human papillomavirus (HPV), a sexually transmitted disease, has also been shown to increase the risk of throat cancer.
- The untreated diagnosis of gastroesophageal reflux disease (GERD) has also been shown as a risk factor in throat cancer.
Surprisingly, a diet with insufficient amounts of fruits and vegetables can also increase the risk of throat cancer! But this may not be surprising considering that a healthy body and, thus, a healthy immune system may decrease the risk of getting any type of cancer.
Signs and Symptoms
The specific location where the malignant growth occurs largely determines the symptoms that can be experienced. There’s also the matter of lumps in the neck or throat being an indication of an upper respiratory infection. The lumps may be caused by enlarged lymph nodes fighting off the infection, such as strep throat, followed by their return to their normal size once the infection clears.
But if a lump persists without the presence of an infection or even after the infection has been treated may be a warning sign of cancer. The lump may or may not be accompanied by a thickness or swelling in the neck.
If you have the following symptoms along with a lump in your neck, then you should seek your doctor’s opinion. Early diagnosis and treatment is key in successfully overcoming throat cancer.
- Difficulty in swallowing that persists for a few weeks without reasonable cause
- Vocal changes like hoarseness
- Feeling of food being lodged in the throat even after swallowing
- Persistent sore throat
- Mouth sores that either doesn’t heal with medication or easily bleeds
- Red- and white-colored patches on the tongue, inside of cheek and/or gums
- Feeling of numbness in the mouth or tongue
- Chronic nasal congestion
- Pain in the ears
Your ENT doctor will perform a series of diagnostic tests to determine the underlying cause of your symptoms. Keep calm, nonetheless, as throat cancer has several effective treatment protocols when administered properly and promptly.
Since ENT problem is quite different from case to case, it is suggested to consult an ENT doctor for the appropriate ENT services and treatment.
Source:
HK ENT Specialist Ltd.
Hong Kong based ENT clinic centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
註: 本站無論中文繁體，中文簡體和英文內容所提及的疾病和治療方法僅供讀者參考，並不代表本站推薦該種療法，亦不能代替專業醫生診治，讀者如有需要，應該尋求專業醫生意見或聯絡香港耳鼻喉專科。
另所有文章內使用的人名均為化名。
另所有文章內使用的人名均為化名。