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October 31, 2009

October 30, 2009

Nasal Endoscopy to Evaluate Hoarseness on Dr. Oz Show!

On Oct 23, 2009, Dr. Oz (his show) with the assistance of Dr. Jonathan Aviv, demonstrated a procedure called Nasal Endoscopy which is the main method of evaluating a patient with hoarseness . A pretty good and accurate demonstration I may add. Watch the video clip here . Of course, I have produced a few video clips of the same of which one can be viewed below. Click here to watch one being performed on a child. Read more about this procedure here as well as what happens when the voice …
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October 29, 2009

Why Does Brain Freeze Occur With Eating Ice Cream and Other Cold Treats?

Believe it or not, this has been the topic of research in the past and even has a medical diagnosis called "sphenopalatine ganglioneuralgia". To sum it up, there are two theories behind this phenomenon: 1) Blood vessel phenomenon: Blood vessels constrict when any part of the body is exposed to cold temperature and dilates when it gets hot. This simple fact can be applied to the biological cause of brain freeze as well. Upon contact with ice, the blood vessels in the roof of the mo…
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October 26, 2009

Possible Dystonia (Rare Neurological Condition) After Flu Shot

Desiree Jennings, a former Redskins cheerleader, received a seasonal flu shot on Aug 23, 2009 and has suffered from a possible dystonia reaction from the flu vaccination resulting in difficulties in eating, talking, and walking. Here is a link to a video where Dr. Stephen Grill (neurologist) is interviewed by Fox News regarding Desiree's condition. Here is a video/article of the initial story. This story is a case of a VERY unfortunate EXTREMELY rare side effect (if true) of the fl…
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October 25, 2009

Our Office Has Been Renovated!

I have been hard at work all weekend with the generosity of friends as well as services of furniture reupholsters and general contractors. The waiting room as well as Exam Room 1 has been renovated for the better! It has been a sore point for me that the walls of my waiting room have been drawn upon with crayons by errant kids. Once one kid has drawn upon it, the other squiggles soon followed (Same kid or different kids? I have no idea). In any case, they are no more. The walls of the waiting r…
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October 24, 2009

NYT: How Tongues Taste Carbonation in Soda

The New York Times published a story on Oct 19, 2009 regarding how tongues taste that "carbonation" we all appreciate when drinking soda pop beverages. The story entitled " How Tongues Taste the Carbonation in a Fizzy Beverage " reveals that the carbonation is NOT due to the bubble popping, but rather a taste receptor. As we all know, there are receptors for five tastes: sweet, sour, salty, bitter and umami (sometimes termed savory). It is the receptor for sourness that i…
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October 22, 2009

AP: HHS Secretary Had Skin Cancer (BCC) Removed From Forehead

Associated Press reported today (Oct 22, 2009)that Health and Human Services Secretary Kathleen Sebelius had a Basal Cell Carcinoma (BCC) skin cancer removed from her forehead. Read the article here . BCC is a very common type of skin cancer that is often curable by complete excision. Often, this procedure is done in the office setting. Of note, our office regularly performs skin cancer excisions of the head and neck regions.
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October 17, 2009

Nasal Irrigation Beneficial for Pregnant Women With Allergies

Italian researchers have reported in the International Archives of Allergy and Immunology in Sept 2009 that saline nasal rinsing is a safe and effective treatment option for nasal problems in pregnant women with seasonal allergic rhinitis. In their paper titled " Nasal Lavage in Pregnant Women with Seasonal Allergic Rhinitis: A Randomized Study ," the researchers instructed the study group to perform hypertonic saline lavages to the nose 3X per day. Of note, HYPERTONIC saline solutio…
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WSJ: FDA Approves Gardasil for Boys (and Girls)!

