Sunday, February 28, 2010

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。


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。


Monday, February 22, 2010





Saturday, February 20, 2010

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 ( 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.

Thursday, February 4, 2010

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.

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