Lawrence Chow / ENT Doctor
Desensitization Therapy: Retraining Your Immune System
Desensitization therapy is a long-term treatment approach that fundamentally alters the immune system’s response to allergens. Unlike medications (such as antihistamines or steroid sprays) that temporarily “suppress” symptoms, it acts like an immune coach, continuously “training” the body to shift from an overreactive state (attack) to immune tolerance (acceptance), ultimately achieving long-term relief or even a cure.
I. Core Principle: From “Attack” to “Acceptance”
Imagine the immune system as a highly alert army that mistakes harmless substances like pollen or dust mites (allergens) for dangerous enemies. Upon detection, it launches a fierce attack, triggering allergic symptoms.
Desensitization therapy works as follows:
- Start with a tiny dose: Introduce a minuscule amount of the “imagined enemy” (purified allergen extract) to the immune system.
- Gradually increase the dose: Allow the immune system to slowly adapt to the presence of the allergen and recognize it as non-threatening.
- Sustain maintenance: Administer long-term maintenance doses to solidify a state of “peaceful coexistence.”
During this process, the immune system undergoes tangible changes:
- Reduces the production of allergen-specific immunoglobulin E (IgE).
- Stimulates the production of immunoglobulin G (IgG4), a “blocking antibody” that acts like a shield. It binds to allergens in advance, preventing them from triggering IgE and mast cells, thereby stopping allergic reactions.
- Promotes the generation of regulatory T cells (Tregs), which effectively suppress excessive immune responses and maintain immune balance.
II. Treatment Process
The entire desensitization therapy course typically lasts 3–5 years and consists of two main phases:
- Dose Escalation Phase (Initiation Phase)
- Gradually increase the dose to help the immune system adapt until an effective and sustainable target dose is reached. This phase usually lasts 3–6 months.
Method 1: Subcutaneous Immunotherapy (SCIT)
- Weekly injections at a clinic.
- The dose is slightly increased with each injection.
- After each injection, the patient must be observed at the clinic for at least 30 minutesto monitor for acute allergic reactions (e.g., difficulty breathing, severe hives) and ensure prompt medical intervention if needed.
Method 2: Sublingual Immunotherapy (SLIT)
- The first dose is usually taken under medical supervision.
- Thereafter, patients can self-administer daily at home(tablets or drops).
- The medication is held under the tongue for 1–2 minutes for mucosal absorption before swallowing.
- The dose escalation phase is shorter, often completed within days or weeks.
- Maintenance Phase
- Stimulate the immune system with long-term “target maintenance doses” to consolidate and enhance tolerance for sustained effects. This phase is the core of the treatment and lasts 3–5 years.
Method 1: Subcutaneous Immunotherapy (SCIT)
- After reaching the target dose, injection intervals are gradually extended to once every 2–4 weeks.
Method 2: Sublingual Immunotherapy (SLIT)
- Patients must continue daily medication without interruption.
The success of the entire desensitization therapy highly depends on patient compliance. Interrupting or discontinuing treatment prematurely may nullify all progress, and the effects may not be sustained.
III. Applicability and Efficacy
Suitable for:
- Respiratory allergies: Highly effective against allergic rhinitis, allergic conjunctivitis, and asthma triggered by dust mites, pollen (grass, tree, weed), mold, or pet dander (e.g., cats, dogs).
- Insect venom allergies: Extremely effective (success rate >90%) for patients with severe allergic reactions to bee or wasp stings.
Less commonly used (still under research):
- Food allergies: Currently, only peanut desensitization therapy is approved. Treatments for other food allergies are mostly in clinical trials and must be conducted with extreme caution at specialized medical centers.
- Severe or uncontrolled asthma: Not suitable for this therapy due to the risk of triggering severe attacks.
IV. Potential Risks and Side Effects
Desensitization therapy is generally safe. However, since it involves active exposure to allergens, side effects may occur. These are generally categorized into local reactions (more common) and systemic reactions (less common but require vigilance).
Local Reactions
- Injection site: Redness, itching, induration (usually resolves within days).
