ENT Head & Neck Surgery Center

Rm 02, 5/F., Kai Seng Commerical Centre,
4-6 Hankow Road, TST Kln, HK
(near Kowloon Hotel)
Tel: (852) 3100 0555
Fax: (852) 3100 0556

Lawrence Chow / ENT Doctor

editor

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Tonsillar Cancer: Understand the Symptoms and Causes to Identify and Treat it Early!

 

Case Study:
“Mr. Cheng, a 55-year-old with a long-term history of smoking and heavy alcohol use, recently sought medical attention due to persistent throat pain and difficulty swallowing. An oral examination revealed swelling and ulceration on one of his tonsils. A biopsy confirmed a diagnosis of tonsil cancer. Unfortunately, due to late detection, the cancer had already metastasized to the cervical lymph nodes, requiring a comprehensive treatment plan involving surgery, radiotherapy, and chemotherapy.”

 

 

What is Tonsil Cancer?
Tonsil cancer is a malignant tumor arising from the tonsillar tissue, predominantly classified as squamous cell carcinoma and categorized as a type of head and neck cancer. In Hong Kong, most patients are males over 45 years old. Tonsil cancer is staged into four phases, but early symptoms are often nonspecific, leading to delayed diagnosis. Many patients are diagnosed at advanced stages (III or IV) when the cancer has already spread to other body parts.

 

Common Symptoms and Complications
Early Symptoms:

  • Throat discomfort or mild pain, often mistaken for pharyngitis.
  • Unilateral tonsil enlargement, surface roughness or ulceration, sore throat, and difficulty opening the mouth.

Progressive Symptoms:

  • Severe throat pain, accompanied by tinnitus or pain on the same side of the ear, unrelieved by medication.
  • Dysphagia, hoarseness, and painless neck lumps (indicating cervical lymph node metastasis).
  • Rapid weight loss and breathing difficulties (due to airway obstruction by the tumor).

Late-Stage Symptoms:

  • Distant metastasis to organs like the lungs or liver, leading to organ failure.

 

Causes and Risk Factors

  • HPV Infection: 70% of tonsil cancers are linked to HPV, particularly high-risk strains like HPV-16.
  • Chronic Inflammation: Recurrent tonsillitis may trigger cellular mutations.
  • Smoking and Alcohol: Synergistic damage to mucosal tissues by tobacco and alcohol.
  • Environmental Exposure: Long-term contact with chemicals or radiation.
  • Immunosuppression: Higher risk in HIV/AIDS patients or organ transplant recipients.

 

Diagnostic Methods

  • Laryngoscopy: Visual examination of tonsil morphology and cervical lymph nodes.
  • Biopsy: Tissue sampling for pathological analysis.
  • CT/MRI Scans: Assess tumor size and invasion extent.
  • PET-CT Scans: Detect systemic metastasis.
  • HPV Testing: Determine viral involvement to guide treatment.

 

Treatment Options
Treatment depends on cancer staging, typically involving a multimodal approach:

Surgery:

  • Early-stage tumors: Tonsillectomy with preservation of surrounding functions.
  • Advanced cases: Extensive resection with cervical lymph node dissection.

Radiotherapy:

  • Effective for radiation-sensitive tumors (e.g., HPV-positive cases), used alone or post-surgery.
  • Advanced techniques like Intensity-Modulated Radiation Therapy (IMRT) minimize damage to healthy tissues.

Chemotherapy and Targeted Therapy:

  • For advanced or recurrent cases, combined with targeted drugs.
  • Immunotherapy (e.g., PD-1 inhibitors): Shows significant efficacy in metastatic or recurrent tonsil cancer.

By raising awareness and promoting early detection, the prognosis of tonsil cancer can be significantly improved. Regular check-ups and lifestyle modifications are critical for high-risk populations.

 

Early detection is critical for effective treatment. Please immediately contact ENT Head and Neck Surgery Centre for detailed evaluation by our ENT specialists (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

Tongue Cancer: Don’t Let Ulcers Become a Crisis — A Comprehensive Guide to Early Detection, Prevention, and Treatment

 

Case Study:
“Mr. Gu, a 52-year-old with a 20-year smoking history and chronic alcohol use, noticed an ulcer on the right side of his tongue six months ago. Initially mistaken for a common mouth ulcer, it failed to heal despite repeated topical treatments. The ulcer gradually enlarged, accompanied by swallowing pain and speech difficulties. Medical evaluation confirmed ‘tongue cancer’ via biopsy, with CT scans revealing cervical lymph node metastasis. Treatment involved partial tongue resection, neck lymph node dissection, radiotherapy, and chemotherapy. His condition is now stable, but long-term follow-up is required.”

