無創科技切除鼻息肉

鼻息肉 (nasal polyps) 可造成不少鼻腔不適，例如鼻塞、容易流鼻血、打鼻鼾、嗅覺不靈、令鼻水混濁及帶有異味等，但倘若鼻息肉沒有得到適當處理，除可併發鼻竇炎 (rhinosinusitis)，鼻腔在長期發炎下，更會影響嗅覺，日後即使成功將息肉除去，患者的嗅覺也未必能夠得以恢復，而且它與鼻竇內翻性乳頭瘤 (inverted papilloma) 的外表類似，故為免卻延治及併發症的風險，應及早確診處理鼻息肉問題。
治療方法視乎病情而定，如果鼻息肉體積細小，可先透過類固醇鼻噴劑控制病情；倘若鼻息肉體積過大，令鼻液不能順利流出時，便可考慮以內窺鏡技術將息肉切除。手術會經鼻孔將內窺鏡放入，再進行切除，故手術不會於患者的面部表面留有傷痕，而手術現時也可用上迴旋刀減低對正常鼻黏膜造成的傷害。
但如果患者過往曾接受鼻息肉手術，鼻腔結構受到改變，為提高手術的精準度，可考慮透過電腦導航技術定位，以減低手術風險。不過，不論接受迴旋刀還是電腦導航技術切鼻息肉，患者於手術後建議在醫生指引下使用類固醇鼻噴劑，降低黏膜發炎及鼻息肉復發的機會。

Nasal polyposis is a common cause of nasal obstruction. It is commonly seen in chronic sinusitis patients, who may suffer from longstanding nasal congestion, decreased sense of smell, and sinus headache. It can be easily diagnosed with nasal endoscopy which shows whitish smooth painless mass blocking the natural sinus drainage pathways. Initial treatment is medical involving oral and topical steroid spray, and comprehensive allergy treatment. Refractory cases require polypectomy via functional endoscopic sinus surgery (FESS). New techniques in sinus surgery include computer navigation system, microdebrider, balloon sinuplasty, and coblation. Patients with nasal polyposis are recommended to follow up with ENT physicians regularly to ensure control of disease.

Sources:
http://www.metrohk.com.hk/index.php

生飛滋

「飛滋」的學名為復發性口瘡或復發性口腔潰瘍 (aphthous ulcer)，是一種經常復發而又能自愈的口腔黏膜潰瘍，它通常出現於唇、面頰或齒齦等，邊界清晰而中間發紅及微腫，有時會造成灼痛感。

其實，飛滋是口腔黏膜表皮層受損傷後形成的傷口，成因未確定，但可能與多種因素有關，例如精神壓力、抵抗力差、身體受流感等病毒感染而削弱黏膜的抵抗力，再加上外來的刺激，如被食物刮損口腔、煙草中的尼古丁等，都會增加飛滋出現的機會。

要避免生飛滋，就要改善上述提過的誘因，多吃蔬果及多喝水，尤其要攝取足夠的維他命B2，以促進黏膜細胞健康。此外，亦要保持口腔清潔，減少細菌孳生，平日最好少吃燒烤、過熱或油炸等食物。

飛滋一般數日內可自愈，若情況持續兩周未愈甚至加劇，又或是經常長出又大又嚴重的飛滋，便可能是口腔黏膜病變或免疫系統出問題的徵狀，應盡快求醫檢查。

Aphthous ulcer is the most common type of nontraumatic ulcer. Incidence ranges from 10-20 % in the general population. The exact etiology is unknown but it has been linked to immunologic mechanism. Minor aphthous ulcers measure less than 1 cm while major ones are larger than 1 cm. The former typically lasts 1-2 weeks and resolves spontaneously, while the latter can persist up to months and heal by scarring.
Diagnosis is clinical and no microscopic feature is diagnostic of aphthous ulcer. Non-painful minor ulcers require no treatment. For painful and major ulcers, treatment ranges from dietary supplements, antibiotics, anti-inflammatory, oral mouth rinse, to chemical cautery with silver nitrate application.

Source:
http://the-sun.on.cc/cnt/news/20100508/00410_003.html

成年睡眠窒息症

一個人常常睡醒, 日間又無精打彩, 很可能是患上睡眠窒息症，保守估計約百分之四的成年男士患有此病，女性發病率則約百分之二，而肥胖及年老退化會增加組織垂鬆阻塞呼吸道的機會，頸頜結構異常的人士亦較高機會患病，例如下顎較小和下巴向後的人，舌頭會被推向咽喉，故也較易出現睡眠窒息症。

在正常情況下，無論我們睡得多熟，身體仍然會維持呼吸，但患有睡眠窒息症的病人，上呼吸道被鬆垂的軟組織及脂肪壓迫，以致呼吸間歇停頓。當大腦感應到身體缺氧時，便會發出指令要身體醒來，咽喉肌肉亦隨即恢復張力並重開氣道，讓空氣再次進入，身體也可以再次入睡。這種睡睡醒醒的情況可能出現多達數百次，而每次窒息可由數秒至數分鐘不等，因此實際上並無充分休息，導致日間精神委靡及感到睏倦，直接影響到工作和學業表現，若在駕駛或操作機械時打瞌睡便更為危險。

睡眠窒息症不能以藥物作治療，但仍有不少方法可以改善病情，例如使用正氣壓睡眠機，便是治療睡眠窒息症的最有效方法。睡眠機把空氣加壓並透過喉管及面罩泵入鼻腔，藉以打開阻塞了的呼吸道，令空氣可如常進出肺部，病人就不再因缺氧而醒。此外，肥胖的病人減肥後情況多會好轉，而避免仰睡則可減少舌頭阻塞咽喉，亦有助紓緩病況。若患者對睡眠機產生抗拒，可考慮接受手術治療，例如喉嚨矯型手術，對初度至中度的睡眠窒息症尤其有效。

Obstructive sleep apnea (OSA) affects close to 12 million Americans and results in significant loss of work efficiency if not treated. It is different from primary snoring disorder in that the latter does not cause long term cardiopulmonary complications such as pulmonary hypertension. Sleep study is the diagnosis of choice and is performed with patient spending a night in a sleep lab. An apnea event is defined as cessation of breathing for 10 seconds. A score known as apnea hypopnea index (AHI) is obtained and used to classified sleep apnea into mild, moderate, and severe categories. CPAP machine is the first line of treatment for OSA, although non-compliance remains a major issue with the device due to the discomfort of sleeping with the mask. For patients unable to tolerate CPAP, surgery is an option offered by Ear, Nose and Throat specialists. Surgery is most effective for patients with favorable anatomy (large tonsils, small tongue), mild apnea (AHI < 15), and strong motivation to lose weight.

Source:
http://the-sun.on.cc/cnt/news/20100507/00410_003.html