Lawrence Chow / ENT Doctor
Interesting Findings About Microtia That Pregnant Women May Want to Know
Pregnant women typically seesaw between being happy about their unborn babies and worrying about their babies’ health. Their concerns aren’t unfounded considering that congenital defects form within the womb, and these congenital defects can range from physical abnormalities to mental retardation.
Among these physical abnormalities are undeveloped external ears, a condition known as microtia. But it isn’t just the atypical size and shape of the earlobes that characterize microtia – it’s also characterized by hearing loss.
Are you intrigued by microtia yet? If you are, you will find these interesting findings about microtia in unborn babies and infants.
Its Cause Remains a Mystery
Scientists have yet to identify a specific cause of microtia. But there are a few theories including malfunctions in a gene located in chromosome 22.
The interplay of genetics and environment in the development of microtia in the womb is also not fully understood yet. In current medical literature, between 3 and 34 percent of patients with microtia have a genetic component.
Scientists, nonetheless, have confirmed that neurofibromatosis Type 2 (NF2), an autosomal dominant disorder, is a risk factor in microtia. If one parent has NF2, his or her children will have a 50-50 chance of getting microtia.
Yet another possible, but unconfirmed risk factor, is the use of isotretinoin, an anti-acne medication. Isotretinoin (Accutane) can result in a pattern of congenital defects believed to be a combination of genes and environmental factors.
It’s More Common in Some Areas
There are no generally accepted theories for why microtia has a higher incidence rate in Latin America, particularly Ecuador, and Asia than in other areas of the world. If you are in these areas, you may want to talk to your doctor about decreasing the risks of your unborn child getting congenital defects.
Boys also seem to be more affected by microtia than girls although both genders will experience similar signs and symptoms. The right ear also seems to be more affected than the left ear, but a small percentage of children with microtia will have it in both ears (i.e., bilateral microtia).
It Can Occur with Other Conditions
Microtia can also occur with other distinct medical conditions. The three more common conditions are:
- Treacher Collins syndrome (TCS) is a genetic disorder characterized by physical abnormalities eyes, ears and cheekbones, as well as the chin.
- Hemifacial microsomia (HFM) is a congenital disorder affecting the proper development of the ears, mouth and mandible.
- Goldenhar syndrome causes physical defects in the face and head. It’s a rare congenital disease.
There are also maternal behaviors and conditions that can increase the risk of microtia in unborn babies. Women with diabetes before their pregnancy have been shown to have higher risk compared to women without diabetes. Pregnant women on a diet characterized by low levels of folic acid and carbohydrates also seem to have an increased risk for their babies developing microtia.
If you would like to learn more about microtia and its treatment, please consult HK 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
Microtia and Surgery: The Reasons for Their Popularity Among Parents
Parents of children with microtia often choose surgery for their offspring. This isn’t surprising considering that microtia has physical and psychological impact on affected children. Parents being parents, they want to minimize the negative effects of microtia on their children.
Take note that microtia is a congenital deformity characterized by an underdeveloped external ear. Just as there are variations in size and shape in developed ears, there are also wide variances in microtia. Nonetheless, most children with microtia have moderate to severe conductive hearing loss due to the abnormalities in the outer ear.
Even with the risks including side effects and complications of microtia surgery, most parents of children with the condition opt for it. Here are two of the common reasons.
Social Interactions
Studies have shown that children with hearing impairments are more likely to have lower self-esteem and self-confidence. This is worsened by the visible signs of the hearing loss, such as in the case of microtia.
Their lower levels of self-esteem and self-confidence are attributed to their decreased ability to communicate with others. The inability to hear sounds and voices make them less able to recognize auditory cues and make appropriate responses. With these disabilities, they feel more isolated and less included in the everyday activities of their family and friends.
Their feelings of isolation become more pronounced in schools. Typically, school-age children with hearing impairments are either placed in a different class for the entirety of the school day or separated for part of the day in special education classrooms.
Even at home, children with hearing impairments can experience stress from their parents and siblings for the same reasons. They may feel isolated from certain activities, perhaps feel discriminated against even when there isn’t an intention.
