Ageing gracefully with your

Ear Nose & ThroatDR HUANG SHOOU CHYUAN

Ear Nose Throat Surgeon,Huang Ear Nose Throat Surgery

Gleneagles Medical Centre #04-17Tel: 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 Surgeryentsurgery.com.sg

Health Promotion Board (HPB)hpb.gov.sg/healthtopics.aspxhpb.gov.sg/hpb/default.asp?pg_id=911

National Cancer Centre (NCC)nccs.com.sg/pbcation/HB/Nasopharyngeal_Cancer_Eng.pdf

Singapore Cancer Societywww.singaporecancersociety.org.sg/lac-fcn-nasopharyngeal-cancer.shtml

Overseas websites:healthyagingprograms.org/content.asp?sectionid=73nihseniorhealth.gov/exercise/toc.htmlaafp.org/afp/990501ap/990501d.html

Deafness in the Elderly

Outer ear

Middle ear

Inner ear

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 tinnitusCoping behaviours : avoid group

meetings asking others to repeat themselves turning up volume of TV misinterpreting messages

Frequency in HertzL

ou

dn

ess

in d

ecid

els

Frequency in Hertz

Lo

ud

nes

s in

dec

idel

s

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:

Eustachian tube blockage after flights or “colds”

Nasopharyngeal cancer (NPC): Nose Cancer

Hearing aids

Head & Neck Cancers- Signs and Symptoms

头部与頚部癌症

Lymph Node Lumps淋巴癌

Salivary Gland Tumour

唾腺癌

Thyroid Cancer甲状腺癌 Vocal cord

cancer 声带癌Tongue Cancer舌头癌

Nose Cancer鼻咽癌

黄守全医生 Dr.Huang Shoou Chyuan

Nasopharyngeal Cancer (1968-2002) 鼻咽癌统计数字 (1968-2002年 )

男性

女性 女性

男性

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 Than You

Think! 45% normal adults snore (occasionally) 25% habitual snorers More frequent in males/overweight/elderlyMechanisms of snoring:Partial obstruction throughout airwayPoor muscle tone eg elderly/alcohol/sleeping

pillsExcessive tissue eg obese/tonsils/small lower

jaw posterior tongue baseLong soft palate/uvulaNose 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 breathing for at least 10 seconds)

3. Waking up tired, even after a full night's sleep

4. Feeling sleepy during the day (at work or while driving)

5. Irritability or short temper6. 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. 

Tests & Treatment for OSAPolysomnogram PSG (Sleep Study):gold-standard for OSA diagnosis originally done at attended Sleep Laboratory

Watch-PAT technology:Avoids pitfalls of conventional PSGie.Electrodes & wires cannot sleep! Expensive FNE-First Night EffectResults validated with sleep lab’s dataReimbursable in many parts of USA

Obstructed airway

Conventional PSG with electrodes & wires

Watch-Pat 200:Non-invasive;Minimal sleep interference Comfort of home Single-button operationInstant 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 caused by respiratory disturbances during sleep

proprietary algorithm analyzes PAT signal identifying sleep apnea events with high degree of specificity and sensitivity

Parameters measured or derived during the night include oxygen saturation, heart rate, sleep and wake states, and REM and non-REM sleep.

Heart rate

O2 satn

Sleep stage

Snoring level

Body position

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 sleeping pills aids), and

avoid sleeping on one's back

2. CPAP (Continuous Positive Airway Pressure)

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 surgeryUPPP- Uvulopalatopharyngoplasty