ENT Head & Neck Surgery Center

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

Sinus Cancer: What Warning Signs to Be Aware Of ?

 

Case Studies

“Mr. Zhong, 45 years old: Suffered from long-term nasal congestion and recurrent unilateral nosebleeds, initially misdiagnosed as sinusitis. Later, he developed facial numbness and blurred vision. Nasal endoscopy and biopsy confirmed sinus cancer. He underwent tumor resection followed by radiation therapy and remains under ongoing monitoring.”

 

“Mr. Li, 35 years old: Experienced nasal congestion and runny nose for six months, dismissed as rhinitis. Subsequent facial numbness and vision decline led to medical evaluation, which revealed a sinus tumor. Biopsy confirmed sinus cancer.”

 

 

What is Sinus Cancer?
Sinus cancer develops in the nasal cavity or paranasal sinuses (e.g., frontal, ethmoid, sphenoid, or maxillary sinuses). Maxillary sinus cancer is the most common type, including squamous cell carcinoma and adenocarcinoma. Due to the sinuses’ concealed location and early symptoms resembling rhinitis, diagnosis is often delayed. By the time of detection, tumors may have invaded surrounding structures (e.g., orbits or skull base).

 

 

Common Symptoms and Complications
Early symptoms are subtle and may include unilateral nasal congestion or runny nose. As the disease progresses, symptoms may involve:

  • Nasal symptoms: Persistent congestion, purulent discharge, blood-tinged mucus, nosebleeds, reduced sense of smell.
  • Facial symptoms: Swelling, pain (e.g., cheek protrusion in maxillary sinus cancer).
  • Ocular symptoms: Vision decline, bulging eyes, double vision due to tumor pressure on optic nerves or orbital invasion.
  • Intracranial symptoms: Headaches, dizziness, or seizures if the skull base is compromised.
  • Complications: Untreated sinus cancer can lead to facial deformity, vision loss, cervical lymph node metastasis, intracranial infections, meningitis, or life-threatening conditions.

 

Risk Factors

  • Chronic inflammation: Long-term sinusitis or nasal polyps may trigger mucosal hyperplasia.
  • Smoking: Harmful chemicals in smoke irritate sinus linings.
  • Occupational exposure: Dust from industries like leather or woodworking.
  • Viral infections: EB virus links to sinus cancer.
  • Other factors: Immunodeficiency or family cancer history.

 

Diagnosis

  • Initial exam: Nasal endoscopy to detect abnormalities.
  • Imaging: CT or MRI to map tumor extent.
  • Biopsy: Confirm cancer type via tissue sampling.
  • Staging: PET scan to check for metastasis.

 

Treatment Options

  • Surgery: Primary treatment for tumor removal and sinus function restoration (e.g., endoscopic or open surgery).
  • Radiation therapy: Controls tumor growth post-surgery or for inoperable cases.
  • Chemotherapy: For advanced or recurrent cases, often combined with radiation.
  • Targeted therapy and immunotherapy: For late-stage patients (e.g., anti-EGFR drugs).
  • Rehabilitation: Post-surgical facial reconstruction and recovery support.

 

 

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

鼻竇癌:需要警惕什麼警訊?

 

「45歲鍾先生,長期鼻塞、單側鼻血反覆發作,誤以為是鼻竇炎。後續出現臉部麻木、視力模糊,經鼻內視鏡檢查和病理切片確診為《鼻竇癌》。鍾先生接受手術切除腫瘤,再進行放射治療,目前持續追蹤中。」

 

「35歲的李先生,近半年來經常鼻塞、流鼻涕,以為是鼻炎發作而未有重視。後來出現面部麻木、視力下降,就醫檢查才發現鼻竇內有腫物,經病理檢查確診為《鼻竇癌》。」

 

 

鼻竇癌是什麼?