With surgery, fortunately, children with hearing loss issues have the opportunity to be part of the hearing world. By opening up their hearing, so to speak, their social interactions with family and friends will blossom. In time, their self-confidence will increase – and that’s what parents who choose surgery for them want to happen.
Aesthetic Appearances
The more common reason for parents choosing surgery for microtia for their kids is to improve the appearance of their external ears. Unfortunately, children without a visible external ear or an abnormal external ear are likely to be ridiculed and bullied by their peers. Even their parents can be subjected to weird looks and awkward questions, if not rude comments, from others!
The stress of dealing with the stares, questions and comments, even the bullying, can really take its toll. Parents then are justified in their choice to ask their children’s pediatricians for surgical options to correct the abnormal ears.
The bottom line: If you are a parent with a child diagnosed with microtia, you are well-advised to explore the treatment options for the condition. Your child deserves it and you will breathe easier for it, too.
For details of the ENT services, diagnosis, and treatment, please consult HK 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
Are You At Risk for Acoustic Neuroma?
Acoustic neuroma is a non-cancerous tumor in the vestibular nerve connecting your inner ear and brain. While it will not kill you, per se, it will cause a wide range of symptoms like headaches, nausea and loss of balance and coordination when it’s large enough. These symptoms are due to the fact that the branches of the vestibular nerve have a direct influence on hearing, balance and coordination.
If it’s any consolation, acoustic neuroma isn’t a contagious disease. You won’t get it by sitting next to a person with it, not even by sharing utensils and a bed. But it’s also important to know the risk factors so you can decide to seek medical opinion in case you have the symptoms.
Risk Factors Explained
Emphasis must be made that risk factors refers to the characteristics, bahaviors and conditions that increase the likelihood of getting a specific illness or injury. The presence of one or more risk factors doesn’t automatically mean getting the illness or suffering from the injury 100%.
For example, a risk factor for lung cancer is the use of tobacco products, particularly smoking cigarettes. But it doesn’t mean that every smoker will be afflicted with lung cancer! It only means that there’s a higher risk for smoker to get lung cancer.
Risk Factor for Acoustic Neuroma
With that being said, scientists have identified a single risk factor for acoustic neuroma: neurofibromatosis Type 2 (NF2). There may or may be other risk factors but NF2 is the only confirmed risk factor, for now. There’s also the matter of NF2 only accounting for around 5% of cases.
NF2 is characterized by the development of benign tumors on the balance nerves that, in turn, affect balance and coordination in the affected person. This is an autosomal dominant disorder, a mutation passed on by a dominant gene of an affected parent. As such, a child with a parent affected by NF2 has a 50-50 chance of getting it through genetic inheritance.
This means that the genetic lottery can swing either way. You can inherit the malfunctioning gene located on chromosome 22 or you don’t have it.
Normally, said gene on chromosome 22 produces a protein that suppresses tumor growth. This tumor suppressor protein aids in controlling the abnormal growth of Schwann cells on the balance nerves.
At present, scientists have yet to determine why and how the gene malfunctions. For this reason, there’s usually no identifiable cause for acoustic neuroma.
If one of your parents has NF2, you may want to look out for possible signs and symptoms of acoustic neuroma. You won’t immediately feel these signs, however, as these are usually subtle and take years to develop.
But if you experience gradual or sudden hearing loss, either in one or both ears, tinnitus, loss of balance and/or dizziness, you should seek medical opinion for your ENT specialist ASAP.
For details of the ENT services, diagnosis, and treatment, please consult HK 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
Untreated Acoustic Neuroma Can Result in Death
Acoustic neuromas are typically benign and, thus, don’t require aggressive treatment. This is usually the case with small acoustic neuromas showing little to no signs of growth or resulting in little to no signs. You and your ENT doctor will likely just monitor it through regular hearing and imaging tests to make sure that it won’t affect your health.
But there are also cases when an acoustic neuroma can be fatal, if and when it’s left untreated after diagnosis! You and your doctor have to discuss your treatment options so that your life isn’t in danger of being prematurely snuffed out.
