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October 31, 2011

A Vampire Who Knows How to Bite Correctly (Anatomically)

Take a look at the pictures below... Which victim suffered a vampire attack who knew what it was doing? If you guessed the middle, you are correct! The large blood vessels in the human neck (carotid artery and jugular vein) are oriented vertically, so an experienced vampire who knows the anatomy and desires a good feast of blood would want to bite in the same direction. The other bites were probably committed by vampires with a total lack of experience.
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October 30, 2011

Why Does the Nose Whistle in Some People?

Though most people like the professional nose whistler shown here require an instrument to enable the nose to whistle, in others it occurs naturally due to unique anatomic features within the nose. Why might someone's nose whistle? Septal Perforation The most common reason it may occur constantly is due to a hole in the septum (septal perforation). The septum is a wall that divides the right nasal cavity from the left side. Normally, it should be straight and without any openings. R…
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October 29, 2011

Singer Adele Has Vocal Cord Hemorrhage and to have Surgery

At least that's what the LA Times reported on Oct 28, 2011. And supposedly will be having surgery to treat it in the near future. Before going any further, the title to the LA Times story was "Adele to have surgery to treat vocal cord hemorrhage. What is it?" I sincerely hope that whomever her surgeon is knows not to perform surgery when the vocal cord is in the middle of a hemorrhage. You do the surgery when the hemorrhage is gone and the culprit blood vessel is left b…
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Cold Sores Due to a Single Gene

Specifically, individuals who suffer from cold sores triggered by Herpes Virus Simplex - 1 (HSV-1) several times a year may have a single nucleotide polymorphism in their gene C21orf91 – dubbed rs1062202. Researchers have suggested it be called by the more "easy-to-remember" name Cold Sore Susceptibility Gene 1 (CSSG1). Having this genetic change of swapping a thymine to a cytosine nucleotide was significantly associated (p=0.0047) with more frequent cold sores. Analysis has also…
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October 26, 2011

The Illusion of Healthcare Progress

Wellcome Film based in London has transferred numerous films dating from the early 20th century related to healthcare and medicine that anybody can view for free. Aside from the historical value, it is amazing that much of what we know and do now is not all that different than what was done in the 1920s. It makes me wonder sometimes what "progress" in healthcare actually has happened over the past century. In some things, tremendous change has occurred whereas in other areas of medi…
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October 25, 2011

Tonsillectomy Circa 1940s [video]

I encountered this interesting video of tonsillectomy being performed in a child with sedation (but NO intubation) performed circa 1940s. Of course, nowadays, tonsillectomy is performed under general anesthesia with intubation for airway protection. Below is a video of the way it is now done. That is, unless, you practice in other parts of the world where modern medicine is not up to United States standards. In those nations, tonsillectomy is STILL being performed WITHOUT general ane…
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October 24, 2011

Singer John Mayer Undergoes Vocal Cord Surgery

In September 2011, grammy-award winning singer  John Mayer announced the cancellation of a number of concerts as well as an album due to the development of a vocal cord granuloma of his voicebox. Read a blog article about this. Last week on Thurs, Oct 20, 2011, he underwent surgery to remove the granuloma and is now on strict voice rest for several weeks. Though removal sounds like a great idea, vocal cord granulomas are notoriously difficult to eliminate completely as they have a hi…
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October 23, 2011

How do Vocal Cord Cysts, Polyps, and Nodules Form?

There are MANY theories as to how vocal cord  cysts ,  polyps , and  nodules  form. However, one theory that seems to make the most sense to me deals with how the vocal cord heals after a traumatic event (ie, screaming, yelling, coughing, etc). With a cyst , the mucosal vocal cord lining breaks down and during the healing process a cyst develops due to entrapped cells meant for creating lining. A polyp , however, is in essence a blistering of the vocal cord lining. Vocal cord nodule for comp…
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New Webpage on Vocal Cord Cysts and Vocal Cord Polyps

We have uploaded a new webpage describing what vocal cord cysts and vocal cord polyps are as well as how they are treated. Vocal cord cysts are masses below the vocal cord lining whereas vocal cord polyps are masses involving the vocal cord lining. Read more here !
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October 22, 2011

Mind Over Body Treatment

24 years old female presents with several week history of progressive stomach pains, substernal chest discomfort, heart palpitations, loss of appetite, headache, insomnia, and growing lump sensation in her throat. Physical exam was essentially normal. Can this previously healthy female have suddenly developed reflux , globus , paroxysmal supraventricular tachycardia, brain tumor, and throat cancer with possible overlying thyroid disorder? Or perhaps has she contracted some other horrifi…
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Even Kids Can Spot Adult Bull^!#$& ... And Publish It in a Medical Journal!

Though often adults find kids to lack intellectual rigor and devoid of rational thought, sometimes it's the other way around. Take Emma Rosa, age 9, who debunked the idea of therapeutic touch back in 1998. She watched a TV program about nurses who practise “Therapeutic Touch”, claiming they can detect and manipulate “human energy field” by hovering their hands above a patient. Emma recognized this adult nonsense and conducted a scientific study for a 4th grade science fair to not only p…
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Cancer Drug to Treat Glue Ear in Kids??!