- Oral/sublingual: Itching, mild swelling of the sublingual mucosa, throat discomfort (usually occurs shortly after administration and diminishes over time).
Systemic Reactions
- Symptoms may include widespread hives, asthma attacks, throat swelling, nausea, or abdominal pain.
- The most severe reaction is anaphylaxis, though it is extremely rare. This is why observation after subcutaneous injections and medical supervision during treatment are mandatory.
V. Efficacy and Important Considerations
Studies show that immunotherapy significantly alleviates symptoms, reduces the need for medication, and improves quality of life. Its effects can persist for years after treatment ends. For insect venom allergies, the efficacy rate exceeds 90%.
However, it may not work for everyone and requires considerable patience and adherence. Self-administration is strictly prohibited. Treatment must be guided and supervised by a physician to ensure safety and efficacy.
For assistance, please contact ENT Head and Neck Surgery Centre (Tel: 3100 0555), where our ENT specialists will provide detailed diagnosis and formulate a treatment plan for you.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Understanding Allergies: A Comprehensive Guide to Causes, Symptoms, Diagnosis, and New Treatment Hope
Allergies are an extremely common modern-day health issue, affecting hundreds of millions of people globally. Allergy sufferers often experience a significantly reduced quality of life: they may be unable to fully enjoy outdoor activities during spring blooms, may have to part with beloved pets, must carefully check food ingredients before eating, and could even face life-threatening anaphylactic shock from accidental exposure. Traditional treatments, such as antihistamines or nasal sprays, only provide temporary symptom relief without addressing the underlying cause—the immune system’s exaggerated response.
What is an Allergic Reaction?
An allergy is essentially a misdirection of the immune system. When the body mistakenly identifies harmless substances—such as pollen, dust mites, pet dander, or certain foods—as dangerous pathogens (like bacteria or viruses), it triggers a defense mechanism. This process involves the production of an antibody called Immunoglobulin E (IgE). IgE acts like an alarm, activating cells such as mast cells to release chemicals like histamine, which leads to classic allergy symptoms such as sneezing, runny nose, and itchy eyes. In short, an allergic reaction is an unnecessary “immune war.”
Symptoms of Allergic Reactions
Allergic symptoms vary widely in type and severity, depending on the allergen and the route of exposure:
Respiratory Allergies (e.g., Hay Fever, Dust Mite Allergy)
- Nose:Sneezing, runny nose (typically clear and thin discharge), nasal congestion, itchy nose.
- Eyes:Redness, itching, tearing, burning sensation (allergic conjunctivitis).
- Throat and Ears:Itchy throat, itchy palate, ear fullness.
Skin Allergies (e.g., Atopic Dermatitis, Hives)
- Skin:Rash, hives (wheals), eczema, intense itching.
Food Allergies
- Mouth:Tingling or swelling of the lips, tongue, or throat.
- Digestive Tract:Nausea, vomiting, abdominal pain, diarrhea.
- Skin:
- Severe Cases:May trigger a systemic allergic reaction.
Insect Sting Allergies (e.g., Bees, Wasps)
- Localized:Large areas of swelling, redness, and pain at the sting site.
- Systemic:May cause life-threatening anaphylaxis.
The Most Severe Reaction—Anaphylaxis
Anaphylaxis is a rapid-onset, whole-body, and potentially fatal allergic reaction. Symptoms include difficulty breathing, a sudden drop in blood pressure, dizziness, rapid heartbeat, swelling of the throat and tongue causing suffocation, confusion, and even loss of consciousness. This is a medical emergency requiring immediate use of an epinephrine auto-injector (EpiPen) and urgent medical care.
Causes of Allergic Reactions
Allergies typically result from an interaction between genetic and environmental factors:
- Genetic Factors:Children with one or both parents having allergies are at a significantly higher risk of developing allergies. This is known as an atopic
- Environmental Factors:
- Hygiene Hypothesis:Overly clean modern environments reduce early childhood exposure to germs and microbes, potentially preventing the immune system from being properly “trained,” making it more prone to overreacting to harmless substances.
- Allergen Exposure:Allergens present in living environments, such as dust mites, cockroaches, mold, and pollen.