 

 

What is Tongue Cancer?
Tongue cancer, the most common type of oral cancer, originates from squamous epithelial cells on the tongue’s surface. It is categorized as:

  • Anterior two-thirds tongue cancer (oral tongue cancer):More common, with noticeable early symptoms.
  • Base-of-tongue cancer (oropharyngeal cancer):Often diagnosed at advanced stages due to its hidden location.

Tongue cancer is highly invasive and prone to metastasis (especially to cervical lymph nodes), but early detection significantly improves cure rates.

 

Symptoms of Tongue Cancer:
Early signs may mimic common ulcers. Warning signals include:

  • Non-healing oral ulcers:Ulcers or red patches persisting over two weeks.
  • Pain or numbness:Discomfort while eating, speaking, or localized numbness.
  • Abnormal lumps:Thickened tongue texture, hard masses, or cauliflower-like growths.
  • Difficulty swallowing:Common in advanced stages.
  • Unexplained bleeding:Easily triggered by touching ulcers or lumps.
  • Worsening bad breath:Caused by tumor necrosis or infection.
  • Neck lumps:Indicative of lymph node metastasis.
  • Voice changes:Hoarseness if the tumor invades the tongue base.

 

Risk Factors:

  • Smoking and alcohol:Synergistically increase risk by over 15-fold.
  • HPV infection:Particularly HPV16, linked to base-of-tongue cancer (rising in younger patients).
  • Poor oral hygiene:Chronic periodontitis, sharp teeth, or ill-fitting dentures causing mucosal damage.
  • Dietary habits:Consuming extremely hot, pickled, or betel nut products.
  • Genetics:Family history of oral cancer.

 

Diagnosis Methods:

  • Physical examination:Visual inspection and palpation of lesions.
  • Oral endoscopy:Detailed examination of the tongue and throat.
  • Biopsy:Pathological analysis of tissue samples.
  • Imaging:
    • CT/MRI:Assess tumor size, depth, and lymph node involvement.
    • PET-CT:Detect systemic metastasis.
  • HPV testing:Guides treatment and prognosis; HPV-related tumors often respond better to therapy.

 

Treatment Approaches:

  1. Early-stage (I-II):
    • Surgery:Primary treatment with tumor excision and safe margins. Minimally invasive robotic surgery for base-of-tongue cancer.
    • Radiotherapy:For small, superficial tumors or patients unsuitable for surgery.
  2. Advanced-stage (III-IV):
    • Combined therapy:Surgery + radiotherapy ± chemotherapy.
    • Targeted therapy:Anti-EGFR agents (e.g., cetuximab).
    • Immunotherapy:PD-1 inhibitors for recurrent/metastatic cases.
  3. Functional and aesthetic reconstruction:
    • Flap reconstruction:Uses autologous tissue (e.g., forearm flap) to repair defects.
    • Speech and swallowing rehabilitation:Post-surgical training.
  4. Follow-up and recurrence prevention:
    • Regular oral exams and imaging (every 3-6 months for the first two years).
    • Smoking/alcohol cessation and oral hygiene maintenance.
    • HPV vaccination (preventive measure).

 

Early detection is critical! Seek immediate medical attention if tongue ulcers persist beyond two weeks. For ENT concerns, contact ENT Head and Neck Surgery Centre or call 3100 0555 for specialized care.

 

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

New Perspectives in the Diagnosis and Treatment of Head and Neck Cancer: From Classification Analysis to Breakthroughs in Precision Therapy

 

Introduction to Head and Neck Cancer

Head and neck cancer encompasses a group of malignancies arising in the head and neck region, including cancers of the oral cavity, larynx, pharynx, salivary glands, nasal cavity, sinuses, and, in some classifications, thyroid cancer. Symptoms vary widely and may include non-healing oral ulcers, voice changes, difficulty swallowing, red/white patches on oral mucosa, or neck masses.

