ageing gracefully with your ear nose & throat dr huang shoou chyuan ear nose throat surgeon,...
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Ageing gracefully with your
Ear Nose & ThroatDR HUANG SHOOU CHYUAN
Ear Nose Throat Surgeon,Huang Ear Nose Throat Surgery
Gleneagles Medical Centre #04-17Tel: 64757995
Website: www.entsurgery.com.sg
"Give a man a fish and he will eat for a day. Teach a man to fish and he will eat for a lifetime."
Unknown author
Singapore websites:Huang Ear Nose Throat Surgeryentsurgery.com.sg
Health Promotion Board (HPB)hpb.gov.sg/healthtopics.aspxhpb.gov.sg/hpb/default.asp?pg_id=911
National Cancer Centre (NCC)nccs.com.sg/pbcation/HB/Nasopharyngeal_Cancer_Eng.pdf
Singapore Cancer Societywww.singaporecancersociety.org.sg/lac-fcn-nasopharyngeal-cancer.shtml
Overseas websites:healthyagingprograms.org/content.asp?sectionid=73nihseniorhealth.gov/exercise/toc.htmlaafp.org/afp/990501ap/990501d.html
Deafness in the Elderly
Outer ear
Middle ear
Inner ear
How do I know I have a hearing loss?
Difficult to hear : women’s voices bird’s singing TV or phone conversation within a group tinnitusCoping behaviours : avoid group
meetings asking others to repeat themselves turning up volume of TV misinterpreting messages
Frequency in HertzL
ou
dn
ess
in d
ecid
els
Frequency in Hertz
Lo
ud
nes
s in
dec
idel
s
Common causes of deafness in elderly
Inner ear: Presbycusis – degeneration of cochlea bilateral with tinnitus lose hi pitch first distorted hearing worse with previous noise
exposure & family history
Outer ear:Ear wax-
Perforated drum-
External ear infection
Middle ear:
Eustachian tube blockage after flights or “colds”
Nasopharyngeal cancer (NPC): Nose Cancer
Hearing aids
Head & Neck Cancers- Signs and Symptoms
头部与頚部癌症
Lymph Node Lumps淋巴癌
Salivary Gland Tumour
唾腺癌
Thyroid Cancer甲状腺癌 Vocal cord
cancer 声带癌Tongue Cancer舌头癌
Nose Cancer鼻咽癌
黄守全医生 Dr.Huang Shoou Chyuan
Nasopharyngeal Cancer (1968-2002) 鼻咽癌统计数字 (1968-2002年 )
男性
女性 女性
男性
Causes of Nose Cancer鼻咽癌病因
Genetics基因 -Chinese esply southern Chinese 尤其华南一带的华族
Epstein-Barr Virus (EBV)细菌 Diet eg salted fish 饮食习惯例如咸鱼咸菜
Familial 家族遗传
Signs and Symptoms of NPC 鼻咽癌的症状
Ear 耳Deafness 耳聋
Tinnitus 耳鸣 Nose 鼻 Nosebleed 流鼻血 Blood in sputum 咳嗽出血 Throat 喉
Neck Lumps 頚部肿瘤
Naso-endoscopy 用内窥镜检查鼻子
Normal正常的
Nose Cancer鼻咽癌
Treatment Methods治疗方法
Radiotherapy 电疗 - Early stage NPC 早期 Combination Radio- and Chemotherapy 化疗与电疗 - Mid- and
Later stage NPC 中期后期 Surgery 动手术 - Recurrent Neck Lump 頚部 肿瘤 复发
Early stage NPC has cure rate of about 80% ! 早期治愈机会高 +/- 80%!
Neck Node Swelling淋巴肿瘤
Lymphoma 淋巴癌 :Fever 发烧General Malaise 疲倦
Metastatic Neck Swelling 癌症扩散 :Cancer-related swelling与癌症有关的肿瘤
Thyroid Cancer甲状腺癌
Neck swelling 肿瘤
Hoarseness (Recurrent Laryngeal Nerve) 声音嘶哑
Swallowing difficulty 吞咽困难
Airway obstruction 呼吸困难
Pain 疼痛
Salivary Gland Cancer 唾腺癌
Swelling 肿瘤
Facial paralysis 脸部扭曲
Pain 疼痛
Vocal Cord Cancer声带癌
Swelling 肿瘤Hoarseness 声音嘶哑Swallowing difficulty 吞咽困难Airway obstruction 呼吸困难Pain 疼痛Blood in sputum 咳嗽出血
Tongue Cancer舌头癌
Non-healing ulcer 无法痊愈的溃疡Pain 疼痛Bleeding 口部流血Swallowing difficulty 吞咽困难Airway Obstruction 呼吸困难
Snoring: More Serious Than You
Think! 45% normal adults snore (occasionally) 25% habitual snorers More frequent in males/overweight/elderlyMechanisms of snoring:Partial obstruction throughout airwayPoor muscle tone eg elderly/alcohol/sleeping
pillsExcessive tissue eg obese/tonsils/small lower
jaw posterior tongue baseLong soft palate/uvulaNose blockage
Pure snoring or OSA?
Obstructive Sleep Apnea apnea episodes (more than
10 secs) + reduced airflow =
> 5/hr
1. Gasping for air during sleep 2. Witnessed apnea (stopping
of breathing for at least 10 seconds)
3. Waking up tired, even after a full night's sleep
4. Feeling sleepy during the day (at work or while driving)
5. Irritability or short temper6. Problems with
concentration or memory
7. Medical conditions such as high blood pressure and heart disease
OSA Risks Risks of accidents High blood pressure Heart disease Stroke Sudden deanth
NB: More than 50% (!) of men with untreated OSA suffer a serious health condition or even death within 10 years.
Tests & Treatment for OSAPolysomnogram PSG (Sleep Study):gold-standard for OSA diagnosis originally done at attended Sleep Laboratory
Watch-PAT technology:Avoids pitfalls of conventional PSGie.Electrodes & wires cannot sleep! Expensive FNE-First Night EffectResults validated with sleep lab’s dataReimbursable in many parts of USA
Obstructed airway
Conventional PSG with electrodes & wires
Watch-Pat 200:Non-invasive;Minimal sleep interference Comfort of home Single-button operationInstant analysis and report USA FDA & European CE cert
Ambulatory Sleep Study by Watch-Pat
Peripheral Arterial Tone Technology(PAT)
physiological signal mirroring autonomic nervous system changes caused by respiratory disturbances during sleep
proprietary algorithm analyzes PAT signal identifying sleep apnea events with high degree of specificity and sensitivity
Parameters measured or derived during the night include oxygen saturation, heart rate, sleep and wake states, and REM and non-REM sleep.
Heart rate
O2 satn
Sleep stage
Snoring level
Body position
OSA treatment options
1. Weight loss:Body Mass Index BMI less than 25
(BMI) = weight(kg) divided by height(m)2
eg Ht 1.67 , Wt 70, BMI= 25
avoid sedatives (including alcohol, antihistamines and sleeping pills aids), and
avoid sleeping on one's back
2. CPAP (Continuous Positive Airway Pressure)
OSA treatments
3.Dental splint: keeps tongue and jaw forward to
prevent airway collapse. Sleep strip on the nose: improves nasal airway
Medications to lessen nose blockage
OSA treatments
4.surgery: to improve airway in nose & throat
Turbinate reduction Septal surgeryUPPP- Uvulopalatopharyngoplasty