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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 tests are needed for adenoid hypertrophy?
The adenoids are located at the back end of the nasal cavity in the nasopharyngeal area, so the examination needed for adenoid hypertrophy is generally the electronic nasopharyngoscopy. Electronic nasopharyngoscopy is a minimally invasive procedure that allows direct visual observation of the enlarged adenoids and the blockage of the posterior nasal apertures. Modern electronic nasopharyngoscopes are very thin; they can be inserted through the nostrils directly into the nasopharynx, providing a clear view of the adenoids with minimal discomfort and no radiation exposure, making it the preferred method. Another test that can be performed is a lateral X-ray of the nasopharynx. This examination has been a classic approach and is available in many township and county hospitals. It can accurately display the condition of adenoid hypertrophy and any airway obstruction. However, the only drawback is that it involves some level of radiation exposure.
How long does it usually take for vocal cord nodules to heal?
Vocal cord nodules are primarily caused by improper pronunciation or overuse of the voice, commonly seen in people who use their voices frequently. Treatment primarily involves vocal rest, which means speaking less and pronouncing correctly. The period of vocal rest usually needs to be relatively long. If the vocal cord nodules are larger, then an even longer period of vocal rest may be required, generally lasting from two to four weeks. Clinically, most cases require four weeks. The effects are generally better after resting for four weeks. During this period, treatment can be complemented with medications, such as nebulized inhalation, which can speed up recovery. The premise is to first undergo vocal rest followed by medication treatment, which generally takes about two to four weeks.
What should be noted after vocal cord polyp surgery?
The most important thing to pay attention to after vocal cord polyp surgery is to speak as little as possible, which means vocal rest. Typically, vocal rest should last between two to four weeks. The better you adhere to vocal rest, the better your voice will recover after the surgery. Once recovered, continue to minimize speaking and ensure correct pronunciation to prevent recurrence of vocal cord polyps. Another important consideration is avoiding environments with tobacco smoke; do not smoke and try to stay away from places where others are smoking. Diet should be light, avoiding spicy and stimulating foods. Also, manage your emotions in daily life; do not rush or shout, as this can affect your recovery. Even if you do not yell when anxious, it can still lead to a less than optimal post-operative recovery.
Symptoms of recurrent sinusitis
The symptoms of recurrent sinusitis are essentially the same as those of sinusitis itself. Symptoms can be divided into local symptoms, which are those of the nasal cavity, as well as some systemic symptoms, because the recurrence of sinusitis often follows a cold that leads to an acute recurrence. The nasal symptoms mainly include nasal discharge, primarily consisting of yellow pus-like mucus. There may also be nasal congestion or a sensation of the nose being blocked, as well as headaches. The location and severity of the headache depend on which sinus is more severely inflamed, which also affects where the headache is felt. Additionally, there may be a disturbance in the sense of smell, which refers to a reduced sensitivity to smells, or a reduced ability to smell or weak sense of smell. Systemic symptoms mainly include lethargy, feelings of headache and weakness, lack of concentration, and a general lack of energy. Overall, the symptoms of recurrent sinusitis are similar to those of initial sinusitis, with most being the same.
How is suppurative tonsillitis caused?
The acute onset of suppurative tonsillitis is commonly due to a weakened immune system, which then leads to bacterial infection and thus suppurative tonsillitis. For example, getting chilled or getting caught in the rain, or having a persistent cold. Other common causes include irritation from smoking and alcohol environments, spicy foods, and staying up late. Also, if there is some chronic inflammation in the tonsils, these adverse stimuli make it easier to trigger this type of suppurative inflammation. Therefore, in addition to maintaining a normal routine in daily life, it is also important to check for the presence of chronic tonsillitis. If chronic tonsillitis is present, it's crucial to choose a proper opportunity for surgical treatment, which means performing surgery when it is not in an acute phase, to prevent the recurrence of suppurative inflammation.
How to deal with nasal polyps and enlarged turbinates?
Nasal polyps and hypertrophic turbinates require surgical treatment because both are manifestations of chronic inflammation in rhinitis. Medical treatment alone is not very effective in these cases. Nasal polyps and hypertrophic turbinates mainly cause poor nasal ventilation, and over time, can also affect the drainage of the sinuses. Therefore, in patients with significantly enlarged nasal polyps, who often also suffer from chronic sinusitis, treatment involves the endoscopic removal of nasal polyps and partial resection of the inferior turbinate, along with the opening of the sinus passages. This is a systematic and comprehensive treatment approach. After surgery, it is crucial to follow a prescribed medication regimen, as this ensures the effectiveness of the surgery. If surgery is performed without subsequent medication, the results may not be very good. Additionally, regular postoperative check-ups and cleanings are essential to maintain the effectiveness of the surgery and to prevent long-term recurrence. Many patients who cease medication and do not return for follow-up cleanings after surgery are likely to experience a quick recurrence.