鼻竇癌是發生在鼻腔或鼻竇(如額竇、篩竇、蝶竇和上頜竇)的惡性腫瘤,其中上頜竇癌最為常見,類型包括「鱗狀細胞癌」和「腺癌」。因為鼻竇位置隱蔽,早期症狀又與一般鼻炎相似,未引起重視。由於這緣故,很多病人在確診時,癌腫瘤常已侵犯周圍組織(如眼眶或顱底)。

 

 

鼻竇癌的常見症狀及傷害有哪些?

鼻竇癌早期症狀不明顯,可能僅有單側鼻塞、流鼻涕等類似鼻炎的表現。隨著病情進展,可能出現以下症狀:

  • 鼻部症狀:持續性鼻塞、流膿鼻涕、鼻涕帶血絲、鼻出血、嗅覺減退等。
  • 面部症狀:面部腫脹及疼痛,尤其是上頜竇癌可引起面頰部隆起。
  • 眼部症狀:癌腫瘤壓迫眼神經或侵犯眼眶時,出現視力下降、眼球突出、複視等。
  • 顱內症狀:頭痛、頭暈,當腫瘤侵犯顱底時,可誘發癲癇。
  • 併發症:鼻竇癌若不及時治療,可造成面部畸形、視力喪失、頸淋巴轉移,甚至顱內感染、腦膜炎等嚴重併發症,危及生命。

 

 

鼻竇癌的病因是什麼?

風險因素包括:

  • 長期慢性炎症:長期慢性鼻竇炎、鼻息肉等,可導致黏膜上皮增生,增加癌變風險。
  • 長期吸煙:吸煙產生的有害物質可刺激鼻竇黏膜,誘發癌變。
  • 職業暴露:長期接觸某些化學物質,如皮革、木材加工等行業的粉塵,可能增加鼻竇癌的發病率。
  • 病毒感染:如EB病毒感染,與鼻竇癌的發生也有關聯。
  • 其他因素:免疫系統低下、家族癌症史,這類人士患病風險較高。

 

 

鼻竇癌如何診斷?

初步檢查: 鼻內視鏡觀察鼻腔異常組織。

影像學檢查: 電腦斷層掃描(CT)或磁力共振造影(MRI)定位腫瘤範圍。

病理確診: 活組織切片(Biopsy)確認癌細胞類型。

分期評估: 正子掃描(PET)檢測是否有遠端轉移。

 

 

鼻竇癌的治療方法有哪些?

  • 手術治療:是鼻竇癌的主要治療方法,目的是徹底切除腫瘤,恢復鼻竇功能。手術方式包括鼻竇內鏡手術和開放性手術。
  • 放射治療:對於無法完全切除的腫瘤,或手術後有殘留的患者,放療可有效控制腫瘤生長,減少復發。
  • 化學治療:主要用於晚期或復發的鼻竇癌患者,通過藥物殺死癌細胞,延長患者生存期。可合併放射治療,增強治療效果。
  • 標靶與免疫治療:針對晚期患者(如抗EGFR標靶藥物)。
  • 復健支持:手術後需修復臉部。

 

 

有任何耳鼻喉問題,請立即聯絡香港耳鼻喉頭頸外科中心,由我們的耳鼻喉專科醫生為你詳細診治(電話3100 0555)。

 

 

資料來源:

香港耳鼻喉專科

耳鼻喉頭頸外科中心

提供耳鼻喉科服務、頭及頸外科服務

聽力及言語治療、驗配助聽器服務

人工耳蝸植入、睡眠障礙治療

https://www.hkentspecialist.hk

Lip Cancer: Learn All About This “Silent Lip Killer”!

 

Case Study:
“Mr. Li, a 60-year-old long-term smoker, noticed a ‘recurrent small ulcer with scabbing’ on his lower lip over the past six months. Self-applied ointments were ineffective. The ulcer gradually enlarged, developing a cauliflower-like surface with mild pain and numbness. After examination, he was diagnosed with ‘lower lip squamous cell carcinoma.’ The treatment team formulated a plan involving surgical resection, radiotherapy, and lip reconstruction, successfully restoring his appearance and function.”