- Air Pollution:Pollutants can worsen allergy symptoms and increase sensitivity.
- Dietary Habits:The timing and variety of early food introductions may also play a role.
Diagnostic Methods for Allergic Reactions
Effective treatment begins with accurately identifying the allergen. Doctors use the following methods for diagnosis:
Detailed Medical History:
A thorough discussion of your symptoms, their frequency, timing, location, and potential triggers is the first and most crucial step in diagnosis.
Skin Prick Test:
The most common test. A small amount of purified allergen extract is placed on the skin, and the surface is lightly pricked with a needle. If a raised, itchy bump (wheal) resembling a mosquito bite appears within 15-20 minutes, it indicates a possible allergy to that substance.
Blood Test (Specific IgE Test):
A blood sample is taken to measure the level of IgE antibodies produced in response to specific allergens. This method is suitable for patients who cannot undergo skin testing (e.g., due to severe skin conditions or antihistamine use).
Challenge Test:
Under strictly controlled medical supervision, the patient is exposed to a small amount of the suspected allergen (e.g., by inhalation or ingestion) to observe if a reaction occurs. Due to its higher risk, this test is only performed when necessary and under specialist care.
Allergy Treatment Methods and Process
Treatment can be divided into two main categories: symptom control and root-cause treatment.
Symptom-Control Medications:
Antihistamines, corticosteroid nasal sprays, and bronchodilators can quickly relieve discomfort but offer only temporary relief.
Root-Cause Treatment—Allergen Immunotherapy (Desensitization Therapy):
This is currently the only therapy that may fundamentally alter the course of allergic disease. It works by exposing the patient to gradually increasing doses of allergen extracts, starting from very low amounts, training the immune system to gradually “accept” the allergen instead of viewing it as a threat, thereby building immune tolerance. The process is akin to a long-term “reeducation of the immune system.” We will explore desensitization therapy in detail in our next article…
For assistance, please contact ENT Head and Neck Surgery Centre (Tel: 3100 0555), where our ENT specialists will provide detailed diagnosis and formulate a treatment plan for you.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Modern Treatment Options for Microtia and New Future Medical Perspectives
Microtia Classification and Symptoms
Microtia is not merely a cosmetic issue, its manifestations range widely from mild underdevelopment of the auricle to its complete absence. It is clinically classified into four grades:
Grade I: The auricle is smaller than normal, but key structures are visible. The ear canal may be narrow or affected by aural atresia.
Grade II: The auricle is partially developed, often hook-shaped or S-shaped. The ear canal is usually affected by aural atresia.
Grade III: Only a vertical remnant of tissue is present (often described as a “peanut” shape). The ear canal is completely affected by aural atresia.
Grade IV: Complete absence of the auricle, with no residual tissue (anotia).
Approximately 50-60% of microtia patients have associated ipsilateral facial underdevelopment, such as Hemifacial Microsomia. Bilateral microtia accounts for about 10-20% of all cases; these patients typically face more complex hearing challenges.
Treating microtia requires the involvement of a multidisciplinary medical team, including:
ENT (Otolaryngologist): Evaluates ear structure and hearing function.
Plastic Surgeon: Performs auricular reconstruction surgery.
Audiologist: Conducts hearing assessments (Audiometry) and provides rehabilitation guidance.
Speech Therapist: Assists with speech development training.
Psychologist/Therapist: Provides psychological support and counseling.
Microtia Diagnostic Process
Initial evaluation typically begins in infancy, including a detailed physical examination, hearing assessment (Audiometry), and imaging studies. Hearing tests may include Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAE) to determine the type and degree of hearing loss. Imaging studies such as CT scans help assess the middle and inner ear structures, providing crucial information for subsequent treatment planning.
Timing and Sequence of Microtia Treatment
Treating microtia is a long-term process, requiring planning based on the patient’s age and specific circumstances:
Infancy (0-3 years): The focus is on hearing management and language development. Children with bilateral microtia should begin using a bone conduction hearing device before 3 months of age. Unilateral cases require regular hearing monitoring. Early intervention is crucial for language development.
