Lawrence Chow / ENT Doctor
A Ruptured Eardrum Is a Serious Condition!
Think of a drum with a hole in the middle and it can be likened to a ruptured eardrum – it’s a serious condition that will likely need prompt and proper attention! But where a ruptured drum cannot make sound, a ruptured eardrum cannot receive sound.
Also known as tympanic membrane perforation, a ruptured eardrum is a tear or a hole in the eardrum. This is the thin tissue separating the ear canal from the middle ear. It’s as serious as it sounds – it can result in hearing loss and it can increase the risk of infections in the middle ear.
Well, we have to be honest. Some cases of ruptured eardrums will heal without medical treatment, usually within a few weeks. But there are some cases that will require medical intervention, usually in the form of surgery, for the ruptured eardrum to heal.
The Risks of an Untreated Ruptured Eardrum
The tympanic membrane, or the eardrum, has two major roles:
- It’s essential in the sense of hearing. When sound waves strike your eardrum, it translates them onto nerve impulses.
- It’s important in protecting your middle ear from foreign objects, such as water, and foreign organisms like bacteria.
As such, a ruptured eardrum can cause complications like:
- Hearing loss, which may only be temporary but can worsen without proper treatment. The degree of hearing loss is influenced by the size and location of the hole.
- Otitis media, or middle ear infection, since bacteria can now enter the ear. The infection can be recurrent or chronic, and it can cause hearing loss and persistent drainage.
- Cholesteatoma, or middle ear cyst, an extremely rare condition. It’s characterized by the accumulation of skin cells and other ear canal debris on the middle ear. It’s a place that promotes bacterial growth and contains proteins resulting in damage to the bones in the middle ear, too.
These complications can happen within three to six months after the rupture occurs.
The Signs to Look Out for
But don’t wait for three months before seeing your ENT doctor! If you experience these signs, you should immediately set an appointment to get a definitive diagnosis.
- Pain in the ear that may quickly subside
- Drainage from your ear, which looks like pus, mucus or blood
- Loss of hearing
- Vertigo, or a spinning sensation
- Tinnitus, or a phantom ringing, hissing or buzzing in your ears
- Nausea and/or vomiting accompanying the vertigo
You should avoid putting pressure on your external ear, much less putting foreign objects into it, such as using cotton buds. You’re only worsening the injury otherwise. You can ask your ENT doctor about the best ways to deal with these symptoms while waiting for your appointment.
Antibiotics are usually the first line of defense for perforated eardrums. But surgery may be necessary, too, and it comes in the form of an eardrum patch or a tympanoplasty.
For details of our 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
The Connection Between Hearing Loss and Mental Health
Many mental health disorders, such as schizophrenia, are characterized by hearing phantom voices. Hearing impairments, in contrast, are characterized by the partial or full loss of the sense of hearing. There are cases, nonetheless, when phantom sounds are heard, too, as is the case with tinnitus but it isn’t considered a mental health issue.
So what then is the connection between hearing loss and mental health? In summary, hearing loss and tinnitus have been shown to increase the risk of mental illnesses! These include anxiety, depression and schizophrenia, as well as trigger disturbing periods of suicidal ideation and extreme anger.
Depression and Hearing Loss
In a study published in JAMA Otolaryngology Head & Neck Surgery, researchers found that more than 11% of the adult participants who reported hearing impairment also experienced symptoms of moderate to severe depression. In contrast, only 5.9% of the participants with typical hearing reported being depressed.
The results aren’t exactly surprising considering that hearing loss can make affected individuals feel socially awkward, if not socially inept, because of their inappropriate reactions during conversations. They may respond with inappropriate answers to questions they haven’t heard well but are too shy to be repeated. They may talk off-topic, or talk too loud to compensate for the hearing loss, or talk too little to avoid embarrassment.
Such struggles can eventually lead to a feeling of isolation that, in turn, feeds on depression. The more a person with hearing impairments feel isolated, the more likely the depression. Of course, there are other risk factors for depression but hearing loss can contribute to the increased risk.
Schizophrenia and Hearing Loss
Several studies have also pointed to the connection between schizophrenia and hearing loss. Schizophrenia, a serious mental disorder, is characterized by the abnormal interpretations of reality as well as by delusions, hallucinations and extremely disordered behaviors. Sadly, these symptoms have negative effects on daily functioning and quality of life.
The connection between these two conditions is supported by the social defeat hypothesis wherein feelings of loneliness and social exclusion predisposes high-risk individuals to schizophrenia. Such predisposition is underlined by the increased sensitization of the body’s dopamine system.
People with hearing impairments can feel social isolation, as previously noted, and social defeat. Emphasis must be made, nonetheless, that not all people with hearing loss will develop schizophrenia since there are other risk factors for the mental disorder. In the same way, not all schizophrenic patients have hearing impairments.
Hearing impairments are an invisible disability in the sense that these are either ignored or unnoticed by the affected persons. This can also be said for mental illness, especially as there’s a deep-seated stigma against depression and schizophrenia even in modern times.
But it’s crucial to look beyond the stigma and into the possible treatments for both hearing loss and mental health disorders! If you have issues with either of these conditions, you should seek professional help as soon as possible.
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
The Surgical Options for Children with Microtia
Unfortunately, microtia isn’t only about the atypical size and shape of the earlobe. Parents and pediatricians are more concerned about the partial or full hearing loss children with microtia will experience. Emphasis must be made that hearing loss has adverse effects on speech and language development, as well as on personal interactions.
The good news is that there are more than a few surgical options for the treatment of microtia. You and your child’s pediatric surgeon will discuss the risks and rewards of these options. You have to remember, too, that surgery may not yet be an option for your child, such as when he’s too young for it.
Rib Cartilage Graft Surgery
This is possibly the most complicated surgical treatment for microtia since it involves several procedures over several months, sometimes up to a year. Due to the possible complications, it’s only recommended for older children, usually between 8 and 10 years old.
Basically, rib cartilage is harvested from the patient’s chest. It’s then used in creating the shape of the external ear before being implanted under the skin where the ear should have been present. But the process doesn’t stop there.
More skin grafts and surgeries may be performed in addition to the new cartilage. These surgeries are done to ensure better positioning of the external ear.
The pros of rib cartilage graft surgery is that rib cartilage from the patient is less likely to be rejected by his body and it’s a sturdier material. But there may be pain, discomfort and scarring in the grafting site.
Medpor Graft Surgery
The Medpor graft surgery involves lesser number of times under the knife and younger age of patients than rib cartilage graft surgery. Basically, a synthetic material is implanted into the external ear to mimic its form and function. It’s then covered by scalp tissue, a way of achieving a more natural appearance.
It’s usually completed in a single session so children are less traumatized by the procedure. In fact, children as young as 3 years old are suitable candidates.
The results are more consistent since the synthetic material can be manipulated than a rib graft. But there are also risks to the Medpor graft surgery including the higher risk of infection. Children are also more likely to lose the implant due to physical trauma or injury.
There’s also the matter of pediatric surgeons either not offering or performing Medford graft surgery because the length of time that the implant lasts isn’t established yet. But if your pediatric surgeon can perform it, you may want to consider it.
If these two surgical options aren’t viable or successful for any reason, you may want to consider ear prosthetics. These look natural and, in fact, can be made based on the size of the normal ear. These can also be attached through an implanted anchor system or worn with a skin-friendly adhesive.
If you would like to learn more about microtia and its surgical options for children, 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
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
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另所有文章內使用的人名均為化名。