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November 27, 2012

Is Patient Abandonment in the Operating Room Ever Justified?

I ask this question mainly because there WAS an ENT who WAS sued for NOT abandoning his patient in the operating room [ link ]. No way to verify, but additional details can be found in this facebook post . Imagine this hypothetical scenario (as details from original case are not available)... You are an ENT surgeon in a rural community hospital performing a fairly difficult but elective sinus surgery on a 12 years old child with cystic fibrosis with extensive pan-sinus nasal polypoid d…
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November 24, 2012

Actor Larry Hagman Dies of Throat Cancer

Image by Toglenn from Wikipedia Today, on November 24, 2013, media has reported that actor Larry Hagman died of complications related to his throat cancer at the age of 81. It is unclear exactly where the throat cancer was localized to (tongue, tonsil, supraglottis, hypopharynx, oropharynx, etc). Larry Hagman is a well-known actor playing oil baron J.R. Ewing in the soap opera  Dallas  (1980s as well as 2012) as well as Major Nelson in  the TV sitcom  I Dream of Jeannie . Most impress…
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November 18, 2012

ENT Surgeon Sues Spine Surgeon for Wrong Sided Surgery

Wrong sided surgery is extremely rare occurring anywhere from 0.09 to 4.5 per 10,000 surgeries performed. It is almost unheard of when the patient is a surgeon as well. On Nov 13, 2012, media reported that an ENT surgeon (plaintiff) sued his spine surgeon (defendant) over wrong-sided surgery. The ENT surgeon had spine surgery in 2011 for low back pain which was allegedly due to pinched nerves. The treatment called for laminectomy surgery on the right side which entails bone removal t…
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November 17, 2012

Taste Changes after Tonsillectomy

Very rarely, patients will complain of taste changes after tonsillectomy . Such taste changes (aka dysgeusia) is most often described as metallic though other taste variations or absences may be reported. Depending on what study you look at, this complaint occurs anywhere from 0.3% to as high as 9% of tonsillectomy cases. Dysgeusia after tonsillectomy is felt to be due to a number of different causes including: 1) medication side effect 2) injury to the lingual branch of the glossop…
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Problem with Medical Protocols (and Lawsuits Because of Them)

Over the past decade working in hospitals, I've seen the proliferation of "established procedures and protocols" for literally everything under the sun... • Chest Pain Protocol • Discharge Protocol • Pneumonia Protocol • Stroke Protocol etc, etc, etc Protocols are essentially standing orders that are supposed to be implemented whenever a given medical situation occurs. It is supposed to follow best evidence-based practices and make it easy for healthcare personnel know w…
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November 14, 2012

Video and Audio Recording with RCA Connectors: Primer for Surgeons

In the medical world, video recording of surgical procedures is not unusual, especially when it comes to endoscopy. A camera attached to an endoscope throws up a live image to a screen for the surgeon (and others) to watch. Video output for recording is now standard in such situations. The monitor where the endoscopy procedure is viewed itself contains video output plugs. The endoscopy equipment itself like the KayPentax EPK-1000 contains not just one video output, but 3... Two S-video…
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November 13, 2012

New Video on Treatment of Hyper-Nasal Speech by Injection

Our office has created a new video that we have uploaded that shows how hyper-nasal speech can be corrected via injection of filler agents under endoscopic guidance. Keep in mind that this procedure ONLY works with small velopharyngeal insufficiency . Hyper-nasal speech  occurs when there is too much nasal airflow during speech as opposed to hypo-nasal speech (ie,  nasal obstruction ) which occurs when there is little or no nasal airflow during speech. In either case, the voice sounds &qu…
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Why Is Eustachian Tube Balloon Dilation to Treat Eustachian Tube Dysfunction Slow to Catch On?

Eustachian tube dysfunction  is a phenomenon whereby a person is unable to  pop their ears  to relieve symptoms of ear pressure, clogging, or fullness. It is much akin to the ear pressure a person experiences when flying, but at ground level. Traditionally, treatment of this condition involved medications like steroid nasal sprays and prednisone along with active valsalva (watch video below). Once medical treatment has failed,  ear tube placement  has been the step of last resort. However,…
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November 11, 2012

Is Social Media Bad for Doctors?

I was recently asked to participate as a speaker in a panel discussion on social media next year in Canada and while preparing my thoughts on this subject, I was pondering several big questions regarding the why and pitfalls of social media for healthcare professionals. There's the obvious "WHY" a physician should participate in social media . But perhaps even a more basic concern for a physician deciding whether to pursue social media or not is whether it may even be a bad …
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November 08, 2012

Brooke Burke Has Thyroid Cancer

Brooke Burke , TV personality best known for winning the 7th season of Dancing with the Stars and later co-hosting the show starting in 2010 announced in a self-published video the fact that she has thyroid cancer and will soon be undergoing thyroid surgery . Apparently, on a routine physical exam, a  neck mass consistent with a thyroid nodule was appreciated in July 2012. This was biopsied (presumably via an ultrasound guided fine needle aspiration) and came back as "atypical&qu…
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November 04, 2012

Dr. Chang Quoted in Voice Council Magazine

Dr. Christopher Chang was quoted in a Nov 4, 2012 article published in Voice Council Magazine. The Voice Council Magazine is based out of United Kingdom and focuses on "practical insight for the emerging vocalist." The article  by Megan Gloss was focused on why Celine Dion cancelled her concert 2/22/12 in Las Vegas (a viral laryngitis ), a subject I already blogged about here . Read the published Voice Council article here . Source: Celine Dion's Viral Voice . Voice …
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Breathing or Voice... You Can Only Have One...

Sounds like a choice taken out of a morbid horror movie... "You can ONLY have one... Your voice or your breath..." The victim than loses one or the other after making a choice getting either the tongue or head cut off with a knife. But patients with vocal cord paralysis on both sides are essentially faced with this very question. Normally, the vocal cords (TVC in picture below) found in the voicebox move to accommodate talking or breathing. When the vocal cords are a…
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November 03, 2012

Nasal Sounding Speech

There are actually TWO different flavors of nasal sounding speech . HYPO-nasal speech is due to reduced or no nasal airflow and HYPER-nasal speech due to too much nasal airflow. HYPO-nasal speech is by far the most common cause of nasal-sounding speech. It is similar to how a person would sound if they pinched their nose shut while talking. As such, ANY anatomic nasal obstruction would by definition lead to such hypo-nasal speech. Treatment, obviously, is to remove this anatomic nasal ob…
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