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Li Mao Cai
Otolaryngology
About me
With over 10 years of experience in clinical otolaryngology, I have accumulated a certain amount of expertise in diagnosing and treating diseases in this specialty. I have a professional perspective on understanding health issues, believing that prevention is better than cure. Therefore, on online platforms, while addressing the concerns of those seeking advice, I am more willing to provide some popular science knowledge on disease prevention. Those in need are welcome to consult.
Proficient in diseases
Allergic rhinitis, pharyngitis, chronic pharyngitis, sinusitis, nasal polyps, nasopharyngeal carcinoma, laryngeal carcinoma, vocal cord polyps, adenoid hypertrophy, chronic tonsillitis, snoring, tinnitus, thyroid nodules, otitis media, etc.
Voices
What should I do if a deviated nasal septum causes nosebleeds?
Nasal bleeding caused by a deviated nasal septum requires active hemostasis treatment. During the period of nasal bleeding, the deviated area of the nasal septum often forms a protrusion, making one side thinner and more severely deviated, forming a bony spur with a sharp point. The mucosa at this point is thinner and more prone to injuring the surrounding tissue structure. Therefore, nasal bleeding is more likely to occur in a dry nasal cavity or when water intake is low. Once bleeding occurs, the treatment method is similar to that of common nasal bleeding. Firstly, the most common method is compression hemostasis, pressing on the bleeding point to stop the bleeding. Additionally, electrocoagulation can also be considered. After the nasal bleeding has stopped, combined with the patient's medical history, if there is a recurrent condition of nasal bleeding, considering correction of the deviated nasal septum might be needed to fundamentally correct the cause of recurrent nasal bleeding.
How to treat chronic pharyngitis?
Treating chronic pharyngitis is indeed a significant issue, and it's not something that can be explained in just a sentence or two. Some causes of chronic pharyngitis are direct, such as not paying attention to diet, poor sleep, or insufficient rest. Some are secondary pharyngitis, which requires active treatment of the primary disease. To address this issue fundamentally, one should first focus on a light diet, avoid smoking and alcohol, and avoid spicy and irritating foods—these are aspects to be mindful of in daily life. It's also important to pay attention to one's emotions; maintaining a calm demeanor, not rushing, avoiding getting angry easily, and not shouting are crucial. Being in a good mood is very important as it is part of actively treating the primary disease. Some primary diseases, such as chronic rhinitis, sinusitis, and gastroesophageal reflux disease, can cause pharyngitis. Therefore, to treat chronic pharyngitis, one should first effectively treat these primary diseases, and the chronic pharyngitis will naturally improve. Thus, the treatment of chronic pharyngitis involves a holistic, differentiated, and systematic approach.
Causes of chronic pharyngitis
Chronic pharyngitis is a very common disease in otolaryngology, with many specific causes that are not singular. Its causes are mainly related to lifestyle habits, diet, and some secondary and primary diseases. Common causes include smoking, alcohol consumption, consumption of spicy and irritating food, staying up late, high psychological stress, and significant emotional fluctuations, all of which can lead to chronic pharyngitis. Another cause is secondary pharyngitis, which results from primary diseases such as chronic rhinitis and sinusitis. Due to the long-term backflow of nasal discharge, which flows back into the throat and irritates the mucous membrane, a chronic inflammatory response is produced. This is also a common cause of chronic pharyngitis. Furthermore, there is reflux pharyngitis, which is also a type of chronic pharyngitis. Some people have stomach diseases and reflux esophagitis, where long-term acid reflux leads to damage in the mucous membranes of the throat, causing chronic inflammation with symptoms such as a foreign body sensation, burning sensation, and throat dryness. Therefore, there are many causes of chronic pharyngitis, including both primary and secondary reasons. A specific diagnosis needs to be made by a doctor based on a thorough medical history and physical examination.
Can adenoid hypertrophy cause otitis media?
Adenoid hypertrophy is commonly seen in children. The adenoids are located at the back of the nasal cavity, more precisely, at the nasopharyngeal region of the posterior nasal cavity. The nasal cavity is connected to the ears via the Eustachian tube, whose internal opening is situated in the nasopharynx. If the adenoids are enlarged, they can block the internal opening of the Eustachian tube. Therefore, adenoid hypertrophy can cause secretory otitis media. The common symptoms of secretory otitis media in children include a decrease in hearing, turning up the volume of the TV intentionally, and a sluggish response when called. This explains the mechanism and clinical presentation of how adenoid hypertrophy can lead to otitis media.
Chronic pharyngitis is classified into several types.
Chronic pharyngitis, based on pathological conditions, is divided into three types. The first type is chronic simple pharyngitis, which is also the most common type we usually refer to. It mainly involves chronic congestion of the pharyngeal mucosa and hyperplasia of lymphatic follicles on the posterior pharyngeal wall. The second type is chronic hypertrophic pharyngitis, which can be observed during examination as congested and thickened pharyngeal mucosa with proliferating lymphatic tissue, appearing rather thick. The third type is atrophic and dry pharyngitis, which is relatively rare in clinical cases and often accompanies atrophic rhinitis. A primary symptom is dryness in the throat because the pathological changes mainly involve a decrease in the secretory function of the glandular tissues in the pharynx, resulting in reduced secretions and the mucosa becoming atrophic and thin. Based on the different causes of the condition, it can also be divided into several types. One type is simple pharyngitis, also referred to as chronic simple pharyngitis, related to smoking, drinking, air pollution, and excessive talking. Another type is reflux pharyngitis, which is now also a disease with a relatively high incidence rate, mainly caused by gastroesophageal reflux leading to chronic inflammation of the stomach and damage to the mucous membrane of the pharynx and throat, known as reflux pharyngitis. Additionally, some cases are secondary to rhinitis and sinusitis, due to the long-term discomfort in the throat caused by the backflow of nasal discharge, leading to chronic inflammatory responses; this is also a type of secondary pharyngitis.
