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December 29, 2012

Do Ear Candles Actually Remove Earwax? [video]

About once a week, I have a patient who presents to my clinic with a history of ear candling for earwax removal due to clogged ear sensation. About once a month, I have a patient with ear canal and/or eardrum damage due to using an ear candle in an attempt to remove earwax. I even have on occasion patients who I thoroughly remove earwax under the microscope, who than go home, perform an ear candle, and inform me of all the "earwax" that I missed. Well... I've decide…
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December 27, 2012

ENT Uses Laser Resulting in Patient Death

In 2010, an ENT used a Sharplan laser with an Omniguide Sidefire Adapter to address a superficial lip hemangioma. The tip of the laser probe was inserted through a small incision made to one side of the hemangioma and activated. Seconds later, the lip and surrounding tissues immediately swelled up indicating trapped gas. A second incision was made in an attempt to release the buildup of gas (analagous to popping a balloon to release air). A short time later, the patient's vital signs dr…
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December 25, 2012

Fake Botox Being Sold to US Physicians: FDA Sends Warning

It is not just patients trying to save money when purchasing medications from online pharmacies located in Canada. It's doctors as well when it comes to expensive drugs like Botox made by Allergan which costs a physician practice $550 per vial (2012 price)... but if purchased from Canada, may cost hundreds less. Unfortunately, just like prescription drugs purchased outside the US, foreign-purchased Botox may be a product that is potentially unapproved, counterfeit, unsafe, or ineffecti…
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December 20, 2012

How Can Nasal Obstruction Cause Post-Nasal Drainage?

Before talking about the nose, consider the way some home humidifiers work. There is a sponge, water supply, and airflow. Humidification occurs by having a fan blow air though the sponge that is soaked by a constant water supply. As the air passes through the wet sponge, evaporation occurs resulting in air humidification. Well, the same thing occurs inside the nose. In a normal nose, about one liter of moisture is produced by the nasal mucosa every day (water supply). This nasal moisture p…
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December 19, 2012

Does WaxVac or EarVac Actually Remove Earwax?

The EarVac or WaxVac  is a device that purportedly suctions out earwax . Shaped like a miniature hair dryer, one simply needs to hold it up to your ear canal in order to suction out the earwax. Recently, they have been marketing this device heavily, especially through TV commercials . Now, does it actually work??? Not really... In fact, British researchers tested it out against the humble ear curette (Jobson-Home Probe). With their test population, the WaxVac worked in exactly…
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December 16, 2012

New Anti-Meth Sudafed (Pseudoephedrine)

As anybody who suffers from nasal congestion and runny nose knows, the nasal decongestant medication Sudafed  can only be obtained from behind the pharmacy counter after showing identification because Sudafed  can be made into meth. This restriction applies to not just sudafed, but any medication containing the active ingredient "pseudoephedrine" which is a precursor for most meth recipes. Well, coming soon to a drugstore near you, a new nasal decongestant has been produced tha…
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Keyword Optimization for Medical Websites

As a general rule of thumb, physicians are terrible at running a business... including their own practice. This unfortunate inability also extends to managing practice websites. When it comes to websites, most physicians take the attitude of "if you build it, they will come" which is doomed to failure. The better way of phrasing it would be "only if patients can find you, they might come." Finding you is the first step... And one important element of accomplishing th…
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December 15, 2012

A New BAHA Hearing Aid... Without the Screw Implant

For patients with a significant conductive hearing loss or mixed hearing loss, B one- A nchored H earing A ids (BAHA) are an option that negates the need to place anything in the ear canal. Traditional hearing aids require some type of ear hook that is inserted into the ear canal to allow amplified sound to reach the middle and inner ear. BAHA transmits sound to the inner ear via a different mechanism using actual bone vibration. The bone vibration can be transmitted either via direct…
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Voice Amplification for Patients with a Weak Voice

There are certain voicebox conditions that naturally tends to a weak sounding voice. For some, the voice is weak all the time sounding breathy or just lacks projection. For others, the voice starts out OK, but than becomes weak after talking for some period of time. There are both pathological (ie, vocal cord paralysis ) as well as functional (ie, muscle tension dysphonia ) causes of a weak voice, but in the end, a patient just wants a better sounding voice one way or another. Although v…
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December 13, 2012

Julie Andrews and Her "Botched Throat Surgery"

