Ask a Ear, Nose Throat (ENT) Specialist: Dr Lim Keng Hua from Mount Elizabeth (Orchard) Hospital Singapore

dr. Lim Keng Hua replied 2 years ago

It will be good to know the cause of your deafness in one ear, Cochlear implant is indicated only in the deaf ear. Post implantation, you will need a period of rehabilitation to get use to the new sound from the implant.

Cochlear implant surgery is a big and complex surgery. There will definitely be some risk. The risk maybe broadly divided into those relating to the surgery itself and the implant. Please discuss with your doctor on the risk.

dr. Lim Keng Hua replied 2 years ago

It will be good to know your age, the duration of symptoms and whether you smoke. Is there any fever?
Most sore throat recovers within 1-2 weeks. If your sore throat is more than 2 weeks, I suggest having a check up by your doctor.

Pain on swallowing and swollen neck suggest an ongoing inflammatory process. You may have tonsillitis or pharyngitis with swollen lymph nodes. You will need a course of antibiotics. Please see your doctor immediately if you notice a definite swelling in the neck.

If you are a smoker, I suggest a ENT specialist consult if your sore throat is not better after a course of antibiotics.

It helps to have good hydration. Please continue to keep yourself well hydrated.

dr. Lim Keng Hua replied 2 years ago

Considering your age and the duration of swollen tonsil, I suggest a consultation with your local doctor , if necessary an ENT specialist. You may need a biopsy of the tonsil to rule out a tumour.

dr. Lim Keng Hua replied 2 years ago

Lipoma are generally benign and may not be removed. The indication to remove it depends on the size, location and symptom. Depending on the location of the lipoma, most ENT surgeons should be able to remove the lipoma. You will only need an excision biopsy of the lipoma if it can be separated from the muscle. Otherwise a cuff of the muscle may need to be resected. The exact surgery will depend on the location and size. Similarly, the fee will depend on the complexity of the case.

dr. Lim Keng Hua replied 2 years ago

If your symptom is blocked nose resulting in you finding it hard to breath, there is likely a cure to it. But, in view of the fact that you have been suffering from this for many years, it is important to find out the underlying cause. Nevertheless, no patient should be suffering from blocked nose for an extended period of time. It should be rectifiable. A nose scope is needed to evaluate.

dr. Lim Keng Hua replied 2 years ago

Sneezing is a protective reflex to clear irritants or foreign particles from the nose. Hence we will sneeze even without hypersensitivity. However, if you sneeze excessively and repeatedly when exposed to the same item, you could have an allergy or hypersensitivity reaction to that particular item. You could also be sneezing because the dust is an irritant and you are sneezing to clear them.

If you have an allergy, besides sneezing, you would usually have other symptoms such as runny nose and nose block. I would suggest wearing a mask when in dusty places. Please consult your local doctor if sneezing continues.

dr. Lim Keng Hua replied 2 years ago

If you have no pain, foul smell nose discharge or fever, you probably don't have sinusitis. It sounded like you have narrowed nasal passage, It is common for exercise to relieve the nose block. But if you are experiencing nose block all the time, you will need a nose scope to determine the underlying cause. You may need surgery to relieve the obstruction.

dr. Lim Keng Hua replied 2 years ago

Use a saline nasal wash or rinse. You may apply vaseline ointment to hydrate the nose for a week. If persistent, please see your doctor to exclude an infection.

dr. Lim Keng Hua replied 2 years ago

There are many causes of vertigo. If the vertigo is transient and resolved within a day, you may continue to monitor. If your vertigo is recurring or lasted more than a day, you need to see a doctor to determine the cause. The treatment depends on the underlying causes. If the origin of the vertigo is from the ear, usually 2 groups of medications are used. First group to control the acute symptoms i.e. vertigo, nausea or vomiting. Second group to improve the sense of balance.

If you are still not better, you may need to see a specialist. Sometimes, vestibular testing and rehabilitation therapy, blood test and even imaging may be needed to determine the cause.

dr. Lim Keng Hua replied 2 years ago

For headaches and pain, the best medicine is pain killers. To remove the pain permanently, the root cause of the problem has to be identified. It is impossible to guess the cause from your description of symptoms. Headache could be due to the brain. Shoulder aches could be due to the cervical spine. The ear pain could be due to the ear or even the throat. These 3 symptoms may be related too. I strongly suggest a formal consultation with a doctor/specialist to workout the cause of your problem.

