食物的營養成分及保健功效 - 蘆筍

蘆筍

適宜：癌症患者

不宜：痛風及尿酸偏高者

營養成分：含蛋白質，碳水化合物，多種維他命和氨基酸，鎂，錳等微量元素等

保健功效：味甘性寒，可健脾益氣，滋陰潤燥，生津解渴，對各種癌症有預防和治療作用。

Tumours of the nasopharynx (鼻咽部腫瘤)

Angiofibroma (鼻咽血管纖維瘤)

Incidence:

A benign vascular tumour occurring in males under the age of 25 years.

Clinical features:

Nasal obstruction, epistaxis and deafness due to middle ear effusion are common characteristics.

Management:

Treatment is by surgical excision, facilitated by preoperative CT scanning, arteriography and embolization.

Malignant tumours (惡性腫瘤)

Incidence:

Common in south east Asia, where they account for 20% of all malignant tumours.

Clinical features:

Present as nasal obstruction, epistaxis and deafness. Metastasis to cervical nodes may occur prior to local symptoms becoming apparent. Cranial nerve palsies occur in advanced cases.

Pathology:

Most are squamous carcinomas, although anaplastic carcinomas and lymphomas also occur.

Management:

Radiotherapy following biopsy confirmation, with surgery used only for cervical nodes not responding to irradiation.

Chordoma (脊索瘤)

A very rare locally invasive neoplasm arising from remnants of the fetal notochord found in the skull base. Presents with neurological, nasal and ophthalmic symptoms.

食物的營養成分及保健功效 - 絲瓜

絲瓜

適宜：月經不調，身體疲乏，痰喘咳嗽，大便乾燥者，產後乳汁不通婦女

不宜：體虛內寒，腹瀉大便爛者

營養成分：含蛋白質，脂肪，碳水化合物，鈣，磷，鐵，維他命B雜，維他命C等。

保健功效：味甘性平微寒，可袪風濕，通經絡，清熱利咽，化痰止咳，涼血解毒，清熱利腸，生津止渴，解暑除煩，可防治壞血病，促進小兒大腦發育及保護中老年大腦健康的作用。

Adenoids (腺樣體)

Lymphoid tissue found at the junction of the roof and posterior wall of the nasopharynx, thought to be involved in the development of humoral immunity as a component of the “gut associated lymphoid tissue” (GALT). Adenoid tissue is present at birth and during childhood, beginning to atrophy before puberty.

Clinical features:

Adenoidal hypertrophy disturbs nasopharyngeal airflow and Eustachian tube function and can also act as a focus of infection for adjacent sites. Common clinical features are nasal obstruction and discharge, deafness due to middle ear effusion and otalgia due to recurrent otitis media. 

Gross adenoidal enlargement, often associated with tonsillar hypertrophy, can cause sleep apnoea syndrome in which apneic episodes during sleep are associated with daytime somnolence and in severe cases pulmonary hypertension and cor pulmonale. Clinical suspicion of enlarged adenoid can be confirmed by lateral radiography.

Management:

Surgical removal (adenoidectomy) can be undertaken if enlarged adenoids are causing sleep apnoea, nasal obstruction or are a contributing factor to persistent middle ear effusions or recurrent otitis media.

Non-infective rhinitis (非感染性鼻炎) - Atrophic rhinitis (萎縮性鼻炎)

Atrophic rhinitis (萎縮性鼻炎)

Aetiology:
A disease of unknown aetiology, occurring mainly in developing countries. It can occur following radical turbinectomy operations or radiotherapy to the nasal cavity.

Clinical features:
Nasal crusting, anosmia and fetor are present. Paradoxically, although the nasal cavity is widely patent, the sensation of nasal obstruction is common.

Management:
Treatment is by removal of crusts and nasal douches.

