Opening of the Chinatown Office

We are pleased to announce the opening of our Chinatown clinic at the Mandarin Tower (950 Stockton Street, Suite 203, San Francisco). Founded in 2010 by Dr. Kevin Ho, we now offer comprehensive ENT care at the heart of both Sunset and Chinatown districts. It is our goal to continue providing great care to our patients in San Francisco and the Bay Area. Please visit our website at www.KevinhoMD.com for more details and services provided by Dr. Ho.

言語治療改善黐脷筋

一個人說話時含糊不清，像含住粒欖核，就會被人取笑是「黐脷根」，而很多家長都怕自己的小朋友有這問題。「黐脷根」(tongue tie) 是一種先天性問題，患者的舌頭因為較正常短而顯得不靈活，以致會影響說話的清晰度，甚至可能會影響進食功能。除了手術治療外，病情較輕微的病人一般只須接受言語治療 (speech therapy)，便能改善問題。 舌根是指舌頭下面與口腔底部連接的筋膜 (frenulum)。正常情況下，我們伸出舌頭時舌尖通常可觸碰上唇，但舌根太短的人，伸出舌頭時舌根會扯着舌頭中間位置，令舌頭中間呈「M」字形凹陷，阻礙舌頭伸展至較遠的位置，部分嚴重個案更連舔雪糕等動作也做不到。由於我們說話時經常都需要舌頭輔助，才能發出正確的聲調語音，故「黐脷根」的人說話會顯得含糊不清。 過去的研究顯示，大約有百分之四小朋友有「黐脷根」問題，當中以男孩較多，但這些患者不一定有發音問題，而有發音問題的幼童或成人也未必一定是因為「黐脷根」，學習遲緩及口肌協調問題也是常見引致發音出問題的原因。因此，家長若懷疑小朋友有「黐脷根」，最好找醫生檢查清楚，有需要時可轉介接受言語治療，糾正發音問題，日後便不會被嘲笑了。至於較嚴重的個案要做手術也十分簡單，例如可以用激光剪掉舌根 (frenulectomy) 即可。 Tongue tie is a common pediatric ENT problem. It affects approximately 4% of the population. It can affect not only the ability to enunciate but also create problems with feeding. When the frenulum of the tongue is foreshortened, normal movement or protrusion of the tongue will be affected. In infants and younger children, surgical excision or frenulectomy is the treatment of choice. In older children who have speech delay or enunciation difficulties, speech therapy is also paramount in correcting this condition. Sources: http://the-sun.on.cc/cnt/news/20130416/00410_013.html

急性和慢性咽炎 病因及徵狀

咽炎是耳鼻喉科常見毛病。咽 (pharynx) 是連接鼻腔後面和口腔後部的通道，下通喉腔及食道，發生在這部位的炎症就是咽炎或咽喉炎，可分為急性 (acute) 及慢性 (chronic) 兩類。據過去調查，每年至少有百分之四十的人會患急性咽喉炎，這是一個人人都有機會患上的疾病。 臨床上，急性咽炎的病因大多數是過濾性病毒 (viral) 或細菌 (bacterial) 感染造成，患者的徵狀一般都不算嚴重，也不會妨礙日常生活和工作，患者通常會有喉嚨痛、喉涸、咳嗽，又或者是喉嚨有異物堵塞的感覺 (globus sensation)，吞口水或進食時會有痛楚。有時候更會伴有發燒、發冷及頭痛，而頸部淋巴可能會脹痛不已。大部分患者在一至兩星期內可以痊愈。 至於慢性咽炎就是指咽部長期發炎，成因有很多，例如空氣的污染物、灰塵或煙草，均會刺激十分敏感的咽膜而引起不適。另外，患有睡眠窒息症 (sleep apnea)、鼻竇炎 (sinusitis)、鼻息肉 (nasal polyp)及鼻中隔彎曲 (deviated nasal septum) 等疾病的人，由於呼吸道受阻而改用口呼吸，未經過濾和加濕加暖的空氣便會刺激咽部，容易誘發不適。慢性咽炎的常見徵狀有長期喉嚨痛、聲音沙啞等等，若置之不理可能會不斷惡化。 近期天氣時冷時熱，不但容易有傷風感冒，也要小心咽炎來襲，尤其是抵抗力較弱的人，例如是幼童、長者及長期患者，較容易受到病原感染而患上咽炎。由於咽炎的徵狀與扁桃腺炎很相似，後者延誤治療可帶來併發症，因此若喉痛持續不退，最好是盡快求醫處理。 Sources: http://the-sun.on.cc/cnt/news/20130423/00410_023.html