Preschool Age (4-6 years): Hearing management and speech therapy continue, while preparation for surgery begins. Discussing the treatment process with the child using pictures and models helps their understanding.
Optimal Surgical Age (6-10 years): By this age, the rib cartilage is sufficiently developed for grafting, and the auricle size is close to adult size. The child also has better psychological readiness and ability to cooperate. Treatment is divided into two main parts—auricular reconstruction and hearing reconstruction—which may be performed in stages based on patient needs.
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- 小耳症（Microtia）耳廓重建手術
Auricular Reconstruction
Primarily employs the following three methods:
Autologous Rib Cartilage Reconstruction: This method typically requires 2-4 stages.
Stage 1: An autologous rib cartilage graft is harvested, carved into a 3D ear framework, and implanted under the skin.
Stage 2 (6-12 months later): Lobule transposition and auricular elevation.
Stage 3: Tragus formation and detail refinement; possible adjustment of the contralateral ear for symmetry.
Advantages: Uses the patient’s own tissue, high stability, low infection risk, appearance becomes more natural over time.
Disadvantages: Multiple surgeries, chest wall scar, longer recovery.
Alloplastic Implant (e.g., Medpor Implant): Uses a synthetic framework.
Procedure: Typically requires 1-2 stages. The implant is placed and covered with a temporoparietal fascia flap, followed by skin grafting.
Advantages: Fewer surgeries, no rib cartilage harvest, no chest scar.
Disadvantages: Higher risk of infection and extrusion; stability may be lower than autologous grafts.
Prosthetic Ear: An option for patients unsuitable for or unwilling to undergo surgery.
Attachment: Can be adhered with medical adhesive or attached via osseointegrated implants.
Advantages: No surgery required, highly realistic appearance, removable.
Disadvantages: Requires daily removal and cleaning, periodic replacement, long-term cost.
Hearing Reconstruction
Most microtia patients have conductive hearing loss, often due to aural atresia. Hearing rehabilitation options include:
Canalplasty: Creates a new ear canal and reconstructs the eardrum and ossicular chain. Success rates vary, with a risk of restenosis.
Bone Conduction Hearing Devices: Traditional devices: Held by a headband or softband.
Bone-Anchored Hearing Aid (BAHA): A surgically implanted abutment connects to an external sound processor.
Softband devices: Suitable for infants/young children, no surgery required.
Middle Ear Implants: Such as the Vibrant Soundbridge, which directly stimulates the ossicles.
Postoperative Recovery and Long-Term Follow-up
Adequate recovery is needed after each procedure. Long-term follow-up includes annual assessment of the auricle’s appearance and stability, regular audiometry (hearing tests), and psychological support.
Expected Outcomes After Microtia Treatment
Improvements are expected in three key areas:
- Appearance: Outcomes vary based on the method chosen (autologous rib cartilage graft, Medpor implant, or prosthetic ear), each with distinct advantages and limitations regarding naturalness, feel, and maintenance.
- Hearing: Hearing can be partially improved with canalplasty or BAHA implantation, but typically not fully restored to normal levels.
- Psychological Impact:Improved appearance usually leads to significantly enhanced self-confidence and social engagement.
Future Perspectives and Emerging Technologies
The field of microtia treatment is continuously evolving. Research areas include tissue engineering (lab-grown cartilage), 3D printing for customized frameworks and surgical guides, and genetic studies on Microtia and Hemifacial Microsomia.
Conclusion: The treatment of Microtia is a journey requiring both patience and courage. However, with advancements in medical technology and the collaboration of multidisciplinary medical teams, patients can now achieve significant improvements in both appearance and functional recovery. It is crucial that treatment is tailored based on individual circumstances, family preferences, and professional medical advice to develop the most suitable personalized plan for each patient. For assistance, please contact ENT Head and Neck Surgery Centre (Tel: 3100 0555), where our ENT specialists will provide detailed diagnosis and formulate a treatment plan for you.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
The Unique Advantages and Benefits of Proton Therapy in the Treatment of Pediatric Head and Neck Cancers
In the previous article “Proton Therapy: Ushering in a New Era of Precision Cancer Treatment!”, we introduced the principles, advantages, applications, and future directions of proton therapy in cancer treatment. This article will focus specifically on the benefits of proton therapy for pediatric head and neck cancer patients.
