Ear nose throat specialist clinic

August 22, 2012

Balloon sinuplasty

Balloon sinus dilation (BSD) represents the first step toward tissue preservation technique and away from the destructive access techniques necessary for FESS. Much like angioplasty is used to open coronary arteries and avoid bypass graft surgery, BSD offers patients with chronic sinusitis the possibility of complete preservation and restoration of the native sinus anatomy.

The technique was first proposed in 2006 by Bolger and Vaughan as a safe, effective, and reliable means of establishing patent sinus ostia.[5] Following the publication of this cadaver study, subsequent multicenter studies in living patients demonstrated similar safety and effectiveness profiles.[6, 7]

Reference: http://emedicine.medscape.com/article/1574031-overview


Allergies are from young and severe reactions can be bad

Read more: http://thestar.com.my/health/story.asp?file=%2F2012%2F8%2F19%2Fhealth%2F11863369&sec=health#.UDO1lS-FMK0.emai

Causes of Sinusitis and risk factors

Causes, incidence, and risk factors

The sinuses are air-filled spaces in the skull (behind the forehead, nasal bones, cheeks, and eyes) that are lined with mucus membranes. Healthy sinuses contain no bacteria or other germs. Usually, mucus is able to drain out and air is able to circulate.

When the sinus openings become blocked or too much mucus builds up, bacteria and other germs can grow more easily.

Sinusitis can occur from one of these conditions:

  • Small hairs (cilia) in the sinuses, which help move mucus out, do not work properly due to some medical conditions.
  • Colds and allergies may cause too much mucus to be made or block the opening of the sinuses.
  • A deviated nasal septum, nasal bone spur, or nasal polyps may block the opening of the sinuses.

Sinusitis can be:

  • Acute — symptoms last up to 4 weeks
  • Sub-acute — symptoms last 4 - 12 weeks
  • Chronic — symptoms last 3 months or longer

Acute sinusitis is usually caused by a bacterial infection in the sinuses that results from an upper respiratory tract infection. Chronic sinusitis refers to long-term swelling and inflammation of the sinuses that may be caused by bacteria or a fungus.

The following may increase your risk or your child’s risk of developing sinusitis:

  • Allergic rhinitis or hay fever
  • Cystic fibrosis
  • Day care
  • Diseases that prevent the cilia from working properly, such as Kartagener syndrome and immotile cilia syndrome.
  • Changes in altitude (flying or scuba diving)
  • Large adenoids
  • Smoking
  • Tooth infections (rare)
  • Weakened immune system from HIV or chemotherapy
    Reference: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001670/

Ear Wax

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Earwax, also known as cerumen, is a yellowish waxy material that is produced by the sebaceous gland in the ear canal inside the ear. Earwax lubricates, cleans and protects the lining of the ear canal by repelling water, trapping dirt and making sure insects, fungi and bacteria do not get through and harm the eardrum. The cerumen is slightly acidic and has antibacterial properties. If we had no earwax, the ear canal would become extremely dry, waterlogged and infected.

Earwax consists mainly of shed layers of skin - 60% of it is keratin, 12% to 20% is saturated and unsaturated long-chain fatty acids, squalene and alcohols, and 6% to 9% is cholesterol.

When we are in a heightened state of fear or anxiety we produce more earwax.

There are two different types of earwax, which are determined by a person’s genetic type. Asians and Native Americans tend to have the dry, gray, flaky type of cerumen, while Europeans and Africans have the wet, honey-to-dark brown and moist type. Anthropologists examine earwax when tracking human migratory patterns.

Soft and hard earwax - children are more likely to have soft earwax. Earwax problems tend to be caused by the hard type.

Reference: http://www.medicalnewstoday.com/articles/248934.php

Rhinology Summit 2013

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Visit www.rhinologysummit.com for details

ear wax

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Ear Wax removal should never be done with cotton buds. This causes wax impaction.

See article: www.nst.com.my/life-times/health/vexed-by-earwax-1.111691

June 10, 2012

Prince Court Medical Centre

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Prince Court Medical Centre is located near to KLCC. Datuk Dr Kuljit Singh ENT consultant clinic is daily at this centre

Breath easy

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ALL humans experienced nasal blockage some time in their lives and some have it almost daily. In most cases, the blockage lasts for a few minutes to hours and it gets better without the patient realising it.

Some nasal blockages can be persistent and may require a detailed examination. In most cases, simple common cold or allergy rhinitis can be the cause.

Types of nasal blockages

The condition can be broadly divided into one side and both sides blockages of the nasal cavity. The causes can be almost similar except that some one-sided blockages are caused by cancers, foreign bodies (in children), antrochoanal polyps or deviated septum on one side.

Blockage on both sides can be caused by anything from narrowing of the nasal opening, allergic rhinitis, sinusitis, large internal nasal bones (hypertrophied turbinates), nasal polyps, septal deviation to nasal cancer.

Identifying the cause

The simplest method is examination of the internal nose (which can be performed by any doctor) but for details, an endoscope is fed into the nasal cavity. This is usually painless and will almost always give enough information on the cause of the blockage.

In some cases, imaging may be done, like CT Scan in order to see the details that could be missed by the endoscope particularly within the sinuses.

Nasal polyps

Polyps are out-growth of the lining of the nose which is painless. One of the main symptoms is nasal blockage. The causes of nasal polyps remain complex and are not well understood.

In most cases, they are not dangerous except that they cause nasal obstruction and loss of smell, headaches due to associated sinusitis and sometimes discomfort and pain due to the mass of the polyps.

When polyps are on one side of the nose, it is common for the doctor to do a biopsy to rule out early signs of cancer cells which is known as inverted papilloma. This condition will require a total removal of the polyps.

Treating nasal polyps

It is important to do a CT Scan Sinus that helps locate the polyps and anything that may be useful to the doctor.

In allergy suspecting polyps, anti allergy medication is started and in sinusitis, infection is also treated with antibiotics.

If the symptoms are troubling or there are signs of potential cancer cells, the polyps should be removed. In most cases, the polyps are removed with rotating cutting devices which causes minimal bleeding and damage to the structure of the nose.

The important part of the treatment is medications to prevent recurrence of the polyps.

Polyps growing again after surgery is common and it is difficult to predict this before surgery. In some patients, polyps never occur again but in others, the polyps reappear just weeks after the surgery.

Nasal cancer

The nasal cavity is much bigger than the nostrils, so any cancer causing an obstruction has to be sufficiently big in size.

Advanced nasapharyngeal cancer can cause significant blockage but there may be other symptoms by then, such as neck swelling, etc.

Sometimes there are cancers that originate from the sinuses that may cause obstruction and these can be detected on endoscopy and CT Scan Sinus.

The writer is consultant ENT Surgeon at Prince Court Medical Centre

Read more: When it’s hard to breathe - Health - New Straits Times http://www.nst.com.my/life-times/health/when-it-s-hard-to-breathe-1.90934#ixzz1xJWGdPQA

August 22, 2011

Sinus Surgery

Modern methods of using balloons has great results. These procedures are useful and now well accepted


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Sinus Forum Asia now goes to Bali in October 2011

Log on www.sinusforumasia.com for registration

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