夜晚咳不停 或鼻水倒流

咳嗽未必是嚴重的健康問題，但經常咳個不停卻也不好受，而不少人更試過日間活動時正常，但每每躺在床上準備睡覺時，咳嗽就特別嚴重，以致整晚無法安睡。原來，睡覺時我們的氣管會因為肌肉放鬆而較日間為窄，故容易受到刺激；有些人則是因為有鼻水倒流 (post-nasal drip)，刺激氣管產生咳嗽反應，於是每次躺臥在床便咳嗽不斷。 鼻水即是鼻涕，主要是用作濕潤及暖化空氣，一般都會經由鼻孔流出或進入食道消化，但有時傷風感冒，或鼻敏感發作 (allergic rhinitis)，鼻水分泌大量增加，在日間病人會用紙巾吸走鼻水，惟晚上躺臥時，鼻水受地心吸力影響後流向入氣管，刺激氣管誘發咳嗽，假如鼻道有阻塞，病人可能日間也會有鼻水倒流的情況。對於睡覺時有咳嗽或咳嗽變嚴重的病人，醫生可以利用鼻內窺鏡 (nasal endoscopy) 檢查細看，便可以知道病人是否有鼻水倒流。 受咳嗽問題困擾的病人，求醫當然想立即止咳，但有時也得容許醫生花一點時間，找出咳嗽的成因才能有效止咳，例如鼻敏感導致鼻水倒流引起的咳嗽，就要好好控制鼻敏感，方能令咳嗽消失，否則即使天天吃咳藥也不能根治問題。 Chronic cough is a common problem facing ENT physicians every day. Its etiology is often multifactorial, making diagnosis difficult. Common causes in the upper airway (nose, throat, pharynx, larynx) include but not limited to allergic and non-allergic rhinitis, post-nasal discharge, laryngopharyngeal reflux disease, chronic tonsillitis, and chronic laryngitis. We as ENT physician can perform a simple in-office procedure called fiberoptic nasopharyngoscopy to evaluate for these upper airway pathologies. Sources: http://the-sun.on.cc/cnt/news/20121030/00410_014.html

Obstructive sleep apnea

Obstructive sleep apnea (OSA) is a common health problems affecting both adults and children. It is often under diagnosed especially in female and senior population. Snoring presents in almost all patients with OSA. Additional symptoms include daytime somnolence, sleep disturbances, decreased work performance and concentration. If untreated, it can lead to cardiopulmonary complications such as hypertension and pulmonary hypertension. In children it is often related to adenotonsillar hypertrophy, hence tonsillectomy and adenoidectomy are curative. Patients can also present with nasal obstruction and narrowing of the nasal passages due to deviated septum, nasal polyps, hypertrophic nasal turbinates, or sinusitis. Sleep study remains the gold standard for diagnosing OSA. It measures the duration and frequency of pauses of breathing, as well as oxygen concentration and other abnormal brain activities. In young children, parental observation is often recommended due to difficulties of obtaining a meaningful sleep study. Mainstay of treatment for OSA in adult population is CPAP device. It provides positive pressure ventilation to "re-open" the collapsed airway. Sleep surgery is considered for patients who are unable to tolerate CPAP and severe cases involving jaw advancement or definitive tracheostomy airway. Weight loss management is also paramount for improving the severity of OSA. Excerpt from Community health talk at the Sunset Church of San Francisco. March 15, 2013.