Case Study:
“Xiao Yong, an 8-year-old boy, was diagnosed with rhabdomyosarcoma of the head and neck region, a rare and aggressive pediatric malignant soft tissue tumor with a high recurrence rate. Due to the tumor’s proximity to critical blood vessels and nerves in the neck, surgical resection was challenging and posed significant risks to the child’s growth and development. Therefore, doctors recommended a comprehensive treatment plan combining surgery, chemotherapy, and radiation therapy. Given the tumor’s location and the need to protect healthy tissues, proton therapy was chosen as the primary radiation modality. Xiao Yong underwent a 6-week proton therapy course. During treatment, he experienced no significant pain or discomfort. Post-treatment imaging showed significant tumor shrinkage with no new lesions detected. His neck function and appearance remained unaffected, and his quality of life was well-maintained.”
Xiao Yong’s case highlights the unique advantages of proton therapy in pediatric head and neck cancer treatment. Its precision and low side-effect profile enable effective tumor control while maximally protecting healthy tissues and organs, reducing long-term impacts on growth and development. Additionally, proton therapy allowed Xiao Yong to maintain a better quality of life during and after treatment. This case underscores the critical value of proton therapy in pediatric oncology, particularly for tumors in complex anatomical locations.
What Are the Specific Benefits of Proton Therapy for Pediatric Cancers?
Proton therapy offers several key benefits for pediatric cancer patients:
Minimized Damage to Developing Tissues
Children’s developing tissues and organs are more sensitive to radiation. Conventional radiation therapy may cause long-term developmental issues, but proton therapy leverages the Bragg Peak effect to concentrate radiation energy on the tumor, significantly reducing radiation exposure to surrounding healthy tissues.
Reduced Risk of Secondary Cancers
Children undergoing conventional radiation face a higher risk of secondary cancers due to radiation-induced genetic mutations in healthy cells. Proton therapy lowers this risk, enhancing long-term health outcomes.
Protection of Critical Organs
For brain tumors, conventional radiation can damage organs like the brain, eyes, and cochlea, impairing cognition, vision, or hearing. Proton therapy reduces such complications.
Preserved Quality of Life
Proton therapy’s milder side effects allow children to maintain normal daily activities and schooling during treatment, alleviating physical and psychological burdens.
Applicability to Diverse Pediatric Cancers
Proton therapy is effective for various pediatric cancers, including head and neck tumors, brain tumors, spinal tumors, retinoblastoma, and neuroblastoma.
Reduced Impact on Reproductive Systems
For prepubescent children, conventional radiation may harm reproductive organs. Proton therapy minimizes radiation dose to these systems, lowering future fertility risks.
Long-Term Follow-Up Feasibility
Proton therapy’s low toxicity enables safer long-term monitoring, allowing physicians to track health outcomes without concerns about treatment-related complications.
Synergy in Multimodal Treatment
Proton therapy integrates seamlessly with surgery, chemotherapy, and immunotherapy. For pediatric patients, such comprehensive approaches enhance efficacy while reducing overall treatment burden.
Conclusion
Proton therapy demonstrates remarkable advantages in pediatric cancer care, offering enhanced protection of healthy tissues, reduced long-term complications, and improved quality of life. These benefits ensure better long-term health outcomes for children. To learn more, please contact ENT Head and Neck Surgery Centre (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Proton Therapy: Ushering in a New Era of Precision Cancer Treatment!
In the long journey of cancer treatment, radiation therapy has always been an indispensable tool. However, traditional radiation techniques like X-ray therapy, while effective at damaging tumor cells, allow radiation energy to penetrate beyond the tumor, harming surrounding healthy tissues and leading to complications and side effects. With continuous advancements in medical technology, proton therapy has emerged as a cutting-edge radiation treatment, offering renewed hope to cancer patients through its exceptional precision and safety.
What is Proton Therapy?
