Transcript Ageing Gracefully with your Ear Nose & Throat

Ageing gracefully with your
Ear Nose & Throat
DR HUANG SHOOU CHYUAN
Ear Nose Throat Surgeon,
Huang Ear Nose Throat Surgery
Gleneagles Medical Centre #04-17
Tel: 64757995
Website: www.entsurgery.com.sg
"Give a man a fish and he will eat for a
day. Teach a man to fish and he will
eat for a lifetime."
Unknown author
Singapore websites:
Huang Ear Nose Throat Surgery
entsurgery.com.sg
Health Promotion Board (HPB)
hpb.gov.sg/healthtopics.aspx
hpb.gov.sg/hpb/default.asp?pg_id=911
National Cancer Centre (NCC)
nccs.com.sg/pbcation/HB/Nasopharyngeal_Cancer_Eng.pdf
Singapore Cancer Society
www.singaporecancersociety.org.sg/lac-fcn-nasopharyngealcancer.shtml
Overseas websites:
healthyagingprograms.org/content.asp?sectionid=73
nihseniorhealth.gov/exercise/toc.html
aafp.org/afp/990501ap/990501d.html
Inner ear
Outer ear
Middle ear
Deafness in the Elderly
How do I know I have a hearing
loss?
Difficult to hear : women’s voices
bird’s singing
TV or phone
conversation within a group
tinnitus
Coping behaviours : avoid group meetings
asking others to repeat themselves
turning up volume of TV
misinterpreting messages
Loudness in decidels
Loudness in decidels
Frequency in Hertz
Frequency in Hertz
Common causes of deafness in elderly
Inner ear: Presbycusis –
degeneration of cochlea
bilateral with tinnitus
lose hi pitch first
distorted hearing
worse with previous noise exposure &
family history
Outer ear:
Ear wax-
Perforated drum-
External ear infection
Middle ear:
Nasopharyngeal cancer (NPC):
Nose Cancer
Eustachian tube
blockage after flights
or “colds”
Hearing aids
Head & Neck CancersSigns and Symptoms
黄守全医生
Dr.Huang Shoou Chyuan
头部与頚部癌症
Nose Cancer
鼻咽癌
Salivary
Gland
Tumour
唾腺癌
Lymph Node
Lumps
淋巴癌
Thyroid Cancer
甲状腺癌
Vocal cord cancer
声带癌
Tongue Cancer
舌头癌
Nasopharyngeal Cancer (1968-2002)
鼻咽癌统计数字 (1968-2002年)
男性
男性
女性
女性
Causes of Nose Cancer
鼻咽癌病因
 Genetics基因-Chinese esply southern Chinese
尤其华南一带的华族
 Epstein-Barr Virus (EBV)细菌
 Diet eg salted fish 饮食习惯例如咸鱼咸菜
 Familial 家族遗传
Signs and Symptoms of NPC
鼻咽癌的症状
 Ear 耳
Deafness 耳聋
Tinnitus 耳鸣
 Nose 鼻
Nosebleed 流鼻血
Blood in sputum咳嗽出血
 Throat 喉
Neck Lumps頚部肿瘤
Naso-endoscopy
用内窥镜检查鼻子
Normal
正常的
Nose
Cancer
鼻咽癌
Treatment Methods
治疗方法
 Radiotherapy 电疗 -
Early stage NPC 早期
 Combination Radio- and Chemotherapy 化疗与电疗
- Mid- and Later stage NPC 中期后期
 Surgery 动手术- Recurrent Neck Lump 頚部 肿瘤 复发
Early stage NPC has cure rate of about 80% !
早期治愈机会高 +/- 80%!
Neck Node Swelling
淋巴肿瘤
Lymphoma淋巴癌 :
Fever 发烧
General Malaise 疲倦
Metastatic Neck Swelling
癌症扩散:
Cancer-related swelling
与癌症有关的肿瘤
Thyroid Cancer
甲状腺癌
Neck swelling肿瘤
Hoarseness (Recurrent
Laryngeal Nerve) 声音嘶哑
Swallowing difficulty 吞咽困难
Airway obstruction 呼吸困难
Pain 疼痛
Salivary Gland Cancer
唾腺癌
Swelling 肿瘤
Facial paralysis脸部扭曲
Pain 疼痛
Vocal Cord Cancer
声带癌
Swelling 肿瘤
Hoarseness 声音嘶哑
Swallowing difficulty吞咽困难
Airway obstruction呼吸困难
Pain 疼痛
Blood in sputum 咳嗽出血
Tongue Cancer
舌头癌
Non-healing ulcer 无法痊愈的溃疡
Pain 疼痛
Bleeding 口部流血
Swallowing difficulty吞咽困难
Airway Obstruction呼吸困难
Snoring: More Serious ThanYou Think!
 45% normal adults snore (occasionally)
 25% habitual snorers
 More frequent in males/overweight/elderly
Mechanisms of snoring:
Partial obstruction throughout airway
Poor muscle tone eg elderly/alcohol/sleeping pills
Excessive tissue eg obese/tonsils/small lower jaw
posterior tongue base
Long soft palate/uvula
Nose blockage
Pure snoring or OSA?
Obstructive Sleep Apnea

apnea episodes (more than 10
secs) + reduced airflow =
> 5/hr
1. Gasping for air during sleep
2. Witnessed apnea (stopping of
3.
4.
5.
6.
breathing for at least 10 seconds)
Waking up tired, even after a full
night's sleep
Feeling sleepy during the day (at
work or while driving)
Irritability or short temper
Problems with concentration or
memory
7.
Medical conditions such as high
blood pressure and heart disease
OSA Risks

Risks of accidents

High blood pressure

Heart disease

Stroke

Sudden deanth
NB: More than 50% (!) of men with
untreated OSA suffer a serious
health condition or even death
within 10 years.
Obstructed airway
Tests & Treatment for OSA
Polysomnogram PSG (Sleep Study):
gold-standard for OSA diagnosis
originally done at attended Sleep
Laboratory
Watch-PAT technology:
Avoids pitfalls of conventional PSG
ie.Electrodes & wires cannot sleep!
Expensive
FNE-First Night Effect
Results validated with sleep lab’s
data
Reimbursable in many parts of USA
Conventional PSG with electrodes & wires
Watch-Pat 200:
Non-invasive;
Minimal sleep interference
Comfort of home
Single-button operation
Instant analysis and report
USA FDA & European CE cert
Ambulatory Sleep Study by Watch-Pat
Peripheral Arterial Tone
Technology(PAT)
 physiological signal mirroring
autonomic nervous system changes
Heart rate
caused by respiratory disturbances
during sleep
O2 satn
 proprietary algorithm analyzes PAT
signal identifying sleep apnea
Sleep stage events with high degree of
specificity and sensitivity
 Parameters measured or derived
during the night include oxygen
saturation, heart rate, sleep and
Body position wake states, and REM and non-REM
sleep.
Snoring level
OSA treatment options
 1. Weight loss:Body Mass Index BMI less than 25
(BMI) = weight(kg) divided by height(m)2
eg Ht 1.67 , Wt 70, BMI= 25
avoid sedatives (including alcohol, antihistamines and
aids), and
avoid sleeping on one's back
 2. CPAP (Continuous Positive Airway Pressure)
sleeping pills
OSA treatments
 3.Dental splint: keeps tongue and jaw forward to prevent airway
collapse
.
Sleep strip on the nose:
improves nasal airway
Medications to lessen nose blockage
OSA treatments
 4.surgery: to improve airway in nose & throat
Turbinate reduction
Septal surgery
UPPPUvulopalatopharyngoplasty
谢谢
THANK YOU