 

 

What is Lip Cancer?
Lip cancer (carcinoma of the lip) is a malignant tumor arising from the mucosa of the vermilion border. Over 90% are squamous cell carcinomas, while adenocarcinomas are rare. According to international cancer classification standards, lip cancer is distinct from oral cancer but is still categorized under head and neck tumors. It commonly occurs at the junction of the middle and outer third of the lower lip. The male-to-female incidence ratio is approximately 7:1, with peak prevalence between ages 50–70.

 

What Are the Symptoms of Lip Cancer?
Lip cancer progresses relatively slowly with late metastasis. However, delayed treatment can severely impact appearance and function. Common symptoms include:

  • Early Stage:Small hard nodules, herpetic-like scabs, localized mucosal thickening, or leukoplakia, often mistaken for common ulcers or angular cheilitis.
  • Progressive Stage:Ulcers expand into crater-like or cauliflower-shaped masses with bleeding, foul odor, and tingling, pain, or numbness around the lips or oral skin. Invasion of muscles or bones may cause difficulty opening the mouth or loose teeth.
  • Late Stage:Metastasis to cervical lymph nodes or distant organs (lungs, liver, bones), posing life-threatening risks.

 

What Causes Lip Cancer?
The exact etiology remains unclear, but risk factors include:

  • Chronic Irritation:Smoking, alcohol abuse, betel nut chewing, or foreign object biting causing repeated mucosal damage.
  • UV Exposure:Outdoor workers with insufficient lip pigmentation face higher cancer risk due to prolonged sun exposure.
  • Chemical Exposure:Long-term contact with substances like asphalt.
  • Precancerous Lesions:Untreated leukoplakia, verrucous hyperplasia, or chronic ulcers.
  • HPV Infection:Some cases correlate with human papillomavirus (HPV).

 

How is Lip Cancer Diagnosed?

  • Physical examination of the lips and cervical lymph nodes, along with lifestyle inquiries (smoking, sun exposure).
  • Biopsy of the lesion for pathological analysis to confirm cancer type and differentiation.
  • CT/MRI to assess tumor depth and lymph node involvement.
  • PET-CT to detect distant metastasis.
  • TNM Staging:Based on tumor size (T), lymph node metastasis (N), and distant metastasis (M) to guide treatment planning.

 

What Are the Treatment Options for Lip Cancer?

  • Surgery:Early cases undergo wide local excision (≥1 cm margins) with direct closure or local flaps. Advanced cases require neck lymph node dissection and possible partial jawbone resection, followed by reconstructive surgery using adjacent tissue or free flaps.
  • Radiotherapy:External beam radiation for postoperative adjuvant therapy or inoperable patients, often using proton therapy for precision. Brachytherapy places radioactive sources directly on the lip to minimize tissue damage.
  • Chemotherapy:For advanced or metastatic cases.
  • Targeted & Immunotherapy:Agents targeting specific mutations (e.g., EGFR) or PD-1/PD-L1 inhibitors to improve survival in advanced stages.

 

Early detection is critical for effective treatment. If a lip ulcer persists for over 2 weeks, 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

唇癌:從早期症狀到治療,全面了解這“沉默的唇部殺手”!

 

「60歲的倪先生長期吸煙,近半年發現下唇出現一處“反復結痂的小潰瘍”,自行塗抹藥膏無效。潰瘍逐漸增大,傷口表面呈菜花狀,並有輕微痛楚和麻木感。經檢查後,確診為「下唇鱗狀細胞癌」。治療團隊為倪先生制定手術切除、放療和修復唇部的方案,成功恢復外觀和功能」。

 

 

唇癌是什麼?

唇癌(Carcinoma of the lip)是發生於唇紅緣黏膜的惡性腫瘤,90%以上為鱗狀細胞癌,腺癌則較罕見。根據國際癌症分類標準,唇癌雖獨立於口腔癌,但某意義上仍被歸為頭頸部腫瘤。唇癌常發生在下唇中外1/3交接處,發病率男女比例約7:1男性顯著高於女性,而高發年齡為50-70歲。

 

 

唇癌有何症狀?