It has already been well-publicized that the former singing sensation Julie Andrews underwent some type of throat surgery in 1997 after which she never regained her phenomenal 4-octave voice thus relegating her to more conventional roles of being an actress without the singing. This "botched throat surgery" per Julie Andrews lead to a lawsuit that was ultimately settled . It is unknown precisely what type of (presumed) vocal cord pathology was present as well as what type of su…
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December 10, 2012

Coffee Reduces Risk of Death from Oral Cancer

In a prior blog , I mentioned that researchers  found that regular coffee drinkers who drank more than four cups of coffee a day had a 39 percent decreased risk of two types of head and neck cancer: oral cavity and pharynx cancers. In the study published in the Journal of Cancer Epidemiology, Biomarkers & Prevention, they found however, that coffee did not decrease the risk of laryngeal cancer. Read a CNN report on this  here . In a more recent study  (Dec 2012), researchers have found…
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December 09, 2012

HIPAA Compliant Text Messaging (for Free)

Let's face it... Physicians love to text message given it is fast, easy, and convenient. However, regular instant messaging (SMS, MMS) that comes with your smartphone is not secure, saved unencrypted on a server somewhere (forever), and most importantly not HIPAA or HITECH compliant. Enter the encrypted and HIPAA compliant messaging services. Though most of these services cost a nominal fee per month, there are a few and growing number of services which offer free and secure instant…
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Embedded Earrings and Treatment

A few times a month, I have a patient, usually a young child, who presents with an earring that not only can not be removed, but is embedded within the earlobe (or ear) itself. There are two common scenarios that lead to this unfortunate situation: infection and fiddling. Infection is fairly straightforward. For whatever reason, the piercing gets infected and the earlobe skin starts to swell around and eventually even enveloping the earring itself. To prevent an embedded earring, immediate…
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December 06, 2012

Actress Jennifer Aniston Underwent Septoplasty Twice

Though not entirely recent news, actress Jennifer Aniston reportedly underwent septoplasty nasal surgery not just once, but twice. The first was done in 1994 and a revision septoplasty was performed in January 2007. [ link ] [ wiki ] This type of surgery is performed to help improve nasal breathing, an issue that Jennifer Aniston apparently had. Septoplasty , unlike rhinoplasty or nosejob, does NOT change the outside appearance of the nose. All the work is done internally. (Watch video h…
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December 04, 2012

Celebrity Actors Who Have Received a Trach (Catherine Zeta Jones Included)

Image Taken From www.TopScarCream.com Tracheostomy (also known as trach) is when a hole is made in the midline neck directly into a person's windpipe ( watch video ). Although many people may shy away from this deforming procedure, it can be life-saving. On that note, here is a short list of famous celebrity actors who have undergone an emergency trach for one reason or another: Catherine Zeta-Jones Apparently, when she was a child, she had an emergency trach done. She still has a…
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December 03, 2012

Brain Fluid Leakage Out the Nose (CSF Leak)

Image by Patrick Lynch from Wikipedia Fox News published a story today (12/3/12), describing one patient's runny nose that was not due to allergies, but in fact due to brain fluid leaking through a crack in the roof of her nose. Also known as  CSF leak  (cerebrospinal fluid leakage), correction of this problem can be performed endoscopically through the nose without any incisions on the face. An interesting trivia related to CSF leaks is that actor George Clooney suffered one after a…
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December 02, 2012

57 Maggots Removed from Woman's Ear

92 years old woman with Alzheimer's was found to have 57 maggots in her ear sparking a lawsuit. Read more from media reports. Beyond the gross factor and questions regarding how this was allowed to happen, this story does bring up some interesting teaching points and the medicinal properties of "maggot therapy". Media reported the patient suffered from earwax build-up and had "an enlarged ear canal from surgery performed decades earlier." This  surgery was …
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Egg Free Flu Vaccine Approved by FDA

Why the concern of egg-allergic patients with the flu vaccine used to defend against both seasonal and pandemic flu virus ? Traditionally, the flu shot vaccine (both H1N1 and seasonal) are grown inside eggs which is where this concern arises. It also doesn't help that the pre-flu shot questionnaire specifically asks about egg allergy. Though egg-based, during vaccine production the egg protein is filtered out such that there should be no egg contaminants in the final vaccine. However, i…
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