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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
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.
What are the symptoms of pharyngitis?
There are many symptoms of pharyngitis, and the specific symptoms can vary from person to person. The most common ones include the following. The first is a foreign body sensation, which is a sensation of a foreign object in the throat, feeling like there is always something that cannot be coughed up or swallowed, which is very typical. Another one is the empty swallow syndrome, meaning that some people feel like there is something that cannot be swallowed when swallowing saliva without food. Empty swallowing refers to just swallowing saliva in this way, feeling more and more like there’s something stuck as one swallows, which is similar to the foreign body sensation and is also a manifestation of the swallowing action. The third symptom is a dry and itchy throat. Some people also experience symptoms such as feeling nauseous and wanting to gag when brushing their teeth in the morning. Therefore, the symptoms of pharyngitis do not manifest exactly the same in everyone; some people may experience several symptoms, while others may have one predominant symptom.
The difference between vocal cord polyps and vocal cord nodules
Vocal cord polyps and vocal cord nodules are diseases caused by incorrect pronunciation or overuse of the voice, with the main clinical manifestation being hoarseness. The difference between vocal cord polyps and vocal cord nodules lies in their appearance under a laryngoscope: Vocal cord polyps often occur on one vocal cord, typically in the anterior one-third where a translucent, smooth swelling is found. This swelling can either have a broad stalk or a smaller stalk, and often, a hole can be observed with respiration. Vocal cord nodules are smaller and usually located symmetrically on the anterior one-third of both vocal cords. This implies that while polyps are commonly found on one vocal cord, nodules occur symmetrically on the anterior one-third of both vocal cords. From a general perspective, vocal cord polyps are wider and larger, whereas vocal cord nodules are only nodular lesions.
What are the dangers of a deviated septum?
The main harms of a deviated nasal septum include several points, mainly causing uncomfortable symptoms. Firstly, the most common symptom is nasal congestion, which is often unilateral, meaning one side of the nose is blocked depending on the side the septum is deviated towards while the other side remains relatively normal. Severe deviation to one side can cause blocked sensation in the nose, or it can affect both sides leading to bilateral congestion. The type of deviation, such as a simple deviation or an S-shaped one where both the front and back are deviated in different directions, can result in blockage in both nasal passages. Another issue is nosebleeds. Sometimes, the deviated septum can form a sharp edge, making the nasal mucosa fragile or piercing other areas, which can easily cause bleeding. Additionally, it can cause headaches due to the pressure exerted on the concha of the opposite side by the deviated septum. It also leads to conditions like rhinitis and sinusitis because the deviation affects the drainage of the nasal cavities and sinuses, resulting in secondary sinusitis, which causes long-term headaches, discomfort, and a series of sinusitis symptoms.
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.