唇癌發展相對緩慢,轉移較晚,但若不及時治療,會對患者的容貌和功能造成嚴重影響。其常見症狀及傷害如下:

  • 早期症狀:嘴唇出現小硬結、皰疹狀結痂、局部黏膜增厚或白斑,易被誤認為普通潰瘍或口角炎。
  • 發展期症狀:潰瘍擴大為如火山口或菜花狀的腫塊,表面滲血、有臭味,嘴唇或口腔周圍皮膚有麻刺、疼痛或麻木感;若侵犯肌肉或骨骼時,導致張口困難、牙齒鬆動。
  • 晚期傷害:頸部淋巴結轉移,也可遠處轉移至肺、肝或骨,嚴重威脅生命。

 

 

唇癌的誘發病因有哪些?

唇癌的病因尚未完全明確,但以下因素可能增加患病風險:

  • 長期刺激:吸煙、酗酒、咀嚼檳榔或銜咬異物導致黏膜反復損傷。
  • 紫外線暴露:戶外工作者因長期日曬,唇部皮膚色素保護不足,增加癌變風險。
  • 化學物質接觸:長期接觸某些化學物質,如瀝青等,可能誘發唇癌。
  • 癌前病變:唇部白斑、疣狀增生或慢性潰瘍未及時治療。
  • HPV感染:部分病例與人乳頭瘤病毒(HPV)感染相關。

 

 

唇癌的診斷方法是什麼?

  • 檢查唇部及頸部淋巴結,詢問病人生活習慣(如吸煙、日曬等)。
  • 取病變組織進行病理分析,明確癌種類型和分化程度。
  • CT/MRI檢查,以評估腫瘤侵犯深度及有否淋巴結轉移。
  • PET-CT檢查,以排查是否出現遠程轉移。
  • 分期診斷:根據腫瘤大小(T)、淋巴結轉移(N)、遠處轉移(M)進行TNM分期,製定治療方案。

 

 

唇癌的治療方法有哪些?

  • 手術治療:早期病例可局部擴大切除(切緣≥1cm),直接縫合或局部皮瓣修復。晚期則要做頸淋巴結清掃術,必要時切除部分頜骨。之後還要採用鄰近組織或游離皮瓣修復,恢復外觀及功能的重建手術。

 

  • 放射治療:外照射適用於術後輔助治療或無法手術的病人,常用質子療法精准靶向腫瘤。近距離放療則是將放射源直接置於唇部,減少周圍組織損傷。

 

  • 化學治療:適用於治療晚期或已出現轉移的病人。

 

  • 靶向與免疫治療:針對特定基因突變(如EGFR)或PD-1/PD-L1抑制劑,提升晚期患者生存率。

 

 

唇癌的治療效果跟早期發現密切相關。若唇部潰瘍超2周未愈,請立即聯絡香港耳鼻喉頭頸外科中心,由我們的耳鼻喉專科醫生為你詳細診治(電話3100 0555)。

 

 

資料來源:

香港耳鼻喉專科

耳鼻喉頭頸外科中心

提供耳鼻喉科服務、頭及頸外科服務

聽力及言語治療、驗配助聽器服務

人工耳蝸植入、睡眠障礙治療

https://www.hkentspecialist.hk

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

扁桃腺癌:認識各期症狀及病因,及早識別與治療!

 

「55歲的鄭先生有長期吸煙、酗酒的習慣,最近喉嚨持續疼痛,進食時也感到難以吞咽而求診。口腔檢查發現鄭先生一側扁桃腺腫大和表面潰瘍,經活檢確診為《扁桃腺癌》。由於發現較晚,癌細胞已向頸部淋巴結轉移,治療上需綜合手術、放療和化療。」

 

 

扁桃腺癌是什麼?