食物的營養成分及保健功效 - 蓮藕

蓮藕

適宜：肝病，肺炎，便秘，糖尿病等患者，瘀血，吐血，尿血，便血等出血者

不宜：胃病，十二指腸潰瘍患者

營養成分：含豐富蛋白質，碳水化合物，纖維素，多種維他命及鈣，鐵，磷等，其中維他命C含量極高。

保健功效：生藕性寒，可生津涼血；熟藕性溫，可補脾益血。蓮藕止血作用強，對體內各種出血症都有較好的療效，常用於治療吐血，咳血，尿血，便血，子宮出血等症。還可預防糖尿病，高血壓，貧血，是養顏美容佳品。

Non-infective rhinitis (非感染性鼻炎) - Non-allergic rhinitis (非應變性鼻炎)

Non-allergic rhinitis (非應變性鼻炎)

Clinical features:

Presents as chronic nasal obstruction and rhinorrhea with no demonstrable allergy.

Management:

If medical treatment in the form of antihistamine or steroid sprays fails to produce relief, nasal obstruction may be helped by surgical reduction or diathermy of the inferior turbinates. 

Long term use of sympathomimetic vasoconstrictor nasal sprays can result in chronic nasal congestion as a rebound effect: rhinitis medicamentosa.

食物的營養成分及保健功效 - 薯仔 (馬鈴薯)

薯仔 (馬鈴薯)

適宜：胃病，濕疹，便秘等患者

營養成分：含蛋白質，脂肪，碳水化合物，類胡蘿蔔素，維他命B雜，維他命C，鈣，磷，鐵，鉀等。

保健功效：味甘性平微涼，可和胃調中，健脾利濕，解毒消炎，整腸通便，降糖降脂，活血消腫，益氣強身，美容抗衰老，對胃火牙痛，脾虛納少，大便乾結，高血壓，高血脂，消化不良，習慣性便秘，神疲乏力，慢性胃痛，關節疼痛，皮膚濕疹等症有一定輔助療效。

Non-infective rhinitis (非感染性鼻炎) - Allergic rhinitis (應變性鼻炎)

Allergic rhinitis (應變性鼻炎)

Aetiology:

Hypersensitivity to inhaled or ingested allergens causes nasal mucosal oedema and exudation. Allergy may be seasonal (e.g. pollens) or perennial (e.g. dust). Allergies may be demonstrated by skin tests.

Clinical features:

Presents as nasal obstruction, sneezing and rhinorrhea with mucosal oedema on examination.

Management:

Treat with steroid nasal spray and oral antihistamines. Avoid any known allergens.

食物的營養成分及保健功效 - 苦瓜

苦瓜

適宜：糖尿病，癌症患者，皮膚熱痱者

不宜：脾胃虛寒者

營養成分：含蛋白質，脂肪，糖類，纖維素，胡蘿蔔素，維他命B2，維他命C，苦瓜苷，鈣，鐵，磷等。其中，維他命C含量十分豐富。

保健功效：味苦性寒，可清暑袪熱，明目解毒，養血益氣，對熱病煩渴，中暑，痢疾，目赤，癰腫丹毒有一定的食療作用，常食苦瓜可降低血糖，增強機體免疫力，使皮膚細嫩柔滑。

Diseases of the nasal septum (鼻中膈疾病) - Septal perforation (鼻中膈穿孔)

Septal perforation (鼻中膈穿孔)

Aetiology:

• Traumatic – after septal surgery, nose picking, cocaine sniffing and pressure from foreign bodies and nasal polyps.
• Infective – due to syphilis and tuberculosis.
• Chronic inflammatory – Wegener’s granulomatosis is a non-neoplastic upper airways granuloma associated with focal lung and kidney lesions. (Lethal) midline granuloma is thought to be an atypical lymphoma occurring in the midline of the face.

Clinical features:

Asymptomatic, or nasal crusting and epistaxis are characteristic of septal perforation.

Management:

Treatment is by removal of crusts, nasal douches and treatment of underlying systemic conditions.