This was reported by the Wall Street Journal on Oct 16, 2009. Why is this significant from an ENT perspective? Well, gardasil is supposed to vaccinate people from getting HPV related diseases like genital warts which would help both genders when individuals become sexually active. Of more note, it has been specifically shown to help prevent cervical cancer in females which is a big killer of women. However, it may potentially prevent other types of HPV related disorders involving the head…
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October 16, 2009

Botox Treatment for Vasomotor Rhinitis (Idiopathic or Non-Allergic Rhinitis)

A new research paper has been published Oct 16, 2009 in Head & Face Medicine entitled " Minimally invasive application of botulinum toxin A in patients with idiopathic rhinitis " in which researchers successfully treated patients with a persistent runny nose not due to any known problems like allergy . Such a condition is called vasomotor rhinitis or idiopathic rhinitis or non-allergic rhinitis. In this new described method of treatment, a sponge soaked with 40 Units of botulin…
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October 15, 2009

MRSA Sinusitis

There seems to be an increasing number of patients I see with MRSA sinusitis. Not many, but definitely not rare. These patients are understandably very concerned with how to treat their MRSA sinusitis. Beyond the usual protocol that applies to any MRSA infection, if the sinusitis is severe, sinus surgery is recommended for 3 main reasons. 1) Get the infection cleaned out surgically (much like draining an abscess of the skin) 2) Enlarge the openings of the sinus cavity to allow good pos…
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October 13, 2009

Tionne "T-Boz" Watkins Suffered from Acoustic Neuroma (Brain Tumor)

It was revealed in Oct 2009 that celebrity Tionne "T-Boz" Watkins of TLC fame (Celebrity Apprentice), that she was diagnosed with a type of benign brain tumor called acoustic neuroma . She underwent surgery in 2006 to have it removed and experienced a difficult recovery especially with balance . One of the earliest symptom of this type of brain tumor is an asymmetric sensorineural hearing loss (ASNHL) or a sudden hearing loss only in one ear (SSNHL). This type of unusual hearing …
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October 12, 2009

Saline Nasal Sinus Irrigation Systems

I must admit... our office is a big fan of the Neilmed Sinus Rinse bottle for patients who suffer from chronic sinusitis and severe allergies as it is cheap, easy to clean, and it works. However, many patients who are already fans of flushing the nose with saline water end up purchasing saline irrigation systems. There's a bunch of these devices sold on Amazon.com . Check them out below, but I would suggest that you first become adept and able to tolerate saline flushes using the Neilmed…
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October 10, 2009

Egg Allergy and the Flu Shot

Several patients have called our office asking whether it is safe to receive the flu shot if they are egg allergic. Generally speaking, for most patients, the blunt answer is that it is safe. The flu shot vaccine (both H1N1 and seasonal) are egg-based from which this concern arises. It also doesn't help that the pre-flu shot questionnaire specifically asks about egg allergy. Though egg-based, most of the egg protein is filtered out such that there are no egg contaminants. However, it is …
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October 09, 2009

October 08, 2009

TWO Ear Canals in the Same Ear!

I recently saw a patient who had a complaint of having two ear canals in each of the ears. To my surprise, the patient had exactly that! You can see the second ear canal in the picture below... it is above the normal one and is about 25% the size. To those in the know, this is due to a congenital birth defect related to the first branchial cleft. Read more about this birth defect here . Clearly, the way to correct this is surgical.
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October 06, 2009

LA Times: Driving a Convertible May Cause Permanent Hearing Loss!

The LA Times published a story on Oct 6, 2009 entitled " Cruising with the top down? Cover your ears " describing research that assessed noise levels in seven different scenarios where the convertible was traveling at speeds of 50, 60 and 70 miles per hour. Researchers found that drivers were consistently exposed to noise levels between 88 and 90 decibels. Even with the windows up, the noise levels were found to be at 82 decibels. To keep these findings in perspective, repeated exposu…
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NYT: Does Snotty Colored Discharge Require Antibiotics? No!!!

The New York Times published a story on Oct 6, 2009 entitled " The Claim: With a Runny Nose, Green Calls for an Antibiotic ." It actually is a pretty good article though I'm not sure how much impact this will have in clinical practice. The story reports that green discharge from the nose is NOT indicative of a bacterial sinus infection and as such, this symptom should not be the sole reason why antibiotics should be prescribed. It does reference a research paper that backs …
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October 01, 2009

Treatment of Chronic Draining Ear Infections Using Antibiotic Powder

Rarely, some unfortunate souls have chronic draining ear infections that do not respond well to oral antibiotics nor antibiotic ear drops. What many people and even physicians are unaware of is that there are alternative ways of addressing the chronic draining ear including use of antibiotics in powder form. The method I like best is by using the Sheehy-House Powder Insufflator Bulb . The pharmacy will make up gelcaps containing antibiotics (anti-bacterial as well as anti-fungal) and even s…
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