扁桃腺癌(Tonsil Cancer)是原發於扁桃腺組織的惡性腫瘤,多屬鱗狀細胞癌類型,也是頭頸癌的一種。在香港,扁桃腺癌發病年齡,大多是45歲以上人士,並以男性患者較多。扁桃腺癌分為四期,由於早期症狀及病徵不明顯,易被忽視。很多時,都是在癌細胞擴散到身體其他部位,出現其他相關症狀才引起關注。這也是為什麼很多病人確診扁桃腺癌時,已屬第三、四期的末期階段。

 

 

扁桃腺癌常見症狀及傷害是什麼?

早期症狀:

  • 咽喉有異物感或輕微疼痛,容易被誤當成一段的咽喉炎治理。
  • 一邊扁桃腺腫大,表面粗糙或潰瘍,喉嚨痛及張口困難。

 

進展期症狀:

  • 劇烈的咽喉疼痛,同一側的耳朵出現耳鳴、痛楚,痛楚無法緩解。
  • 吞咽困難、聲音嘶啞、頸部出現無痛腫塊(這是頸淋巴結轉移症狀)。
  • 體重驟降、呼吸困難(這是腫瘤阻塞氣道)。

 

後期症狀:

  • 遠處轉移至肺、肝等器官,引起相關症狀,甚致器官衰竭。

 

 

扁桃腺癌病因是什麼?

主要風險因素:

  • HPV病毒感染:70%的扁桃腺癌與HPV有關,特別是高危型如HPV-16。
  • 長期炎症刺激:慢性扁桃腺炎反復發作,可能導致細胞變異。
  • 吸煙酗酒:煙草和酒精協同損傷黏膜,是重要的誘發因素。
  • 環境暴露:長期接觸化學物質或放射線。
  • 免疫抑制:如愛滋病患者或器官移植病人患病風險較高。

 

 

扁桃腺癌診斷方法有哪些?

  • 喉內鏡檢查:通過喉鏡觀檢查扁桃腺形態及病變情況,也要檢查頸部淋巴結。
  • 病理活檢:抽取組織化驗。
  • CT/MRI掃描:評估腫瘤大小及侵犯範圍。
  • PET-CT掃描:檢測腫瘤是否出現全身轉移。
  • HPV檢測:明確了解患病是否跟病毒感染相關,用作指導治療方案。

 

 

扁桃腺癌治療方法有哪些?

根據分期選擇治療方案,一般採用綜合治療方法,大致如下:

 

手術治療:

早期局限腫瘤可切除扁桃腺及周圍組織,保留功能。

晚期需擴大切除並清掃頸部淋巴結。

 

放射治療:

對放療敏感的腫瘤(如HPV陽性)可單獨或手術後使用。

精準放療技術(如調強放療)減少對正常組織的損傷。

 

化療與標靶治療:

晚期或復發病人,採用標靶藥物治療。

免疫療法(如PD-1抑制劑):對於晚期、復發或轉移的扁桃腺癌,免疫治療有顯著效果。

 

 

如你有任何耳鼻喉問題,請立即聯絡香港耳鼻喉頭頸外科中心,由我們的耳鼻喉專科醫生為你詳細診治(電話3100 0555)。

 

 

資料來源:

香港耳鼻喉專科

耳鼻喉頭頸外科中心

提供耳鼻喉科服務、頭及頸外科服務

聽力及言語治療、驗配助聽器服務

人工耳蝸植入、睡眠障礙治療

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

舌癌:別讓潰瘍變成危機 — 及早發現、預防及治療全解

 

「52歲古先生,有20年吸煙史且長期飲酒。半年前發現舌頭右側有一處潰瘍,起初以為是普通口腔潰瘍,但反復塗抹藥物後仍未癒合。潰瘍逐漸擴大,伴隨吞咽疼痛和說話困難。就醫後,通過活檢確診為「舌癌」,CT檢查發現頸部淋巴結轉移。經手術切除部分舌頭、頸部淋巴結清掃,並配合放療和化療,目前病情穩定,但需長期隨訪。」

 

 

舌癌是什麼癌症?