食物的營養成分及保健功效 - 白蘿蔔

白蘿蔔

適宜：大便不暢，胃脹燒心，肥胖者

不宜：脾虛泄瀉，胃潰瘍，十二指腸潰瘍，慢性胃炎，單純甲狀腺腫，先兆流產，子宮脫垂等患者。

營養成分：含蛋白質，多種氨基酸，脂肪，葡萄糖，果糖，維他命C，鈣，多種酶類，揮發油等。

保健功效：含有促進新陳代謝的物質，有助於消除皮下脂肪，可有減肥作用。白蘿蔔中的揮發油和芥子油可刺激胃腸蠕動，幫助消化，增強食欲。

Diseases of the nasal septum (鼻中膈疾病) - Septal abscess (鼻中膈膿腫)

Septal abscess (鼻中膈膿腫)

Aetiology:

Septal abscesses usually result from secondary infection of a septal haematoma.

Clinical features:

Manifests by the development of severe pain, nasal swelling and pyrexia following a septal haematoma. Cartilage necrosis often complicates septal haematoma and abscess with the production of a saddle-nose deformity.

Management:

Treatment is by incision and drainage with appropriate antibiotic therapy.

食物的營養成分及保健功效 - 蕃茄

蕃茄

適宜：熱性病，發熱，口渴，食欲不振，牙齦出血，貧血，頭暈，心悸，高血壓，急慢性肝炎，急慢性腎炎，夜盲症患者

不宜：急性腸炎，菌痢及潰瘍活動期患者。

營養成分：含豐富維他命，蛋白質，脂肪，碳水化合物，鈣，鐵，磷，茄紅素等。茄紅素是一種不含氧的類胡蘿蔔素，可預防及改善前列腺增生，前列腺炎等泌尿系統疾病，保護心血管，提高免疫力，抗老化。

保健功效：生津止渴，清熱解毒，健胃消食，涼血平肝，對高血壓，夜盲症，乾眼症，腎病患者均有一定的食療作用，還可促進皮膚健康，預防口腔炎症，防癌抗癌，美白抗衰老等。

Diseases of the nasal septum (鼻中膈疾病) - Septal haematoma (鼻中膈血腫)

Septal haematoma (鼻中膈血腫)

A collection of blood beneath the mucoperichondrium and posteriorly the mucoperiosteum of the nasal septum.

Aetiology:

Usually complicates nasal trauma, either accidental or iatrogenic following septal surgery. Rarely a spontaneous haematoma can occur in a bleeding diathesis.

Clinical features:

Presents as nasal obstruction with widening of the septum on inspection.

Management:

In the acute stage, treat by incision and drainage, however, after 48hrs, organization of haematoma occurs and evacuation of the clot is difficult. Antibiotics are given to prevent secondary infection.

食物的營養成分及保健功效 - 洋蔥

洋蔥

適宜：高血壓，高脂血症，動脈硬化等心血管疾病，糖尿病，癌症，急慢性腸炎，痢疾患者。

不宜：熱病，皮膚瘙癢性疾病，眼疾，胃病患者。不可過量食用洋蔥，可導致目糊和發熱，產生揮發性氣體，引起脹氣和排氣過多。

營養成分：含尼克酸，維他命B1，維他命B2，胡蘿蔔素，檸檬酸鹽，多糖和多種氨基酸。揮發油中富含蒜素，硫醇，三硫化物等。

保健功效：味甘辛性溫，可袪痰，利尿，健胃，潤腸，解毒，殺蟲等功能，對食欲不振，大便不暢，痢疾，腸炎，蟲積腹痛，創傷潰瘍，赤白帶下等症有一定的食療作用。

Diseases of the nasal septum (鼻中膈疾病) - Deviated nasal septum (鼻中膈偏曲)

Deviated nasal septum (鼻中膈偏曲)

Aetiology:

This occurs following previous nasal trauma or results from asymmetric septal development possibly following birth trauma.

Clinical features:

Presents as unilateral nasal obstruction and less commonly epistaxis. The inferior and middle turbinates on the side opposite the septal deflection often undergo compensatory hypertrophy.

Management:

If symptoms warrant, the septum can be positioned in the midline as in the operations of septoplasty and submucosal resection.