Why It Can be Fatal
Keep in mind that an acoustic neuroma is a tumor, an abnormal growth in the small canal linking the inner ear to the brain. If said tumor keeps on growing, no matter how slowly it may be, it can expand into the skull activity.
The growing acoustic neuroma can squash the tissue at the base of the brain and the brain stem. The brain stem regulates consciousness, heart rate and breathing, among other life functions. As the brain tissue and brain stem are being squashed by the tumor, their functions are being compromised.
Take note that there can be a build-up of cerebral spinal fluid (CSF), too, a condition known as hydrocephalus. The excessive pressure can damage brain tissues and cause impairments in brain function, as well as observable symptoms like headaches, impaired vision and loss of balance, even mild dementia.
If the tumor isn’t treated, it will adversely affect blood pressure, breathing and consciousness, too. Think of it as suffering from a slow death, which can be prevented with prompt and proper treatment.
How It Can be Treated
The type of treatment for an acoustic neuroma varies depending on its size and specific location. Your overall health as well as your medical history and physical symptoms will also be considered in deciding the treatment protocol. You doctor will consider one or more of these treatments.
- Surgery
Your surgeon will remove the tumor from the small ear acanal and its surrounding area so as to stop its growth. But it isn’t just tumor removal at stake here. Your doctor will also work toward preserving your hearing and facial nerve. You should still have control over your facial muscles instead of suffering from facial paralysis.
Like all invasive surgery, there are complications to the removal of an acoustic neuroma. These can include facial numbness or weakness, balance issues and hearing loss.
- Radiation therapy
Known as stereotactic radiosurgery, it’s usually recommended for small tumors less than 3 centimeters in size. It’s also a common option for older adults and for people who aren’t suitable candidates for surgery.
In both surgery and radiation therapy, your ENT doctor will recommend supportive therapy. You may even be recommended for hearing aids or cochlear implants to restore your sense of hearing.
For details 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
What Are Your Surgical Options for Dysphagia?
In some cases, surgery is a must in addressing dysphagia, a condition characterized by persistent difficulty in swallowing. Surgery is usually recommended when the underlying cause is GERD, pharyngoesophageal diverticulum, throat blockages, achalasia, or esophageal cancer.
The type of surgery will depend on the underlying cause. Furthermore, speech and swallowing therapy will likely be recommended after recovery from surgery. Here are three options that you may want to discuss with your ENT doctor.
Heller Myotomy
The Heller myotomy procedure is typically used in the treatment of achalasia, a disorder of the esophagus that makes swallowing abnormally difficult. This is a minimally invasive procedure wherein several tiny incisions are made in the esophagus, followed by the insertion of small scope into these tiny incisions.
The small scope has miniature surgical instruments passing through it while a video camera connected to it sends enlarged images of the esophagus to a monitor. The surgeon can then perform the operation by manipulating the miniature instruments in the scope.
The Heller myotomy procedure has several advantages that make it popular among surgeons and patients with dysphagia caused by achalasia. These include:
- Less pain after the operation since only minimal manipulation has been done
- Faster recovery
- Shorter stay in the hospital, usually 1-2 days, as compared with the possible 7-day stay for a conventional open procedure
In short, you can more quickly return to your normal activities and work.
Peroral Endoscopic Myotomy (POEM)
Yet another possible surgical option for the treatment of swallowing disorders like achalasia is peroral endoscopic myotomy (POEM). This is an endoscopic procedure wherein your surgeon inserts an endoscope through your mouth and down your throat. Your surgeon then makes an incision in your esophagus’ inner lining and cuts the muscle responsible for dysphagia.
POEM is an in-patient procedure requiring between two and three hours for completion. Like the Heller myotomy procedure, it’s popular because it doesn’t require incisions in the abdomen or chest. It also doesn’t require long hospital stays.
Esophageal Dilation
The medical professionals qualified to perform an esophageal dilation are otolaryngologists, or ear, nose and throat specialists, and gastroenterologists. Esophageal dilation stretches the abnormally narrow passages of the esophagus, known as strictures, which can be caused by underlying medical conditions.
In it, your ENT doctor inserts an endoscope into your esophagus, just as with the POEM procedure. He then inflates the balloon attached to the endoscope, which results in the gentle expansion of the strictures.