 

Most cases are linked to tobacco or alcohol use, with emerging risks from e-cigarettes. HPV infection is increasingly associated with these cancers, particularly oropharyngeal cases. Other risk factors include betel nut chewing, radiation exposure, malnutrition, and occupational exposure to carcinogens. Over 90% of head and neck cancers are squamous cell carcinomas. Diagnosis involves biopsy, imaging, and blood tests to assess disease progression.

 

Preventive measures include abstaining from tobacco/alcohol, regular dental check-ups, and HPV vaccination. Treatments combine surgery, radiotherapy, chemotherapy, and targeted therapy. Early-stage cancers have high cure rates, but approximately 50% of patients present with advanced-stage disease.

 

Classification of Head and Neck Cancer

Malignancies in the head and neck region include:

  • Oral cancers: Tongue, buccal mucosa, gingiva, and lip cancers.
  • Laryngeal and hypopharyngeal cancers: Tumors of the vocal cords, larynx, and hypopharynx.
  • Nasopharyngeal carcinoma: Strongly associated with Epstein-Barr virus (EBV), prevalent in Asian populations.
  • Oropharyngeal cancer: Includes tonsillar and base-of-tongue cancers, increasingly linked to HPV.
  • Salivary gland cancers: Parotid, submandibular gland tumors.
  • Thyroid cancer: Included in some classifications.
  • Nasal and sinus tumors: Squamous cell carcinoma, adenocarcinoma, etc.

The WHO 5th edition classification introduces dedicated sections for familial tumor syndromes (e.g., Gorlin syndrome, Cowden syndrome) and soft tissue tumors.

 

According to Hong Kong Cancer data (2010–2020), head and neck cancer incidence rose by 25% in Hong Kong. In China, head and neck squamous cell carcinoma (HNSCC) accounts for over 90% of cases:

  • HPV-associated oropharyngeal cancer: Represents >70% of cases in Western countries; China reports 25%–37% HPV positivity, rising annually.
  • Nasopharyngeal carcinoma: Endemic in southern China, linked to EBV, contributing to >40% of global cases.
  • Key risk factors: Smoking, alcohol, betel nut chewing, HPV/EBV infection.

 

Latest Advances in Head and Neck Cancer Treatment

Immunotherapy

  • PD-1/PD-L1 inhibitors: Pembrolizumab and nivolumab are now first-line treatments for recurrent/metastatic cases, improving 2-year survival rates to >50%.
  • Combination therapies: Immunotherapy combined with chemotherapy or targeted drugs enhances efficacy.

 

Precision Radiotherapy and Surgical Innovations

  • Intensity-modulated radiation therapy (IMRT): Reduces damage to healthy tissues, ideal for early-stage patients.
  • Transoral robotic surgery (TORS): Used for early oropharyngeal cancer, offering precise resection with functional preservation (though long-term quality of life may slightly lag behind radiotherapy).
  • Endoscopic surgery: For recurrent nasopharyngeal carcinoma, improves survival by 17.8% compared to re-irradiation, with fewer side effects.

 

Targeted Therapy

  • EGFR inhibitors: Cetuximab for advanced-stage patients.
  • Anti-angiogenic drugs: Inhibit tumor blood vessel formation.

 

Molecular Testing-Guided Treatment

  • HPV/p16 testing, PD-L1 expression analysis, and EBV detection inform personalized treatment strategies.

 

For ENT concerns, contact ENT Head and Neck Surgery Centre or call 3100 0555 for specialized care.

 

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

ocal Cord Cancer: When the Voice Becomes Hoarse, Be Alert to This Early Sign

 

Case Study

“Mr. Jia, 56 years old, experienced breathing difficulties and hoarseness for two years, with symptoms worsening recently. Upon seeking medical help, a laryngoscopy revealed a cauliflower-like growth on his left vocal cord. A PET-CT scan showed abnormally high metabolic activity, leading to a diagnosis of squamous cell carcinoma of the vocal cord. This case highlights the importance of timely medical evaluation for persistent hoarseness to rule out malignancy.”

 

 

What is Vocal Cord Cancer?
Vocal cord cancer is a malignant tumor affecting the vocal cords—key structures for sound production. It accounts for over 60% of laryngeal cancers. The majority (96%–98%) are squamous cell carcinomas. Early-stage tumors are often localized but highly invasive, potentially destroying laryngeal cartilage or spreading to neck lymph nodes.

