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

Ask a Doctor ForumCategory: OtorhinolaryngologyAsk a Ear, Nose Throat (ENT) Specialist: Dr Lim Keng Hua from Mount Elizabeth (Orchard) Hospital Singapore
dr. Lim Keng Hua asked 3 years ago
I am Dr Lim Keng Hua, Ear Nose Throat Surgeon at Ear Nose Throat, Head And Neck Surgery, an ENT clinic based in Mount Elizabeth (Orchard) Hospital. I have special interest in nose and sinus diseases and allergies, with a subspecialty focus in rhinology and sinonasal allergy. I have accumulated more than 18 years of clinical practice, and am well-versed in managing both adult and children ENT problems such as ear infections, hearing loss, voice disorders, snoring and sleep disorders, salivary gland disorders and thyroid swelling. I was awarded a clinical rhinology fellowship award by the Ministry of Health to train in Europe to expand Singapore’s repertoire in the management of rhinology, endoscopic skull base surgery and sinonasal allergy, where I trained under world-renowned rhinologist Professor Wytske Fokkens and endoscopic skull base surgeon Professor Christos Georgalas. During my tenure as a consultant at Tan Tock Seng Hospital, I started the allergy and immunotherapy service to manage difficult nasal allergies and smell disorders. I was the lead ENT tutor and adjunct lecturer at Nanyang Technological University's Lee Kong Chian School of Medicine, a senior clinical lecturer at National University of Singapore's Yong Loo Lin School of Medicine, and a core faculty member in the National Healthcare Group ENT residency programme. I have published in local and international journals and collaborated with several international centres like Beijing Tongren Hospital to improve the management of chronic rhinosinusitis. I also received a Singapore Clinician-Investigator Award for my work on allergic rhinitis at the 2011 Singapore Health & Biomedical Congress. I am a member of the American Rhinologic Society, European Rhinologic Society, the Allergy and Clinical Immunology Society (Singapore) and the Asia-Pacific Society of Thyroid Surgery. I am also an executive member of the Society of Otorhinolaryngology Head and Neck Surgery of Singapore. Learn more about Mount Elizabeth (Orchard) Hospital here: Learn more about me here: I am excited to be here to share/discuss ENT Health with everyone. Whether you've got questions about ENT disorders such as snoring, sinus problems, and nasal allergy, ask me anything! === Want to ask a question? Submit your question at the bottom of this page. Don’t forget to include your name and email address to get notified when the doctor answers your question.
20 Answers
Noormadjid answered 3 years ago
Doctor, one of my ears is deaf. The doctor said the hearing aid won’t help and suggested having cochlear implants. Do I need to have a cochlear implant in both of my ears or just the one that is lack of hearing? Are there any risks of complications?
dr. Lim Keng Hua replied 3 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.

Tiurma answered 3 years ago
 Doctor, my throat hurts when I swallow my food. It feels like my neck is swollen. What treatment should I do? I drink a lot of water and take medicine for my sore throat, but it doesn’t get better.
dr. Lim Keng Hua replied 3 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.

Karlin Tuda answered 3 years ago
It has been 4 months since my tonsils are swollen, both left and right. Drinking cold water makes me ache. I feel as though something is blocking my throat. What problem is this, Doc? I am a 46 year old female.
dr. Lim Keng Hua replied 3 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.

David Rasul answered 3 years ago
My name is David Rasul, and I am 61 years old. 10 months ago, I saw several ENT specialists in Jakarta, but no one can diagnose the disease I am having. Then I went to Penang and after an MRI, the doctor said I had a benign tumor in my neck called INTRAMUSCULAR LIPOMA. Because the tumor didn’t disturb or affect me, I was advised to come back and do an MRI and CT scan in a year to see whether surgery is necessary. My question is, which ENT surgeon should I see and what procedures am I likely to undergo? How much will the procedures cost? Thank you.
dr. Lim Keng Hua replied 3 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.

Sumardi answered 3 years ago
I have been living with sinusitis for a long time. I cannot stay in an air-conditioned room at all because I find it hard to breathe. I am 50 years old. Can I still resolve this, Doc?
dr. Lim Keng Hua replied 3 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.

Widyasari Kirana answered 3 years ago
I sneeze a lot in a dusty place. Is it normal or am I having a dust allergy? I can sneeze continuously up to 10 times, but without other symptoms.
dr. Lim Keng Hua replied 3 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.