Proton therapy is a type of particle beam therapy. By utilizing the unique physical properties of protons, it precisely calculates the depth and intensity of the proton beam to concentrate radiation energy within the tumor. The proton beam releases its maximum energy at the end of its range, forming a phenomenon known as the “Bragg Peak.” This ensures that radiation energy is delivered to destroy cancer cells and then dissipates immediately, sparing healthy tissues from damage. This approach maximizes protection of normal tissues and reduces the risk of complications and side effects associated with conventional radiation therapy.
Advantages and Limitations of Proton Therapy
The advantages of proton therapy lie not only in its high precision but also in its ability to preserve patients’ quality of life. Compared to traditional radiation therapy, proton therapy carries lower risks of both short- and long-term side effects, allowing patients to maintain their daily routines during and after treatment. Additionally, proton therapy causes less harm to developing tissues, making it particularly suitable for pediatric cancer patients and effectively lowering their risk of secondary cancers later in life. For tumors sensitive to traditional radiation, such as brain tumors and breast cancer, proton therapy has demonstrated enhanced safety and efficacy.
Which Cancers Are Suitable for Proton Therapy?
Proton therapy has broad applicability, covering various cancer types including brain cancer, head and neck cancers, lung cancer, liver cancer, breast cancer, prostate cancer, and more. It offers a safer and more precise radiation treatment option for both adult and pediatric patients. However, proton therapy is not suitable for all cancer cases (e.g., metastasized cancers). Physicians evaluate individual patient conditions to determine its appropriateness and effectiveness. Furthermore, proton therapy can be combined with other treatments—such as surgery, chemotherapy, and immunotherapy—to form integrated treatment plans, further improving outcomes.
Key Value and Future Directions of Proton Therapy
The proton therapy procedure is non-invasive and painless. During treatment, a specialized medical team uses positioning tools and supports to ensure patient stability, guaranteeing precision. Most treatment courses last several weeks, with sessions conducted five times per week, allowing patients to continue their daily lives. Despite its high safety and precision, proton therapy remains relatively costly, and accessibility is still limited globally. However, with ongoing technological advancements and broader adoption, proton therapy is expected to become more accessible and effective in the future.
In our next article, we will specifically explore the benefits of proton therapy for pediatric head and neck cancer patients.
For any ear, nose, or throat concerns, please contact ENT Head and Neck Surgery Centre immediately. Our ENT specialists will provide detailed consultation and treatment (Tel: 3100 0555).
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Minimally Invasive Tympanoplasty: An Expert Overview by Dr. Chow Chun-Kuen
Minimally Invasive Tympanoplasty: An Expert Overview by Dr. Chow Chun-kuen
The following content is excerpted from an interview with Hong Kong ENT specialist, Dr. Chow Chun-Kuen, explaining the principles and benefits of minimally invasive tympanoplasty.
Various conditions can lead to tympanic membrane (eardrum) damage, such as excessive force during ear cleaning or chronic otitis media. If not properly managed, these issues may result in eardrum perforation and potential hearing loss. Traditional eardrum repair procedures are often highly invasive and entail prolonged recovery times. However, a more straightforward minimally invasive tympanoplasty is now available; patients can undergo this procedure under local anesthesia and be discharged on the same day. Remarkably, even those with decades-old eardrum damage can experience significant auditory improvements post-surgery.
Eardrum perforations can cause symptoms like pus discharge from the ear, tinnitus (hearing noise), and inexplicable nasal airflow during exhalation—symptoms many patients tend to neglect. In 1999, Dr. Chow pioneered a simplified technique for eardrum repair using a minimally invasive approach through the outer ear canal to harvest a small section of muscle membrane for repairing the damaged eardrum.
Procedure Duration Approximately 45 Minutes
Patients undergo local anesthesia for this procedure which takes roughly 30 to 45 minutes to complete. The incision is minimal and located within the inner ear without requiring sutures as it naturally heals within two days post-operation—a stark contrast to conventional methods that involve making incisions behind the ear up to five centimeters long needing ten to twenty stitches along with general anesthesia and hospitalization for at least two days.