 

Common Symptoms and Risks

  • Hoarseness:The most typical early symptom. Seek evaluation if it persists beyond two weeks.
  • Throat discomfort:Sensation of a foreign object, pain, coughing, or difficulty swallowing. Late stages may involve blood in sputum or coughing up blood.
  • Breathing difficulties:Tumor obstruction of the airway can become life-threatening.
  • Spread risk:Early tumors are localized, but advanced stages may invade surrounding tissues, damage laryngeal function, spread to neck lymph nodes, or metastasize to distant organs (e.g., lungs, liver), complicating treatment.

 

Causes of Vocal Cord Cancer

  • Smoking and alcohol:Smokers face a 10-fold higher risk. Combined with alcohol, the risk escalates.
  • HPV infection:Some cases are linked to human papillomavirus (HPV).
  • Environmental factors:Long-term exposure to industrial dust, air pollution, or occupational carcinogens.
  • Demographics:Most common in males aged 50–70.

 

Diagnostic Methods

  • Laryngoscopy:Fiber-optic laryngoscopy detects mucosal abnormalities. Narrow Band Imaging (NBI) enhances early detection.
  • CT/MRI:Assesses tumor extent and cartilage involvement.
  • PET-CT:Detects distant metastasis and aids staging.
  • Biopsy:Confirms cancer type via tissue analysis.

 

Treatment Options
Surgery

  • Laser minimally invasive surgery:For early-stage tumors. Preserves function but may affect voice.
  • Partial laryngectomy:Preserves partial laryngeal function for localized tumors.
  • Total laryngectomy:Required for advanced/recurrent cases. Requires a tracheostomy.

Radiation Therapy

  • Advantages:Preserves vocal function; suitable for elderly or comorbid patients.
  • Drawbacks:May cause throat pain, swallowing difficulties.

Combined Therapies

  • Radiation + Chemotherapy:Shrinks tumors pre-surgery in advanced cases.
  • Targeted + Immunotherapy:Emerging treatments targeting genetic mutations or boosting immune response.

 

Early detection and treatment are critical. If you experience prolonged hoarseness, seek immediate medical attention. High-risk individuals should undergo regular screenings. For ENT concerns, contact  ENT Head and Neck Surgery Centre or call 3100 0555 for expert consultation.

 

 

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

Hypopharyngeal Cancer: The Silent Throat Killer – Do Not Ignore the Warning Signs of Swallowing

 

Case Study
“Mr. Kang, a 58-year-old with a long-term smoking and alcohol consumption history, recently experienced persistent sore throat, dysphagia, and hoarseness. After examination via endoscopy, he was diagnosed with Stage III Hypopharyngeal Cancer (mid-to-late stage). Mr. Kang underwent tumor resection surgery followed by radiotherapy and is currently under observation, requiring regular check-ups to monitor recurrence.”

 

 

What is Hypopharyngeal Cancer?
Hypopharyngeal cancer originates in the hypopharynx (the area connecting the throat to the esophagus) and is a type of head and neck cancer. Due to its隐蔽位置 (hidden location), early detection is challenging. Approximately 70% of patients, like Mr. Kang, are diagnosed only after the cancer has metastasized to cervical lymph nodes or distant organs (e.g., lungs, bones, liver). Consequently, treatment outcomes are often poor.

 

Common Symptoms and Complications
Early symptoms are subtle, but the following signs warrant vigilance:

  • Typical symptoms: Sore throat, dysphagia, hoarseness, neck mass, ear pain (referred pain).
  • Long-term complications: Tumors may obstruct the airway or esophagus, leading to malnutrition or breathing difficulties. Metastasis to lymph nodes or distant organs significantly complicates treatment.

 

Causes and Risk Factors

  • Primary risk factors: Smoking, heavy alcohol consumption, betel nut chewing (a major trigger in regions where betel nut use is prevalent).
  • Other factors: Chronic irritation from gastroesophageal reflux disease (GERD), diets lacking fresh fruits/vegetables, human papillomavirus (HPV) infection.
  • Genetics and environment: Family history or prolonged exposure to asbestos/chemical dust increases risk.

 

Diagnosis and Tests

  • Endoscopy: Flexible fiber-optic laryngoscopy to visualize lesions.
  • Imaging: CT/MRI scans to assess tumor extent and metastasis.
  • Biopsy: Tissue sampling to confirm cancer type.
  • Systemic evaluation: PET-CT scans to detect distant metastasis.