舌癌是口腔癌中最常見的類型,起源於舌頭表面的鱗狀上皮細胞,屬惡性癌細胞。根據發病的部位可分為:

  • 舌前2/3癌(口腔舌癌):佔多數,早期症狀較明顯。
  • 舌根癌(口咽癌):位置隱蔽,發現時可能已進展到中晚期。

舌癌具有侵襲性強、易轉移(尤其是頸部淋巴結)的特點,但早期發現治癒率較高。

 

 

舌癌症狀有哪些?

舌癌早期可能被誤認為普通口腔潰瘍,一旦有下列信號,就要警惕:

難以癒合的口腔潰瘍:如果舌頭出現潰瘍或紅斑,超過2周仍未癒合,就要留意。

  • 疼痛或麻木:進食、說話時疼痛,或舌頭局部麻木感。
  • 異常腫塊:感到舌頭增厚、有硬塊或菜花樣腫物。
  • 吞咽困難:晚期可能影響進食。
  • 不明原因出血:觸碰潰瘍或腫塊時易出血。
  • 口臭加重:因腫瘤壞死或感染引起。
  • 頸部腫塊:舌癌易出現頸淋巴結轉移。
  • 聲音改變:腫瘤侵犯舌根可能導致聲音嘶啞。

 

 

舌癌的誘發病因是什麼?

舌癌是多種因素共同作用的結果,主要風險包括:

  • 吸煙與飲酒:兩者協同作用使風險增加15倍以上。
  • HPV感染:尤其是HPV16型,與舌根癌密切相關(年輕患者比例上升)。
  • 口腔衛生差:長期牙周炎、尖銳牙齒或不合適假牙,長期磨損舌頭黏膜。
  • 飲食習慣:長期食用過熱燙、醃制或檳榔。
  • 遺傳因素:家族中有口腔癌病史者風險較高。

 

 

舌癌如何診斷?

  • 初步檢查:醫生通過視診、觸診判斷腫塊位置和範圍。
  • 口腔鏡:觀察舌部及咽喉細節。
  • 活檢:取病變組織進行病理分析,明確是否為惡性。
  • 影像學檢查:
  • CT/MRI:評估腫瘤大小、深度及淋巴結轉移。
  • PET-CT:可排查有否出現全身轉移。
  • HPV檢測:指導治療和預後判斷,相較其他舌癌種類而言,HPV相關的舌癌有較好的治療反應和存活率。

 

 

舌癌的治療方法是什麼?

1.早期(I-II期)

手術切除:優先選擇,切除腫瘤及周圍安全邊界。機器人微創手術用於舌根癌,減少創傷。

放射治療:適用於淺表小腫瘤,無法手術或保留舌功能的需求的病人。

 

2.中晚期(III-IV期)

綜合治療:手術 + 放療 ± 化療。

靶向治療:針對EGFR過表達(如西妥昔單抗)。

免疫治療:PD-1抑制劑用於復發或癌細胞擴散或轉移患者。

 

3.功能與外觀修復

皮瓣重建術:用患者自身組織(如前臂皮瓣)修復舌頭缺損。

語言與吞咽康復:術後需專業訓練恢復功能。

 

4.隨訪與預防復發

  • 定期口腔檢查、影像複查(前2年每3-6個月一次)。
  • 戒煙戒酒、保持口腔衛生。
  • 接種HPV疫苗(預防相關類型)、

 

 

及早發現舌癌至關重要!若舌部潰瘍超過2周仍不痊癒,請立即就醫。如你有任何耳鼻喉問題,請聯絡香港耳鼻喉頭頸外科中心,由我們的耳鼻喉專科醫生為你詳細診治(電話3100 0555)。

 

 

資料來源:

香港耳鼻喉專科

耳鼻喉頭頸外科中心

提供耳鼻喉科服務、頭及頸外科服務

聽力及言語治療、驗配助聽器服務

人工耳蝸植入、睡眠障礙治療

https://www.hkentspecialist.hk

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