A Case Study
Mr. Cheung, who served in an executive role, encountered severe bilateral middle-ear infection due to polluted water exposure while swimming years ago coupled with improper use of over-the-counter ear drops causing both his eardrums’ rupture. After undergoing traditional surgery on his left ear twenty-five years ago where he recovered successfully; three years prior faced recurrent infections affecting his right ear leading him difficulty concentrating at work compounded by strenuous efforts needed for listening exacerbating fatigue levels significantly until opting for this advanced surgical method has progressively restored his hearing capacities encompassing perceiving stereo sounds too.
Absence of Adverse Reactions
Accordingly noted by Dr. Chow majority seek tympanoplastic owing chronic otitis media progressing acute states involving pus generation alongside occasional accidental puncture treatment inadequacy reaches beyond normal self-healing approximately spanning few months necessitating operative intervention promptly warned ignoring latent risks deepening untreated paths possibly culminating continuous vertigo episodes thus progressive deterioration optionally avoidable through prompt procedural recourses ensuring preserving optimized auditory functions future devoid adverse postoperative implications whatsoever additional constraints comprising extensive miniaturized perforations width narrowness preclude eligibility newer operant techniques deployed herein.
For details of our ENT services, diagnosis, and treatment, please consult our ENT specialist.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Patient’s Experience with Balloon Dilation of the Eustachian Tube
Eustachian tube dysfunction seriously affects the hearing of patients. Balloon dilation of the Eustachian tube is currently a widely respected treatment method. What are its advantages? What are the comments between doctors and patients?
This article is an interview with patients and doctors on this surgery with citations for your reference.
Doctor : The tube dysfunction is a problem that can affect the entire population. I think at some point everyone has experienced tube dysfunction as part of an infection and can therefore judge how it impairs upon both hearing and general well-being.
Patient : I constantly had ear pressure issues. I felt that I couldn’t hear conversations properly. My personal impression was that my hearing had greatly deteriorated. In my job, I have to take care of a lot of people, and that was no longer possible. It was also not possible for me to balance the pressure in my ears on an aeroplane. That was particularly awful for me. In larger groups, I felt that I was no longer able to process what was going on around me or follow conversations in a restaurant, for example.
Doctor : Balloon tube dilation has been available for a few years. In this context, a small balloon is inserted via the nose into the tube ostium and then the tube.
Patient : The ENT doctor found out that I had a ventilation problem in the tube. It turned out to be chronic otitis. I was recommended to have a ventilation tube inserted, which was then carried out in the ENT practice. The ventilation tube failed to bring the desired results. The complaints did not go away and I could still hear very little.
Doctor : We have been performing tube dilation for a good year. We treated our first patient in September 2013 and have been able to help a large number of people using this method since then. During the operation, the catheter is placed in the tube via the nose and dilation is carried out at 10 bar pressure for 2 minutes. In our clinic, we perform tube dilation in patients who suffer from chronic middle ear diseases and have developed hearing loss, hoping to eliminate these symptoms and avoid ear surgery.
Patient : In the ENT clinic, Professor suggested expanding the tube with a balloon.
Doctor : The operation itself always takes place under general anaesthetic. Tube dilation is a low-risk procedure that may provoke bleeding in the nasal mucosa, but this can be resolved very easily. There are no serious risks to expect.
Patient : I was able to leave the clinic 24 hours after the operation, without pain, freed of my problems. I was able to resume work immediately.
Doctor : The follow-up inspection is carried out regularly at six to eight weeks. Post-operatively, patients are instructed to safeguard tube ventilation by performing the Valsalva maneuver 20 to 30 times daily. In the Valsalva maneuver, the patient tries to inflate the tube opening by building up pressure in the nasopharynx and thus forcing air into the middle ear areas. It looks like this. I seal my nose and with my mouth closed I increase the pressure until it arrives in the middle ear. This is easy for a person who does not have a tube dysfunction, but for people with chronic tube dysfunction it is sometimes impossible.
Patient : The clinic recommended that I use the Valsalva method Valsalva, which I perform several times a day, so I always ensure that the tube is open.
Doctor : It varies from patient to patient as to how quickly success is achieved. We have some patients where tube ventilation is immediately restored after surgery and who report that they can hear better on the day of the operation.