 

Treatment Options

  • Early-stage (I/II): Radiotherapy ± localized surgery.
  • Advanced-stage (III/IV): Multidisciplinary approach (e.g., tumor resection with lymph node dissection, followed by adjuvant chemo/radiotherapy).
  • Targeted & immunotherapy: Anti-EGFR agents (e.g., Cetuximab) or immune checkpoint inhibitors (e.g., Pembrolizumab) for late-stage cases.
  • Supportive care: Nasogastric tube placement, speech therapy to improve quality of life during recovery.

 

Conclusion
Quitting smoking/alcohol and early detection are crucial in combating hypopharyngeal cancer. Individuals with smoking/drinking habits experiencing persistent throat discomfort should seek prompt medical evaluation. For ENT concerns, contact ENT Head and Neck Surgery Centre or call 3100 0555 for specialized care.

 

 

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 Salivary Gland Endoscopic Surgery: Say Goodbye to Pain and Scars, Protect Your “Salivary Health”

 

Case Study:
“Mr. Chao, a 40-year-old patient, experienced recurrent swelling and pain in his left submandibular gland after meals for over two years. The worsening symptoms eventually impacted his work and daily life, prompting him to seek medical help. Examination revealed redness and swelling at the opening of the left submandibular gland duct, with pus discharge upon gentle pressure. Ultrasound confirmed a 1.5cm × 0.8cm stone within the duct, diagnosed as a salivary gland stone. The stone was successfully removed using minimally invasive salivary gland endoscopic surgery, resolving his symptoms.”

 

 

What is Minimally Invasive Salivary Gland Endoscopic Surgery?
This technique employs endoscopic technology to diagnose and treat salivary gland diseases. A thin endoscope with a micro-camera is inserted into the salivary duct, allowing direct visualization of the duct’s interior. Advantages include minimal trauma, reduced pain, rapid recovery, negligible scarring, and preservation of salivary function. It effectively treats ductal stones, strictures, infections, and inflammation.

 

Who Needs This Surgery?
The procedure is suitable for patients with:

  • Salivary stones: Recurrent swelling (e.g., in adolescents) treated by stone extraction, avoiding gland removal.
  • Duct strictures: Caused by trauma or infection; the endoscope can dilate the duct and place stents.
  • Chronic parotitis: Traditional treatments are limited; endoscopic duct irrigation removes infections.
  • Salivary leakage: Post-traumatic saliva leakage repaired via precise duct restoration.

Ideal candidates include those with benign conditions (stones, strictures, chronic inflammation), children, elderly patients unfit for traditional surgery, and individuals prioritizing aesthetics. Contraindications include malignant tumors, acute infections, or coagulation disorders.

 

Procedure Overview:

  1. Preparation: Local or general anesthesia, followed by lesion localization.
  2. Stone Removal: A tiny incision (0.8–2.6 mm) in the mouth or behind the ear allows endoscope insertion. Micro-baskets extract small stones, while larger stones undergo laser lithotripsy before removal.
  3. Duct Dilation: Balloon dilation or silicone stents prevent recurrence.
  4. Irrigation and Drainage: Infected secretions are flushed to alleviate inflammation.
  5. Postoperative Care: Most patients discharge the same day with oral painkillers and follow-ups.

 

Five Key Advantages:

  • High Success Rate: 80–90% stone clearance; >70% stricture relief.
  • Scarless: Incisions hidden in the mouth or behind the ear.
  • Preserved Salivary Function: Avoids dry mouth or taste abnormalities post-surgery.
  • Low Complication Risk: Minimal bleeding/infection; safer for children and elderly.
  • Rapid Recovery: Most resume eating and daily activities immediately.

 

Technological Advances:

  • Single-Port Non-Insufflation Endoscopy: Reduces trauma with one incision.
  • Robot-Assisted Systems: Tested in Japan/Europe for complex cases, enhancing precision.
  • Pediatric Applications: Over 90% of children experience no recurrence or developmental issues post-surgery.

For ENT concerns, contact ENT Head and Neck Surgery Centre . Our specialists provide detailed consultations (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

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:

  1. Start with a tiny dose: Introduce a minuscule amount of the “imagined enemy” (purified allergen extract) to the immune system.
  2. Gradually increase the dose: Allow the immune system to slowly adapt to the presence of the allergen and recognize it as non-threatening.
  3. 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:

 

  1. 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.

 

  1. 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

 

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