Yohanes answered 3 years ago
Doctor, I am a 30 year old male. I have been experiencing a blocked nose for a long time and sometimes it makes it hard to breathe. In 2018, I went to see an ENT specialist because I suspected it was sinusitis. But the doctor said it was just narrowed nerves inside my nostrils. He said it was because I stopped doing my regular exercise (there was a time I routinely do some exercises). The doctor suggested that I continue my exercise and only gave me antibiotics and saline liquid to clean my nostrils. But I don’t feel much improvement in my nose and my breathing. Although it is true that doing exercise helps me to breathe easily. Is it true that the problem is only about sensitive nerves inside my nostrils, Doctor? Or is it sinusitis? But I have never had a headache in a cold place like people with sinusitis usually do.
dr. Lim Keng Hua replied 3 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.

Maria Lince answered 2 years ago
Doctor, what can I do to prevent and resolve crusting in the nose? Is there any alternative treatment besides medical treatment? Thank you
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.

NELI answered 2 years ago
I have vertigo.
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.

Watiana answered 2 years ago
I am 50 years old. I experience headaches quite often, and stiff shoulders and pain in the ears. What is the best medicine?
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.

Fony Widjaja answered 2 years ago
Good afternoon. My name is Fony, and I am 63 years old and from Surabaya. My left ear is buzzing. I have seen a doctor - I take 1 methycobal in the morning, vertizin 12.5 gr and betasere 12.5 at night, and ginkgo biloba in the afternoon. I have taken them all for one year and counting. However, the buzzing is reduced but not completely gone. What should I do, Doctor? Thank you
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.

novi answered 2 years ago
I use a headset for hours everyday. Is this bad for my ears?
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.

Etty Sumantri answered 2 years ago
Doctor, my voice has been hoarse for almost 3 years. I have seen doctors but to no improvement. Sometimes my throat feels hot. Is it okay if I keep taking antibiotics over and over again?
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.

May Hambali answered 2 years ago
Doctor, I have been experiencing vertigo for more than 10 years. It recurs quite often, and I have been hospitalised several times. Sometimes it even recurs while I am sleeping. I took Vastigo to treat this.
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.

Cindy answered 2 years ago
Doc, my mother had a thyroidectomy around 1 year ago. And since then, she often has vocal cord spasms that lead to shortness of breath for a few seconds and a stridor. After a few moments, she can breathe normally. I looked it up on Google and found out it might be laryngospasm. My question is: is there any medicine for this? Because it disturbs her daily activities. A doctor in Penang said she has asthma and needs to be given steroids when it recurs. Is there any other way, doc?
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.

Tania Nurafifah answered 2 years ago
Doctor, my child is 1 year old. My breast milk accidentally entered his ear and now his ear is smelly and watery. There is also wax inside. How do I treat this, Doc?
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.

ArDhelia answered 2 years ago
Good evening, Doctor. My son is 1 month old. One week ago, a thick and smelly liquid leaked out of his ear. I took him to a hospital and was given antibiotics but to no improvement. Is it an infection, Doctor? Is it curable? How do we treat this?
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.

tedy answered 2 years ago
Good morning, Doctor. I am a 42 year old male. There are white spots behind my tonsil. They hurt, but I don’t feel it when I swallow my food. I don’t have a fever either, and my appetite is normal. I have taken medicines, such as cataflam, cravit, mesol. It has been 7 weeks but it is not cured yet. I want to go see an ENT specialist, but I am afraid to contract COVID-19 in the hospital. Is it normal for this kind of disease to need months to get totally cured? Please give me your answer. Thank you.
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.

Yenny answered 2 years ago
Good morning, Doctor. My name is Yenny. My son who is 8 years old, often suffers from nose bleeding. This morning at 7am, he bled. Last week, it happened again too. He doesn’t like vegetables and fruits. What should I do?
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.

wilzan answered 2 years ago
Morning doctor ... I have had a chronic sore throat for about 4 years ... I've consulted with an ENT specialist, he said it was gastroesophageal reflux disease (GERD). I don’t feel pain when eating and drinking, but my throat wall is a bit reddish and my tonsils were removed about 5 years ago. What should I do? I feel stressed with this condition because I keep thinking about it. Thank you.

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