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March 31, 2013

Infographic on Obstructive Sleep Apnea (OSA)

Check out this great infographic by Aviisha Medical Institute (generated from information by PubMed.gov, Medscape, and BioMed Central) on the numerous adverse consequences that can arise from the onset of Obstructive Sleep Apnea (OSA). [Thanks to @ hobsonent who brought it to my attention.] Here's another one regarding how important sleep is:
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March 30, 2013

The Art of Facial Paralysis

Professional photographer Sage Sohier spent 3 years in a Boston ENT clinic photographing patients suffering from facial paralysis along with family members. These intimate portrayals document the personal struggles patients with facial paralysis go through that is shared with family. Patients shown include children suffering from this malady. Her collection of photographs include people with mild to complete degrees of facial paralysis , a condition that usually occurs on just one si…
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March 23, 2013

Stroke vs Non-Stroke Facial Paralysis

Image by Patrick Lynch from Wikipedia A recent blog post about a ER doctor who was found negligent for not pursuing a stroke workup for an isolated facial paralysis did bring up an interesting medical phenomenon about what differentiates a facial paralysis due to stroke vs facial paralysis due to facial nerve inflammation. To begin, the facial nerve innervates the entire half of the face. The nerve itself exits from the skull behind the ear and sends finger-like branches to all the musc…
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March 22, 2013

Surgeries on a Weekend Have More Complications

The New York Times published an interesting story regarding how patients with ulcerative colitis suffered significantly more surgical complications when performed on a weekend compared to a weekday. Just how much worse? The cited  research  reported that the most common post-operative complication was post-operative infections (Weekend 30% vs. Weekday 20%). However, there was also an increased risk of need for repeat laparotomy, mechanical wound complications, and pulmonary complications…
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ER Doc Found Negligent in Bell's Palsy Case

This case is not quite what you might think... Here's the background... The Wisconsin State Supreme Court  found an ER physician negligent for failing to offer a carotid ultrasound for a patient who presented with an isolated facial paralysis  (patient did not exhibit paralysis anywhere else in the body) and upheld a $2 million jury award to the patient in 2008. Not only that, the Wisconsin Medical Board reprimanded the ER physician and fined her $300. [ link ] Hmmmm... After all, …
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March 17, 2013

Mal de Debarquement Syndrome - Rare Cause of Dizziness

The BBC recently printed a story describing a rare condition called mal de debarquement which causes  dizziness , typically after a boat cruise, though can occur with airplane flights and even a long drive in a car with switchbacks (going up/down a mountain). Two signs that a patient has mal de debarquement are if they feel a rocking sensation for weeks or months starting AFTER a cruise and two, if they're much better when in motion like vigorous exercise, but feel much worse when sta…
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Some Facts About Q-Tips and Ears

In this week's episode of " Girls " (Season 2; Episode 9 "Girls Gets Dark"), Hannah grappling with OCD, inserted a Q-tip deep into her ear canal and "heard air hiss out the hole" due to perforating her eardrum . Although this scene came out of a TV show, this scenario is not uncommon and results in many ENT office visits every month for not only eardrum perforations , but bleeding due to trauma to the ear canal skin. Some facts about Q-tips as it rela…
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Dr. Chang Quoted in the Wall Street Journal

The Wall Street Journal on 3/15/13 published a story on how voice therapy and vocal surgery can dramatically improve a person's vocal quality... seemingly taking years away from how you sound. In this story, Dr. Chang was quoted a few times and even included a patient he has treated successfully with voice surgery to restore his voice. In regards to how aging can create muscle atrophy and bowing resulting in: "It creates a breathy, raspy voice," says Christopher Y. C…
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March 15, 2013

Diagnose Cancer with Flash of a Light!

Traditionally, cancer is diagnosed by a surgical biopsy  with pathology results taking days later. Supportive evidence for a cancer is also determined based on visualizing the lesion as well as radiological studies (CT, MRI, Ultrasound, etc). However, there is a very exciting breakthrough technology that may be able to make a cancer determination under 1 second with only a flash of a light... meaning no biopsy with associated pain and scar to go along with it. Called Verisante Aura , a p…
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March 13, 2013

Kim Kardashian Gets Allergy Testing

Celebrity Kim Kardashian of Keeping up with the Kardashians reality TV show underwent allergy testing with Dr. Mirmelli. Allergy testing was accomplished via skin prick (our office performs allergy testing by blood draw instead called immunocap ). She apparently was allergic to her pet cat... Kim apparently decided to let her pet cat Mercy go... a decision in contrast to what most cat-allergic people do. Watch the video .
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March 11, 2013

Book on Hoarseness

My fellowship mentor, Dr. James Thomas , taught me much of all I know about the voicebox both when it works and when it doesn't leading to hoarseness . Much of his knowledge is imparted in a book he wrote which is now available for purchase on Amazon.com . Although healthcare professionals interested in the voice will find the book very helpful, it is written in such a way that any layperson without a medical background can also find it understandable and helpful. Check it out here !��…
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March 06, 2013

Hearing and Understanding ONE Voice Among Many Sounds

Have you ever wondered how is it that a normal hearing human being can hear and understand one person talking in an environment where there are many other people talking just as loudly be it a restaurant, conference, county fair, etc? How is it that you can hear and understand one particular person over another, even if they are both talking equally loud? Researchers are just beginning to understand how a human does it... Before explaining, lets use an analogy. In the past, I used the a…
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March 05, 2013

The Facial Triangle of Danger (Even Death)

Image by SpooSpa from Wikipedia If you draw a line between the eyebrow to the corners of the lip, a triangle is created which delimits a region esoterically known as the "danger triangle". Why is this region considered dangerous? It's because infections within this region can lead to infections of the brain (rarely). Why? The blood supply within this triangular area communicates with the cavernous sinus found at the bottom of the brain. This anatomic structure is a major …
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Do Surgeons Swear When Operating?

Surgeons, whether deserved or not, have a reputation of being mean-spirited and foul-mouthed as a group overall. It does not help that TV shows and movies perpetuate this reputation. Well, a study was actually carried out to see if surgeons are truly foul-mouthed or not and published their findings in the British Medical Journal in 1999. Using a grading system based on how bad the swearing is, researchers secretly tallied how often surgeons used profanity in the operating room. The obs…
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March 02, 2013

The Problem with Universal Healthcare

I usually hit the delete key whenever I get a chain email... But this particular one caught my eye enough for me to read the whole thing. This story is probably impossible to prove or disprove (I tried to find the name of this professor), but the overall message was quite intriguing... enough so to share given its applicability to universal healthcare. My healthcare commentary is provided after the end of the story below (to preface, I believe in a compromise of sorts... I guess I'm a c…
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