I read with astound that a class of cancer drugs known as VEGF Inhibitors (ie, Avastin and Erbitux) used to treat colorectal, lung, breast, and kidney cancers can also be used to potentially treat a type of chronic ear infection known as glue ear... at least in theory and in mice. Glue ear is when an individual suffers from repetitive ear infections or upper respiratory infections to the point where the fluid in the ear turns into a maple syrup consistency. It's thick, sticky and tough …
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October 21, 2011

New Webpage on Vocal Cord Nodules

Our office has created a new webpage on the evaluation and management of vocal cord nodules . Vocal cord nodules also known as Singer's nodules is a common cause of a painless raspy voice that mainly affects individuals who use their voice a lot. Such individuals include teachers, singers, cheerleaders, and people who simply just love to talk a lot. Read more about this condition here and how to treat it! Of note, the cartoon is by   Dave Walker  at   We Blog Cartoons .
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October 18, 2011

Steroid Injection to Eliminate Vocal Cord Nodules

Vocal cord nodules are most always due to excessive voice use leading to "callous" formation on the vocal cord lining, much like shoveling dirt will eventually lead to callous formation on the hands. Traditional standard of care management of vocal cord nodules is voice therapy and avoidance of any activities leading to voice abuse (screaming, yelling, etc). However, resolution of nodules with such behavior focused treatment takes months. However, although it takes a while f…
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Working in a Salon Can Be Unhealthy for Your Nose and Throat!

We already know that small hair clippings from cutting hair can cause septal perforation and chronic sinusitis due to long-term inhalation. Worse case scenario, it can even lead to an external nasal deformity! (Read blog about this here .) However, it seems that it's not just hair that can damage the nose, but also hair products especially to straighten/smoothen hair popularly known as "Brazilian" treatments. In a report published by Washington Post on Oct 17, 2011, such B…
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October 14, 2011

Nasal Congestion Affected By How Well the Nose is Able to Cool Itself

Researchers at Monell Chemical Senses Center have figured out that nasal congestion is influenced by more than just nasal airflow. Apparently temperature and humidity influence the perception of nasal congestion just as much as how physically obstructed the nose is. By having volunteers breath air with variations in temperature and humidity, they have determined that cool and dry air minimizes nasal congestion without any change in how open the nasal cavity is. By taking into account …
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October 13, 2011

Realistic Face Masks

With halloween coming up and more face transplants occurring to address severe facial disfigurement, it was only a matter of time when a commercial company can recreate a 3-dimensional replica of a person's face. Unlike medical facial transplants which creates a face that's a cross between the donor face and the patient's face prior to disfigurement, these faces are perfect replicas down to scars, blood vessels, skin pores, etc. Well, there's a Japanese company called Real-f…
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October 11, 2011

Respiratory Spasmodic Dysphonia

Respiratory spasmodic dysphonia is one of the most rare subtypes of a class of laryngeal dystonia collectively known as spasmodic dysphonia . It is also known more accurately as laryngeal adductor breathing dystonia or respiratory spasmodic dystonia or respiratory laryngeal dystonia. Introduction Spasmodic dysphonia is a type of dystonia in which there are involuntary muscle spasms or contractions of the muscles involved in voice production. This disorder is similar to the involuntary…
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October 07, 2011

The Four Types of Patients Seen in a Surgeon's Clinic

Over the years, I have found that patients can be loosely grouped into 4 different types. Nothing particularly wrong with any type, but it does help me to approach patients appropriately if I can get a sense of what type they are. The four types are: Type A:  If a surgery can "fix" or "cure" me such that I won't have to take medications every day of my life, than let's do it. Type B: I will never consider surgery unless it is a life-threatening situation. I…
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October 06, 2011

Posterior Tongue Tie

An ordinary garden-variety tongue tie  (also known as ankyloglossia) is an uncommon condition whereby the tongue is anchored to the floor of the mouth preventing the tongue tip from moving freely. Patients with tongue tie have greater difficulty with: feeding if infant speech if school-age child french kissing if young adult (more info on adult tongue ties here ) Treatment is tongue tie release which can be done at any time if difficulties arise. In infants and young adults , this …
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YouTube Ranks Fauquier ENT as Most Viewed for Medical Videos

I was informed that our practice's  YouTube channel  has been ranked as one of the most viewed channels related to medicine  in the world ! As of Oct 6, 2011, our channel  which contains 52 videos has received 198,064,840 views. We currently average over 500,000 views a day! We far surpass other more "prestigious" medical organizations with a YouTube channel. Mayo Clinic Channel Channel 4,936,943 views University of Maryland Medical Center Channel 2,047,260 view…
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October 04, 2011

Sedated Anesthesia for Kids Under 2 Years May Cause Learning Disability

There is mounting evidence in animals and in humans that general anesthesia might damage developing young brains. Researchers at Mayo Clinic compared the learning skills of 350 kids who underwent 1 or more general anesthesia before age 2 to 700 kids who have never been under sedated (general) anesthesia. What they found was that before the age of 19 (after statistical normalization): No significant difference in learning disability between kids who have been under anesthesia once (23 out…
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New Webpage on Facial Fractures and Nasal Fractures

Our office has created a new webpage describing the evaluation and management of not only nasal fractures, but also facial fractures. Fracture types discussed include: Nasal Fractures Orbital Fractures (around the eye) Maxillary Fractures (cheek) Zygomatic Fractures (behind cheekbone) Tripod Fractures (cheekbone) Mandible (lower jawbone) LeFort (upper jawbone) Check it out here !
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October 01, 2011

Are You Able to Use Expired EpiPens Safely?

Though one should always use an EpiPen that is not expired, it is better to use an expired EpiPen to treat anaphylaxis than to do nothing at all. Some Canadian researchers studied expired EpiPen auto-injectors 1 to 90 months past the expiration date. What they found was that the older the EpiPen, the less effective it was due to decreased epinephrine bioavailability. The inverse correlation was 0.63 (months past expiration and decreased epinephrine content). As long as the solution is …
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New Webpage on Thyroid Mass (Evaluation and Management)

A new webpage has been uploaded to our practice website describing the evaluation and management of a thyroid mass. Surgical removal is discussed along with risks involved. Click here to read more!
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