I recently saw a female patient complaining of a deep voice... and it's been getting deeper over the years. She also is a big-time smoker and talker. Fiberoptic laryngoscopy revealed early stage Smoker's Polyps. An example of Smoker's Polyps with video and audio feed is shown here on our website.
This condition almost always is due to the combination of smoking (a lot) and talking (a lot). Though it is not cancer, it is yet another reason to stop smoking!
A new video of bilateral thyroarytenoid paralysis (partial vocal cord paralysis) via fiberoptic stroboscopy of the voicebox is shown here. Note the harsh and breathy quality to the patient's voice. It was felt that his condition was brought on by a viral upper respiratory infection. After a prednisone burst and taper along with limited voice use, his voice returned to normal in 2 weeks.
An example of complete unilateral vocal cord paralysis is shown here.
As people may know from reading our article on snoring on our website, there are many different levels in our upper airway anatomy that may contribute to the noise produced. However, most commonly, the culprit sources are the tongue and palate. Procedures such as the "Pillar Procedure" that has recently received media attention as well as UPPP address only the palate. Procedures like base of tongue reduction, hyoid advancement, etc that address the tongue are more difficult and morbid.
However, I was recently at a conference where a prominent Australian ENT gave a talk where he mentioned one previously unreported way to treat OSA and snoring due to the tongue... DISCLAIMER: I am not advocating one way or another this treatment! I am just mentioning as something of interest. As always, see your doctor before proceeding with any type of treatment!
Apparently, there is a community in Australia where citizens put tongue bolts in their tongue, not because it looks cool, but because it really, truly helps with snoring as well as OSA. Apparently, when these citizens go to sleep, they place a rubber band around the tongue bolt and anchor it to their front teeth. This method would prevent the tongue from vibrating as it would stretch and stiffen the tongue AND also prevent the tongue from falling backward.
This simple procedure actually duplicates the surgical procedures performed in the United States including hyoid advancement, genioglossus advancement, Repose tongue advancement, etc. All these surgical procedures for the tongue, in essence, try to anchor the tongue forward, just like the tongue bolt/rubber band technique.
We have suddenly noticed a number of phone calls to our office as well as inquiries from our established patients regarding the Pillar Procedure for snoring and obstructive sleep apnea after a recent television news report.
We used to offer this procedure, but as of Jan 2010, we no longer do.
An article entitled "Neo-Ossification of the Cricothyroid Joint After Elective Cricothyroidotomy: A Case Report and Discussion on the Merits of This Procedure" authored by Dr. Chang has been published in pre-print form online in the Journal of Trauma, a peer-reviewed publication. This article will be published in print in the near future. Click here to view the pubmed stub.
In the June 2007 edition of the journal Otolaryngology-Head & Neck Surgery, Dr. Chang's original research has been published. The title of the paper is "Relationship of botulinum dosage to duration of side effects and normal voice in adductor spasmodic dysphonia." Click here to read the abstract.
Dr. Chang treats patients with spasmodic dysphonia using BOTOX every Friday afternoon. To watch a video of how exactly her performs this procedure in a patient, click here.
Two new webpages have been added to our website. The first new webpage describes where snoring comes from and how it is treated. Obstrutive sleep apnea as how it relates to snoring is also discussed. Click here to check it out!
The other new webpage added describes sinusitis. CT scan of normal as well as abnormal sinuses are shown. Check it out here!
Our office provides complete management (medical to surgical) of sinusitis whatever its cause.
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