Dicky Febryan replied 2 years ago

Dok saya ingin bertanya
Waktu saya membersihkan kotoran telinga saya,saya memasukkan air garam,den mengorek2 nya, setelah beberapa hari telinga saya mengalami sakit dan penurunan pendengaran serta telinga saya mengalami ada yg bergerak atau bergetar di dalamnya ketika mendengar suara yg agak keras

dr. Lim Keng Hua replied 2 years ago

Air garam yang masuk kemungkinan tidak bisa keluar. Kelembapan di dalam telinga menyebabkan saluran telinga membengkak dan terasa sakit. Kemudian telinga tersumbat dan pendengaran menurun. Sensasi seolah ada yang bergerak di dalam telinga adalah karena adanya air yang tidak bisa keluar dari dalam telinga. Kemungkinan lain, kotoran telinga terdorong ke dalam dan menyentuh gendang telinga. Temui dokter agar cepat diobati. Jika tidak, Anda bisa terkena infeksi saluran telinga.

dr. Lim Keng Hua replied 2 years ago

I assume your doctor has examined you thoroughly before putting you on these medications. These medications are appropriate and I am glad to know your tinnitus is better. The tinnitus may not disappear completely. Long term management involves identifying any treatable cause and understanding the mechanism. You can try tinnitus rehabilitation therapy or obtain a masker.

dr. Lim Keng Hua replied 2 years ago

Headsets are not harmful to the ear if worn properly without excessive pressure. Please avoid excessively loud volume too to prevent noise-induced hearing loss.

dr. Lim Keng Hua replied 2 years ago

If there is no infection, no antibiotics is needed. My advice is to have a nose scope and throat examination by an ENT specialist. You will need a specialist assessment if you have a sore throat for 3 years and not better. You need to see someone who can diagnose your problem holistically. If you are a smoker, I suggest that you stop smoking.

dr. Lim Keng Hua replied 2 years ago

There are many causes of vertigo ranging from ear, eye, muscles, brain and nervous system. Our circulation can also affect balance. Sometimes the cause may be multifactorial. The approach has to be holistic to restore or improve the function of the person. Occasionally, some vertigo cannot be totally removed but the quality of life can certainly be improved. Your vertigo has been 10 years. You need to have at least a brain scan to make sure no brain tumour. You need to identify your trigger to avoid or minimise future attacks. I am not familiar with Vastigo. Anti-dizzy medications are good but I advise not for long term daily use, it may dull your sense of balance. Please see a doctor who is able to address your problem holistically.

dr. Lim Keng Hua replied 2 years ago

It is necessary to rule out vocal cord palsy since your mother's symptoms started after thyroidectomy. Treatment of laryngospasm involves treating the triggers. It is more likely that your mother has vocal cord palsy leading to aspiration and hence laryngospasm, shortness of breath and stridor. Please have an ENT specialist check her vocal cords.

dr. Lim Keng Hua replied 2 years ago

Milk tends to turn stale and ferment. Wax traps moisture. If you notice a smell coming out from your child's ear, there may be an ear infection. Please bring your child to a doctor. Your child may need antibiotics ear drops. If the infection persists, the child may need to have the contents ( ie wax and milk) in the ear sucked out by an ENT specialist.

dr. Lim Keng Hua replied 2 years ago

Thick smelly discharge from the ear does suggest an infection. My suggestion is to return to the hospital for a check up if your son is still not better after antibiotics. Please see a pediatric ENT specialist or an ENT specialist who is comfortable treating 1 month old babies.

The most likely cause is otitis externa which is treatable. Besides antibiotics, ear drops and sometimes ear cleaning i.e. sucking the pus out will help. Sometimes, intravenous antibiotics are necessary.

dr. Lim Keng Hua replied 2 years ago

White spots seen in the back of the mouth is most commonly due to infection. If the white spot persists after a course of antibiotics, one has to consider fungal infection. Other less common considerations include a tumour if it's associated with ulcers or swelling. You may need to see a specialist for a proper assessment. I won't advise waiting further since it has been 7 weeks.

dr. Lim Keng Hua replied 2 years ago

It is important to identify the cause of repeated nose bleeding. The most likely cause is due to a broken blood vessel in the front of his nose. This may occur due to drying, frequent nose rubbing, sneezing or uncontrolled allergic rhinitis. Other rarer causes are deviated nose spetum, nose polyp, and tumour.

First, please apply proper first aid whenever it bleeds, i.e. pinch the soft part of the nose for 5-10 minutes. Meanwhile, breathe through the mouth. Second, treat all precipitating factors i.e. treat allegric rhinitis, nose itch and stop nose rubbing or nose picking. Thirdly, please consult an ENT specialist if the bleeding continues. A nose scope is needed to confirm the diagnosis. Definitive treatment depends on the cause of the bleeding.