Is minimally invasive surgery for nasal polyps painful?
We often talk about the minimally invasive surgery for nasal polyps, which is the most common procedure of endoscopic nasal polyp removal that we use today. This type of surgery does not only remove the nasal polyps, but also the root of the polyps and even opens up the sinuses. This is crucial for eliminating the cause of the nasal polyps and is very important for preventing their recurrence. Although it is a minimally invasive surgery, it can still be quite painful. After the surgery, both nostrils need to be packed. If the packing material is absorbable, such as Nasopore, the discomfort might be less because after the surgery, one just needs to wait for the packing to gradually dissolve into a mucus-like substance and get expelled. However, if expandable sponges or even gauze strips are used, these materials need to be removed after several days. Removing these materials can cause significant pain for the patient. During the period of packing, the patient can also experience a lot of discomforts such as headaches, dry throat, discomfort in the eyes, tearing, and even some might feel foggy in their ears and uncomfortable while eating and drinking, along with other painful symptoms. Additionally, after the minimally invasive surgery for nasal polyps, regular follow-up cleanings are necessary. The purpose of these follow-up cleanings is to timely clear out any blood clots or secretions from the nasal cavity and sinuses, aiding the recovery of the mucous membranes in these areas and also preventing the short-term recurrence of the nasal polyps, which is a very important part of ensuring the effectiveness of the surgery. Thus, these procedures can induce a certain amount of fear and pain for the patients, but before performing these surgeries and examinations, doctors generally engage in thorough discussions and provide comfort to the patients, advising them not to be too nervous. The actual discomfort is temporary and will pass after enduring it for just a few days post-surgery.
Postoperative Care for Deviated Septum Surgery
Postoperative care after septoplasty mainly involves the following points: Since nasal packing is generally required after septal surgery, the physical condition of the person is quite painful during this period. Some people may experience headaches, continuous nasal discharge or even bleeding, nasal congestion, and some might even feel ear stuffiness and dry throat, etc. Therefore, it is important to rest after the surgery. Also, it is important not to be too anxious or impatient, cooperate with the doctor for appropriate treatment, and not to worry too much about recurrent symptoms of nasal bleeding, as these are normal occurrences. Once the nasal packing is removed, these symptoms will gradually improve. After the nasal packing is removed, care should be taken not to blow the nose forcefully, especially to avoid sneezing vigorously, as this may cause complications like nasal septal hematoma. After stitches are removed, it is crucial to avoid pressing on the nasal bridge forcefully, as protecting the nose in this way is key to ensuring proper nasal shape development.
Early symptoms of throat cancer
The early symptoms of laryngeal cancer vary depending on the type, as laryngeal cancer is categorized into three types. The most common type, accounting for over 80%, is glottic cancer. The early symptom for this type is primarily hoarseness, making it the type of laryngeal cancer where symptoms appear earliest. The other two types are supraglottic and subglottic cancer. These types are less likely to show early symptoms, or the symptoms may not be typical and easily noticeable or taken seriously. The main symptom is a foreign body sensation in the throat, which is often mistaken for pharyngitis or laryngitis and not given due attention. Therefore, when experiencing persistent hoarseness or a noticeable foreign body sensation in the throat, and if throat discomfort persists, it is advised to visit the Ear, Nose, and Throat (ENT) department of a hospital promptly for an examination with an electronic laryngoscope. This can help in the early detection, exclusion, and diagnosis of the condition.
Can you eat after a total laryngectomy for throat cancer?
After the total laryngectomy for throat cancer, a period of recovery is necessary, during which time liquid food is administered via a nasogastric tube. Once recovery is complete, it is possible to eat orally. Because the entire larynx is removed during a total laryngectomy, the functions of voice and breathing are lost, and breathing is instead facilitated through a tracheostomy in the neck. Eating is completely unaffected. After recovery from the total laryngectomy, food is ingested orally, passes through the pharynx, and goes directly into the esophagus. Thus, it is possible to eat orally after a total laryngectomy for throat cancer.
Vocal cord polyp general anesthesia surgery process
Vocal cord polyp surgery under general anesthesia currently involves the use of a combined inhalation and general anesthesia approach, employing a supporting laryngoscope for the excision of the vocal cord polyp. Before the surgery begins, general anesthesia is administered. After the patient is under general anesthesia, the doctor uses a supporting laryngoscope to fully expose the vocal cord polyp. Next, through a fibroscope, in conjunction with fiberoptic instruments or a carbon dioxide laser, the vocal cord polyp is completely excised. The source of the vocal cord injury is repaired to make the vocal cord surface smooth, and then the surgery is concluded. After the surgery, the anesthetist waits for the patient to wake up from the general anesthesia before they can be taken back to their room. The overall duration of the procedure, from anesthesia to surgery to awakening, is typically about an hour or so. Of course, treatment needs to be tailored to the specific patient. In some patients, the vocal cord polyps may not be easily exposed under the supporting laryngoscope, which might extend the duration slightly, whereas in others, where the exposure is straightforward, the procedure may be relatively shorter.