Esophageal dilation is performed as a treatment for certain swallowing disorders like:
- Achalasia, wherein the sphincter muscle in the esophagus becomes abnormally tight
- Esophageal stricture, or the narrowing of the esophagus
- Schatzki’s ring, an abnormal ring of tissue at the point where the esophagus and stomach meet
These three surgical options have their pros and cons in terms of the success rate, total cost and risks for side effects and complications. You should be well aware of these things before going under the knife, so to speak.
For details 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
Be Prepared to Answer Questions and to Ask Questions During Your Dysphagia Appointment
We experience difficulty swallowing, known as dysphagia, at one point or another, usually when we attempt to swallow large food or when we eat too quickly. When dysphagia happens occasionally, there’s no cause for concern as it’s quite normal. But if you experience persistent dysphagia, you should see your ENT doctor as soon as possible.
Your persistent difficulty may be a sign of an underlying medical condition. This is particularly true if it’s associated with discomfort or pain, perhaps extreme difficulty in swallowing that makes it impossible.
But before getting to your doctor’s clinic for your appointment, you may want to prepare a list of questions and be ready to answer questions from your ENT doctor. The exchange of questions and answers will contribute to a better appointment.
List Down Your Questions
On the phone while setting your appointment, you should ask about pre-appointment restrictions necessary for diagnostic exams. You may have to restrict your diet, for example. You should also list down your symptoms – what they are, when they started and how they are manifested – as well as your medications, drugs and supplements.
You should also write certain key personal information that may have affected your ability to swallow. These can include surgery, medications and major life changes and stressful events.
And don’t forget to list down a few basic questions. You don’t want to forget a question in the clinic and remember it when you’re already at home.
- What are the possible causes of my swallowing difficulty?
- Why are these risk factors in my case?
- What are the medical tests that I have to undergo?
- What are the possible medical interventions for my condition?
- What are the ways I can manage dysphagia with my other health conditions?
- What do I have to do in terms of lifestyle habits?
- What other resources can I refer to about dysphagia?
Don’t hesitate asking these questions as you are well within your rights to do so. Just be courteous so you can get the answers you’re seeking for.
Anticipate Your Doctor’s Questions
The appointment is, of course, a two-way street. Your doctor will also ask questions intended to determine the possible causes of your dysphagia and their corresponding treatments.
The questions your doctor will likely ask and for which you should ideally have ready answers are:
- When did your symptoms start?
- Were your symptoms occasional or continuous, chronic or acute, tolerable or painful?
- What things appear to alleviate or worsen your symptoms? (You may have a more difficult time swallowing some food, for example, than others)
- What other symptoms aside from difficulty swallowing have you experienced? (You may regurgitate food, or vomit after eating or drinking, or bring up black bile-like material or blood)
- Have you been unintentionally losing weight?
The back-and-forth exchange will eventually narrow down the possible causes of your difficulty in swallowing. Be honest in your answers even when it seems embarrassing – your ENT doctor has probably heard and seen it all in his line of work.
If you have been experiencing symptoms such as voice changes, constant coughing, pain when swallowing, ear pain and sore throat that has not disappeared for more than two weeks, get yourself checked by a qualified ENT doctor. It could be nothing but it’s always better to be safe than sorry.
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
A Ton of Useful Information About Tonsillectomy: During and After the Surgery
Part of the preparations for a tonsillectomy is getting reliable information about it. The more you know about it, the more confident you will feel of the outcome. Indeed, a tonsillectomy is a routine surgery with high success rate!
Your tonsillectomy journey, of course, starts with a series of consultations with your surgeon. You will be asked to undergo a series of physical and laboratory tests before your surgery is scheduled. Of course, be sure to turn up at the hospital on the scheduled day!
At the Operating Room
When you arrive at the hospital, you will be briefed about the procedure by the anesthesiologist and nursing staff. You will also be asked to change into a hospital gown – you will be completely naked underneath – and to lie down on a gurney. Afterwards, you will be taken into the operating room, transferred to the operating table and strapped down.