食物的營養成分及保健功效 - 蕃薯

蕃薯

適宜：痢疾，泄瀉，酒積，濕熱，黃疸，血虛，月經失調，小兒疳積患者。

不宜：胃酸多者不宜多食，多食令人反酸，脾胃虛寒者也不宜多食。

營養成分：含豐富糖類，蛋白質，膳食纖維，多種維他命，鉀，鐵，銅，鈣等，其中胡蘿蔔素，維他命E，維他命C。

保健功效：味甘性平，補虛益氣，健脾益陰，可治療痢疾，泄瀉，酒積，濕熱，黃疸，血虛，月經失調，小兒疳積。

Epistaxis (鼻出血)

Aetiology:
Most cases of epistaxis are idiopathic, although bleeding can also result from a number of specific conditions.

• Local conditions – include nasal trauma, nasal and paranasal sinus tumours and nasal septal perforations.
• General conditions – include systemic bleeding diathesis such as leukemia, anticoagulant therapy and thrombocytopenia, and systemic vascular disorders. In hereditary hemorrhagic telangiectasia (Rendu-Oster-Weber syndrome), epistaxis is a prominent feature and usually arises from abnormal vessels on the nasal septum.

Systemic hypertension, although not a cause of epistaxis, is often associated with an increased severity of bleeding.

Clinical features:

In most cases of epistaxis bleeding originates from the nasal septum, particularly Little’s area just behind the mucocutaneous junction where there is a rich anastomosis of vessels (Kiesselbach’s plexus). Bleeding from a posterosuperior site in the nasal cavity can occur, especially in the elderly. 

Haemorrhage can present via the anterior nares or pass backwards via the nasopharynx where it is spat out or swallowed. In severe cases with profuse blood loss, hypotension and tachycardia may occur.

Management:

Initial measures to stop bleeding consist of exerting pressure on Little’s area by pinching the nose, with the patient leaning forward and spitting any blood into a bowl. If a bleeding vessel is seen, it may be coagulated with chemical or electric cautery following topical application of local anaesthetic, but this is rarely successful in the acute stage. 

Epistaxis not responding to pressure necessitates nasal packing either with gauze impregnated with an antiseptic such as bismuth, iodoform and paraffin paste or with nasal balloons. Patients requiring nasal packing also require hospitalization.

In severe cases arterial ligation may be required. Endoscopic ligation or diathermy of the sphenopalatine artery in the nasal cavity is the commonest method. Other available arteries are the external carotid via the neck and the anterior ethmoidal via an inner canthal incision.

An alternative to arterial ligation in severe cases is arterial embolization performed with angiographic control by a radiologist. Intravenous resuscitation with blood or plasma substitute is necessary in cases where hypotension and tachycardia are present.

食物的營養成分及保健功效 - 西蘭花

西蘭花

適宜：癌症，心臟病，中風患者

不宜：紅斑狼瘡患者

營養成分：含粗蛋白，纖維素，胡蘿蔔素，維他命B1，維他命B2，維他命B6，維他命C，葉酸，鈉，鉀，鈣等多種礦物質。

保健功效：味甘性涼，入腎，脾，胃經，可補腎填精，健腦壯骨，補脾和胃，適用於久病體虛，肢體痿軟，耳鳴健忘，脾胃虛弱，小兒發育遲緩等。

Rehabilitation of deafness (耳聾的治療與康復)

Early diagnosis of the deafness is the key to successful auditory rehabilitation, particularly in children with congenital deafness. With early intensive auditory training most children will develop the ability to communicate orally. Lip reading is an adjunct to oral communication. Manual communication, as in sign language, may be applicable for severely deaf people.


Hearing aids
Hearing aids amplify and modify incoming sound. The most modern aids use digital technology to tailor the performance of the aid to individual patterns of hearing loss. The postaural aid is mostly widely used, although body-worn and in the ear alternatives exist. Aids to communication such as electromagnetic loop systems can enable hearing aids in function in a group environment such as a theatre or lecture hall.


Cochlear implants
Direct electrical stimulation of the cochlear portion of the inner ear in response to incoming sound waves has been investigated in the development of cochlear implants. Electrodes are either placed on the surface of the cochlear(extracochlear) or inserted into the lumen of the cochlear(intracochlear).

The use of cochlear implantation is now established in patients with both acquired and congenital severe sensorineural hearing loss. Profoundly deaf children ideally have implants fitted before primary school age.

