黐脷根 真假有分

「黐脷根」有真假之分，真正的「黐脷根」(ankyloglossia) 是因為天生舌根 (frenulum) 太短，導致舌頭不靈活，影響咬字及發音；假的「黐脷根」純粹受懶音或習慣說話含糊不清等後天因素影響，兩者也可以透過言語訓練 (speech therapy) 糾正，但若舌根天生非常過短，則可能要透過手術矯正。

天生舌根太短的人，當伸出舌頭時，舌根會扯着舌頭中間位置，形成舌頭兩端較長、中間凹陷呈M字形，導致不能正常伸出。舌根正常的人伸出舌頭時，長度一般可超過嘴唇，但舌根過短的人伸出舌頭時，多只僅及嘴唇，甚至只能到達牙齒。

舌根太短對兒童學習講說話構成負面影響，會出現咬字不清的情況。很多人以為「黐脷根」的小朋友需接受俗稱「剪脷根」的手術 (frenuloplasty)，其實家長可考慮透過言語治療改善，只要經過適當的練習，可將問題完全糾正過來。

Source:
http://the-sun.on.cc/cnt/news/20100301/00410_032.html

以毒攻毒治愈花生敏感

食物敏感情況嚴重可致命，家長會因子女食物敏感，避免他們接觸致敏的食物，不過，英國劍橋一間醫院的研究人員嘗試以毒攻毒，把花生磨成粉末加入乳酪中，讓對花生敏感的兒童進食，劑量逐日增加，直至他們每日可吃五粒花生，使免疫系統對花生產生耐受性。初步發現二十三名參與研究的兒童中，二十一人不再對花生產生敏感。

研究人員希望將這種治療方法發展為治療敏感的方法，甚至擴展到對牛奶及雞蛋等食物敏感的人士身上，但他強調，這類治療必須在醫護人員監察下進行，家長千萬不要在家中自行為子女治療。

Source:
http://the-sun.on.cc/cnt/news/20100223/00410_032.html

Hearing loss

Hearing loss is one the most common complaints seen by ENTs nowadays. There are two types of hearing loss: conductive and sensorineural hearing loss. Conductive hearing loss results from disruption of the conduction mechanism of the ear, namely the outer ear, ear drum, and the middle ear which houses the 3 hearing bones. Sensorineural loss is a result of damage to our primary hearing organ, the cochlea, and the hearing nerve. A significant proportions of sensorineural hearing loss in adult is due to noise exposure. A simple tuning fork test can differentiate the two types of hearing loss. To find out more details about a hearing loss, a formal hearing test is required. Direct visualization of the ear canal, ear drum, and the hearing bones under microscopy is important to evaluate for any rupture of the ear drum or obstruction of the ear canal. Our Stonestown office (www.kevinhomd.com) is fully equipped to address hearing loss at any ages. We have a licensed audiologist to perform hearing evaluation and hearing aid prescription and maintenance. Hearing is an important component of our lives and don't hesitate to contact us for any questions about your hearing.

Allergic rhinitis

Allergic rhinitis affects about 1/3 of the US population. Morbidity from this disease leads to decreased productivity, lost work/school days, and increasing costs of medical care and treatment. It is an important entity for the practicing otolaryngologist because many of these patients have failed medical management. In order to treat these patients, allergy testing may need to be performed in order to start vaccine immunotherapy.

Inflammation of the membrane lining the nose secondary to hypersensitivity to aeroallergens, characterized by rhinorrhea, sneezing, pruritis, congestion, post nasal drip and associated conjunctival, otologic or pharyngeal inflammation. These symptoms can be episodic, seasonal or perennial. Severity ranges from mild, to seriously debilitating with excess days of missed school or work. Risk factors include family history of atopy, serum IgE > 100 IU/ml before age six, higher socioeconomic class, exposure to aeroallergens, presence of positive allergy skin prick test.

Prick/scratch testing (SPT) is a superficial skin reaction that does not penetrate dermis. It is highly specific, sensitive, convenient and safe. A test is positive if there is a wheal and flare reaction which is greater than or equal to the histamine control.

Intradermal testing (IT) a dilute antigen extract is injected into the dermis, and a superficial wheal forms. After ten minutes, the wheal is measured again to see if there was any progression. If the diameter of the wheal has increased by 2mm or greater, then a positive response has occurred. This causes relatively minimal patient discomfort.

Immunotherapy is a viable option for patients not benefiting from traditional medical management (eg. nasal steroid spray, antihistamine, etc.) that works by altering one’s immunologic response. Adjuvant therapies may be useful to maximize effect of immunotherapy.

Source:
Medical Management of Allergic Rhinitis UTMB Dr. Quinn's online textbook of Otolaryngology [Apr 30, 2009]