Treatment methods for vocal cord nodules
The treatment is primarily divided into conservative treatment and surgical treatment. Generally, conservative treatment is implemented first. The main strategy of conservative treatment is vocal rest, which entails speaking as little as possible, typically for a duration of two to four weeks. Concurrently, medication is administered, often through nebulized inhalation therapy. The second approach is surgical treatment, which is considered if the conservative treatment does not yield satisfactory results, or if the condition worsens. At this point, surgical treatment of vocal cord nodules is typically performed using support laryngoscopy, microscopy, and either laser or fiber instruments to remove the vocal cord nodules. Post-surgery, a period of vocal rest is necessary for recovery, also lasting two to four weeks. During the recovery period, it is important to speak less, use proper phonation, avoid smoking and alcohol, follow a light diet, and steer clear of spicy and irritating foods.
The difference between vocal cord polyps and laryngeal cancer
The difference between vocal cord polyps and laryngeal cancer is firstly notable in their nature. Vocal cord polyps are benign lesions, and their removal generally does not significantly affect the patient's quality of life or lifespan. Laryngeal cancer, as the name implies, is a malignant lesion that greatly affects both the patient's quality of life and lifespan. Location-wise, vocal cord polyps are found on the vocal cords, while laryngeal cancer can be located in one of three areas: on the vocal cords, known as glottic laryngeal cancer; below the vocal cords, known as subglottic laryngeal cancer; and above the vocal cords, known as supraglottic laryngeal cancer. The prognosis for vocal cord polyps is very good; after surgery, if the patient rests well, their future quality of life is generally unaffected. Laryngeal cancer is divided into three types: glottic, supraglottic, and subglottic, with glottic being the most common, accounting for about 80%. This type of laryngeal cancer usually presents early symptoms such as hoarseness, similar to vocal cord polyps. Therefore, glottic laryngeal cancer can often be detected early. With prompt and correct treatment, the postoperative results can be good. As it typically involves highly differentiated squamous cell carcinoma, if it is completely excised surgically and regularly reviewed postoperatively, it doesn't greatly impact lifespan or quality of life. In contrast, subglottic and supraglottic laryngeal cancers often show symptoms later, which means they tend to be diagnosed at a later stage, usually at a mid to advanced stage. Supraglottic laryngeal cancer, in particular, is prone to cervical lymph node metastasis, thus usually having a poorer prognosis compared to glottic laryngeal cancer. There's also a higher likelihood of recurrence and metastasis, and the surgery may involve greater trauma. These are the main differences.
How is chronic tonsillitis diagnosed?
The diagnosis of chronic tonsillitis mainly relies on the patient's usual symptoms, medical history, and physical examination by the doctor. The symptoms of chronic tonsillitis typically include sore throat, frequent colds, dry throat, itchy cough, foreign body sensation, and even snoring during sleep among some individuals. Medical history is particularly crucial. If there are recurrent acute episodes, characterized by sore throat, painful swallowing, and sometimes accompanied by high fever, and these episodes occur more than four times a year, this history is significant for diagnosing chronic tonsillitis. Additionally, physical examination by a doctor, who will inspect the tonsils, is essential for making the diagnosis of chronic tonsillitis. The main basis for diagnosis includes symptoms, medical history, and physical examination.
What are the symptoms of chronic tonsillitis?
The symptoms of chronic tonsillitis during the non-acute phase vary from person to person. Some individuals may not exhibit clear symptoms, while others may display more typical ones. The most common symptoms include recurrent sore throat, and sensations of dryness, itchiness, the presence of a foreign body, and discomfort in swallowing or coughing. Another common symptom is persistent cough, which can be irritating, with some individuals frequently clearing their throat. Bad breath may also occur, such as when stone-like substances form on the tonsils and are expelled, carrying a foul odor. If the tonsils are excessively enlarged, they can interfere with breathing, cause snoring during sleep, and even lead to breath-holding, resulting in unclear speech, as if speaking with a mouthful. These are commonly seen in clinical settings. Additionally, some systemic reactions may occur, including fever, fatigue, low-grade fever, and headaches.