食物的營養成分及保健功效 - 冬菇

冬菇

適宜：貧血，肝炎，腫瘤，疹，食欲不振等患者

不宜：脾胃寒濕氣滯，皮膚瘙癢症患者

營養成分：高蛋白，低脂肪，含有香菇多糖和多種酶類，氨基酸和維他命等。

保健功效：味甘性平，可補氣養血，健脾消食，益腎和胃，袪風活血，化痰，抗癌，防衰老。對貧血，肝炎，腫瘤，麻疹及食欲不振等有一定食療作用。

Local conditions of the tympanic membrane (鼓膜的局部疾病)

Bullous myringitis
Aetiology:
An influenza virus infection of the tympanic membrane and deep external meatus, often associated with an acute otitis media.

Clinical features:
Presents as otalgia, deafness and serosanguinous otorrhoea. Haemorrhagic bullae are seen on otoscopy. Secondary bacterial infection can occur with purulent otorrhoea leading to otitis externa.

Management:
Treat with analgesics; local and systemic antibiotics for secondary bacterial infection.


Tympanosclerosis
Aetiology:
Deposits of collagen beneath the mucosa of the tympanic membrane and middle ear following otitis media or middle ear surgery, particularly grommet insertion.

Clinical features:
Tympanosclerosis is mostly asymptomatic. Deposits are visible as white chalk patches in the tympanic membrane. Middle ear deposits may cause conductive deafness by ossicular fixation.

Management:
None if asymptomatic. Ossiculoplasty may be required for conductive deafness.

食物的營養成分及保健功效 - 金菇

金菇

適宜：氣血不足，營養不良的老人和兒童，癌症患者，肝病和胃腸道潰瘍，心腦血管疾病患者。

不宜：脾胃虛寒者

營養成分：含蛋白質，碳水化合物，胡蘿蔔素，維他命B2，維他命C，多種氨基酸和礦物質，多糖，牛磺酸等。

保健功效：性涼，入脾，大腸經，可補肝，益腸胃，抗癌，適用於肝病，胃腸道炎症，潰瘍，腫瘤等。

Complications of suppurative otitis media (化膿性中耳炎的并發症) - Intracranial (顱內并發症)

Intracranial spread of organism may occur via the middle ear by thrombophlebitis or by penetration of the dura of the middle or posterior cranial fossae.


Meningitis
Clinical features:
Presents as headache, neck stiffness and photophobia. Lumbar puncture confirms the diagnosis. Pneumococcus and Haemophilus influenzae are common pathogens.

Management:
Treatment is by intravenous antibiotics followed by mastoidectomy once the meningitis has revolved.


Venous sinus thrombosis
Follows spread of middle ear and mastoid infection through the bone over the sigmoid sinus.

Clinical features:
Presents as headache, pyrexia and rigors. Extension of thrombus to the superior sagittal sinus leads to CSF outflow obstruction: otitic hydrocephalus.

Management:
Treatment is by intravenous antibiotics and mastoidectomy, during which infected thrombus may need to be removed from the sinus lumen.


Intracranial abscess
Extradural, subdural and cerebral abscesses occur. Infection spreads into the middle and posterior cranial fossae leading to temporal lobe and cerebellar abscesses respectively. Diagnosis by CT scan and treatment by neurosurgical drainage.

食物的營養成分及保健功效 - 蘋果

蘋果

適宜：肥胖，胃炎，腹瀉，高血壓，結腸炎患者。

不宜：胃寒，脾胃虛弱者

營養成分：含有糖類，蛋白質，脂肪，粗纖維，鉀，鈣，磷，鐵，胡蘿蔔素，維他命B1，維他命B2，維他命C，山梨醇，香橙素等營養物質。

保健功效：味甘性平，可降低膽固醇，降脂，對消化不良，脂肪積聚過多，口臭等有輔助療效，還可抑制黑色素形成，減淡雀斑，黃竭斑。

Complications of suppurative otitis media (化膿性中耳炎的并發症) - Extracranial (顱外并發症)

Facial nerve paralysis

Aetiology:

Pressure by cholesteatoma on the facial nerve in the middle ear or mastoid.