(The strapping down part is scary because you will be rendered immobile. When you think about being put under, your anxiety may increase. But trust the ENT doctors and nurses for their professional competence)
During the Operation
You will be asleep during the entirety of the tonsillectomy. But here’s a summary of what goes on while you’re sleeping on the table.
- The surgeon places a small tool in your mouth, said tool of which will keep your mouth open.
- The anesthesiologist and nurses monitor your vital signs, among other tasks.
- The surgeon removes your tonsils or the affected tonsil tissues by cutting, shaving or burning them.
There will be no stitches made on the area operated on because the wounds will heal naturally. The entire procedure can last between 20 and 30 minutes but it may also last for 60 minutes.
After the Operation
You will be still asleep when you’re transferred to the recovery area. You will wake up disoriented from the anesthesia, perhaps even vomit black bile and feel dizzy. You will be asked to stay flat until such time that the anesthesia wears off.
While a tonsillectomy can be a one-day procedure, don’t expect to be sent home a few hours after the surgery. You will be under observation for several hours during which time the surgeon and nurses will regularly check on your condition.
Just like any surgery, the recovery period can be challenging. You may have to take time off work for one to two weeks depending on your progress. You will also feel pain and discomfort in your throat, especially when eating food and drinking fluids.
Your diet for the first few days will include soft foods like ice cream, gelatin and pudding as well as plenty of water and fruit juices. Your transition to a solid food diet should be gradual so as not to further irritate the surgery area.
After a few weeks, you will feel better! You may even thank your ENT doctor because without oft-infected tonsils, you can now breathe easier.
For details of our ENT services, diagnosis, and treatment, 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’s Behind Your Hot Ears?
Have you ever felt like your ears was on fire, smoke and all? Yes, you likely have because it’s a quite common occurrence for children and adults alike. But there’s likely no need to worry as hot ears, as the temporary condition is oftentimes called, can be resolved with simple measures.
How do you know when you have hot ears? The symptoms are easy to determine, usually with your ears feeling warm, if not warm, to the touch; the skin on your earlobes turning a reddish color; and possibly a burning sensation. Your ears may or may not feel painful to the touch, and hot ears may affect just one or both ears.
Sunburn
Yes, your ears can become sunburned just as the rest of your body can fry, so to speak, from the sun’s ultraviolet rays. You may have sunbathed for an hour or two in the summer, slathered on sunblock on every nook and cranny of your face and body except for your ears, and ended up with hot ears.
Aside from feeling abnormally warm to the touch, the sunburned skin may also look reddish, flaky or crusty. You may not even want to touch your affected earlobes because of the discomfort.
Fortunately, hot ears caused by sunburns can be prevented. You should apply sunblock or sunscreen on your outer ears and wear a hat to protect them, if possible. But if your ears become sunburned, you can apply ice packs, aloe vera gel, and hydrocortisone cream for faster healing.
Feelings
If you’re the type who feels strong emotions, such as anxiety, embarrassment or anger, you may feel hot ears more times. Think of it as your ears blushing in the same way that your face becomes flushed whenever you feel strong emotions.
Don’t worry about hot ears in this case. Your ears will return to their normal temperature and color once you have calmed down. You may have little to no control over your ears’ reactions to your emotions but at least you know that hot ears aren’t life-threatening.
Temperature Changes
Extremely cold temperatures, such as during the winter months, can result in vasoconstriction wherein there’s reduced blood flow to the body’s surface including the skin. This is the reason why your nose, cheeks and ears appear red when exposed outdoors during the peak of winter.
If you like to engage in winter sports, you will likely get hot ears. Don’t worry as it’s only your body’s attempt at self-regulating blood flow. You can wear ear muffs or caps with covers at the side to keep your ears warm, as well as to protect against sunburn in winter.
Infections and Illnesses
What you should be considered about are the infections and illnesses that may be behind hot ears! If the abovementioned causes aren’t possible, then you should talk to your ENT doctor.
Hot ears can be caused by an underlying medical condition like an ear infection, hormonal changes, and rare illnesses, such as red ear syndrome and erythermalgia.
The good news: Even these rare illnesses are treatable!
For details of our 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
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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。