Patient : For me it was a total improvement in my quality of life. After the procedure I felt that I had been given a completely new quality of life with which I am very satisfied.
Doctor : We often get the feedback that the patients are happier again, more optimistic and not so caught up in their ear problem.
Patient : The surgery took place a year ago. I am still satisfied and free of all complaints.
Doctor : This form of treatment has become well established in adults in recent years. In the future, I think it will probably also be extended to children who also suffer from chronic tube dysfunction. I can imagine that children too will benefit greatly from tube dilation in the future.
Did you find the information useful? If so, continue reading our ENT posts.
For details of our ENT services, diagnosis, and treatment, please consult our ENT specialist.
Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
Balloon Sinuplasty Procedure Performed In-Office
Balloon Sinuplasty is a new treatment for chronic sinusitis. Its basic principle is to place a balloon through a catheter at the opening of the sinus, and expand the opening through the balloon to facilitate sinus drainage. This article is an interview conducted by doctors for patients undergoing this surgery for your reference.
Doctor : A balloon sinuplasty procedure is an in-office procedure that we perform for patients that have either recurring sinusitis, chronic sinusitis, or recurring sinus headaches. It’s performed in the office as an outpatient awake with minimal to no recovery time. If an individual is having multiple sinus infections a year or a chronic sinus infection, meaning an infection that doesn’t resolve with multiple rounds of antibiotics, that’s the first step of determining candidacy for the procedure itself. The second criteria is their CT exam findings. So usually on the first visit or second visit, we’ll perform a sinus scan to sinus-related problems or potentially allergy-related issues as well. So using those two criteria really helps us define which patients will be a good candidate and which patients will have great success from doing the procedure.
The procedure is very simple. It’s usually performed in about a 45 minute to 60 minute time frame in the office. The patient is awake for it, which sounds scary to a lot of people, but in the hundreds of procedures we’ve done, patients have done very well with it. The first 30 to 45 minutes is limited to just numbing up the nose and it’s really a two-step process. The first thing we do is place a piece of cotton that’s coated in numbing medication on both sides of their nasal cavities. And then once that has a chance to set, we then do a numbing injection in their nose, which the patients don’t feel other than maybe a little tingly sensation. Once the anesthetization is complete, then we do the procedure, which lasts maybe 10 to 15 minutes. The procedure itself is really just a dilation of their sinus openings. So we use a balloon and it goes into the narrowed openings of their sinus cavities. Once that balloon is in place, then we inflate it for about 3 to 4 seconds and that expands or opens that sinus cavity up.
Patient : Good. We’re in perfect position here. You’re going to feel a little bit of pressure as we inflate. Go ahead and inflate.
Doctor : There’s usually two to three areas on each side of their sinuses that we dilate. And then once that’s completed, the procedure is done. And typically the recovery time is a little bit of headache for that first evening, maybe the next day, but a lot of patients are able to return to their work, their job, their normal activity that same afternoon.
Doctor : Are you feeling okay?
Patient : Yeah, it really wasn’t that bad.
Doctor : Okay. Great. So I’ll see you back next week and we’ll take a look in there and see how you’re healing. Okay. I’ll walk you up to the front.
Patient : Okay.
Doctor : My experience. And if you look at research across the country, it’s, it’s pretty well documented that the success rate is well above 90%. And I would say it’s even probably above 90% for our practice. We define success as a 85 to 90% reduction in the number of headaches and or sinus infections that that patient has having. Usually I’ll have patients follow up within one to two weeks after their procedure, and almost invariably they all come back with smiles on their face, let me know how much better their sinus issues are, how much better they feel. I’ve had some patients, well, they’ll go 20, 30 years with sinus issues, sinus headaches almost every day of their life, and then you’ll see them at that two-week mark, and some of them even with tears in their eyes are so happy because they’re able to now live without having daily headaches.
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Source:
HK ENT Specialist Ltd.
ENT Head and Neck Surgery Centre
For ENT Services, Audiology & Speech Therapy,
Sleep Disordered Breathing Management,
Hearing Aid Prescription & Medical Cosmetic Services
https://www.hkentspecialist.hk
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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。