Clinical features:

Presents as partial or complete lower motor neurone facial paralysis with evidence of chronic middle ear disease on otoscopy.

Management:

Treatment is by immediate surgical decompression of the facial nerve via a mastoidectomy operation.

Suppurative labyrinthitis

Aetiology:

Follows erosion of the bony labyrinth most commonly over the lateral semicircular canal. In the early stages compression of the air in the external meatus causes vertigo from mechanism stimulation of the labyrinth (fistula test). Later purulent infection in the inner ear causes severe vertigo and sensorineural deafness.

Management:

Treatment is by intravenous antibiotics and eradication of cholesteatoma via mastoidectomy.

Gradenigo’s syndrome

Otorrhoea is associated with pain behind the eye and diplopia, caused by fifth and sixth nerve irritation resulting from air cell infection at the petrous apex.

食物的營養成分及保健功效 - 水蜜桃

水蜜桃

適宜：氣血兩虛，面黃肌瘦，心悸氣短，便秘，閉經，瘀血腫痛。

不宜：內熱偏盛，易生瘡癤者，糖尿病患者，嬰兒，孕婦，月經過多者。

營養成分：含蛋白質，脂肪，糖類，鈣，磷，鐵，維他命B雜，維他命C。

保健功效：味甘酸，性微溫，可生津潤腸，活血袪瘀，消積清熱，解毒袪濕，可消除皮膚色素沉著減淡雀斑，黃褐斑等。

Suppurative Otitis media (化膿性中耳炎) - Chronic otitis media (慢性中耳炎)

Chronic otitis media (慢性中耳炎)

Aetiology:
Chronic inflammation of the middle ear cleft is usually associated with a perforation of the tympanic membrane. Perforation usually result from previous episodes of acute otitis media when the membrane fails to heal following rupture, but can be due to direct or indirect trauma. In children, perforations can persist following extrusion of ventilation tubes from the tympanic membrane. 

Organism can reach the middle ear from the Eustachian tube or from the external meatus. Chronic middle ear infection is also associated with ossicular damage, with the incudostapedial joint being the most commonly affected linkage.

Clinical features:
A central perforation in the pars tensa part of the membrane is associated with recurrent otorrhoea and conductive deafness. This type of perforation is regarded as safe as neurological complications are rare. An attic or marginal perforation can be associated with the development of a cholesteatoma and is regarded as unsafe.

Management:
Cases of central perforation should be kept dry. If recurrent otorrhoea occurs, ear drops containing a mixture of steroid and antibiotic are used and attention should be paid to possible source of infection in the nasopharynx, nose and paranasal sinuses. A dry perforation can be repaired by myringoplasty. Traumatic central perforations usually heal spontaneously. 

食物的營養成分及保健功效 - 龍眼

龍眼

適宜：四肢乏力，心緒不寧，記憶力減退者

不宜：消化不良，感冒，慢性支氣管炎患者，孕婦本身體質偏熱，應慎食龍眼。

營養成分：含蛋白質，脂肪，維他命A，維他命B雜，維他命C，鈣，鐵，磷，蔗糖，葡萄糖等。

保健功效：味甘性溫，可補腦安神，止咳潤肺，止瀉養顏，對四肢乏力，心緒不寧，記憶力減退等症有輔助療效，亦可滋潤肌膚，使皮膚嫩滑細膩，富有光澤，婦女用於產後調補也很適宜。

Suppurative Otitis media (化膿性中耳炎) - Acute mastoiditis (急性乳突炎)

Acute mastoiditis (急性乳突炎)

Aetiology:
Acute mastoiditis may complicate acute otitis media. Infection of the mastoid air cell system occurs.

Clinical features:
Presents as worsening of otalgia with tenderness over the mastoid antrum. The external meatus may be narrowed by oedema of the posterior-superior wall. In advanced cases a subperiosteal abscess may push the ear forward. Diagnosis is confirmed by opacity of the mastoid cells on CT scan.

Management:
Initially high-dose parenteral antibiotic therapy is required, although in cases that fail to respond to antibiotics, or in which a subperiosteal abscess has formed, surgical drainage via a cortical mastoidectomy is required.