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January 31, 2015

Dr. Chang Invited Lecturer at the American Society of General Surgeons 2015 Meeting

It was with great honor and pleasure that I was invited to give not only one talk but two at the 2015 American Society of General Surgeons meeting held at the Marriott Marquis in Washington DC on Jan  31, 2015.  The two talks I lectured on were: "Social Media for the Busy Surgeon" and "Laryngo-Pharyngeal Reflux: Collaborative Treatment Between General Surgeon and ENT" This is the 2nd time I have been asked to give a talk at this meeting, the first time be…
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January 27, 2015

Large Thyroid Nodules Have Higher Risk of Cancer Even if Needle Biopsy is Normal

A recent 2015 study revealed that large thyroid nodules (over 3cm) have a higher risk of cancer and that needle biopsies are not very accurate in diagnosing cancer in such large nodules. This is hardly the first study to demonstrate this. In a 2009 study , surgeons at the University of Wisconsin found that fine needle aspiration  biopsy  (FNAB) in 26 of 52 FNAB reported as benign (50.0%) turned out to be either neoplastic (22) or malignant (4) on final pathologic analysis after  thyroidect…
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January 24, 2015

At-Home Influenza (Flu) Testing

There are kits that can be purchased inexpensively over-the-counter to test for strep and mono . You can also add influenza (aka "the flu") to the do-it-yourself list, but unfortunately, this test kit is expensive at several hundred dollars on Amazon to perform 10-20 tests or about $20 per test. Taking about 15 minutes to perform, these flu test kits are designed to detect Influenza A (including H1N1 virus) as well as the Influenza B virus antigens in nasopharyngeal specimens …
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At-Home Rapid Mono Testing

Rapid mono test kits  can be purchased by anybody to be done at home which may save parents/patients money in doctor visits as well as getting an answer right away. Indeed, should mono testing be positive, than you know that the patient is contagious... and that there's not much to do other than give it time to resolve. A doctor visit may still be worthwhile since there are other possible causes of a sore throat including strep throat, cancer ,  aphthous ulcer ,  sinus infection ,  reflux …
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January 20, 2015

How Accurate is Food Allergy Testing by Blood vs Skin Prick?

A great new allergy research paper came out in Jan 2014 comparing the accuracy of skin prick versus blood testing for food allergies. In summary, skin prick edges out blood testing in terms of accuracy, however mainly in terms of specificity. Sensitivity of both methods of testing is pretty comparable. However, blood testing tends to give more false-positives (test says you are allergic when you really aren't) compared to skin prick. Blood testing may be more convenient and may prov…
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January 18, 2015

Recurrent Infections of the Ear, Sinus May be Due to Immunodeficiency

Image Courtesy of marcolm at FreeDigitalPhotos.net Your immune system is what helps to fight off infections. But if the immune system is deficient in some way, a child or adult may experience recurrent infections. When it comes to ENT, such repeated infections may only involve the ear / sinus , or manifest itself as frequent URI. What are some key questions that may prompt an investigation for an immunodeficiency, especially if surgical management fails to resolve? • Need more than fo…
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January 17, 2015

January 16, 2015

Actress Kaley Cuoco Reveals Afrin Nasal Spray Addiction

Image by Tabercil of Wikipedia Actress  Kaley Cuoco  of  Big Bang Theory  fame revealed that she was addicted to Afrin nasal decongestant spray for years which ultimately made necessary her recent sinus surgery . This confession was made during Ellen Degeneres talk show Jan 2015 . “I was actually really addicted to nose spray. Like, Afrin. Like, for years... At awards shows I would have to pick out the right clutch so I could fit my Afrin in it, and I’d be under the table snorting it. …
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January 11, 2015

Antique Cough Syrups (Cannabis, Heroin, Chloroform, etc)

Image from Antique Cannabis Handbook A blog reader pointed me to this interesting website that contains pictures of antique cough syrup preparations. The interesting historical information is that pretty much all cough syrups in the 19th and early 20th century contained some combination of alcohol, cannabis (marijuana), chloroform, heroin, and/or morphine. I suppose alcohol as a cough suppressant ingredient is not too surprising since it is still used even today. See chart below. Heroi…
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January 10, 2015

Tonsillectomy "May" Help with PANDAS?

Only in kids, there is a VERY rare (and controversial) disorder where strep throat infections can rapidly lead to involuntary tics including  chronic throat clearing ,  cough , head/neck movements, sneeze, etc as well as OCD behavior. Known as PANDAS ( P ediatric A utoimmune N europsychiatric D isorder A ssociated with S treptococcus), it is felt to be an autoimmune reaction triggered by antibodies produced by the body when fighting a strep infection. With this disorder, an evaluation with…
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January 08, 2015

Elderberry Juice Helps Reduce the Severity and Duration of Viral URI (Flu and Cold)

Image by Lefterov in Wikipedia There has been more research being produced that suggests that Elderberry Juice may help reduce the severity and duration of viral upper respiratory illnesses including the common cold and the flu. However, in order for its beneficial effects to be maximally achieved, it needs to be taken within 24-48 hours of symptom onset. The suggested dosage for adults is 1 tablespoon 4x per day for 3-5 days. For children, the dosage is 1 tablespoon 2x per day for 3 d…
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January 06, 2015

January 04, 2015

Big Bang Theory TV Star Kaley Cuoco Undergoes Sinus Surgery

On Dec 26, 2014, Kaley Cuoco of Big Bang Theory fame posted on instagram pictures of herself after undergoing sinus surgery . Apparently the need for sinus surgery was present for over one year. Given Kaley has been suffering from some kind of sinus problem for over one year, what could those possibly be? She may have suffered from recurrent sinus infections or even nasal polyps which would lead to persistent nasal congestion , sino-nasal pain/pressure, and/or need for repeated cours…
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January 02, 2015

Senator Harry Reid Suffers Facial Fractures

Senator Harry Reid was reported to have suffered facial fractures (and rib fractures) from a fall due to a malfunction in an exercise machine he was using at home Jan 1, 2015. Although details are sparse, he was apparently admitted overnight for observation and released Jan 2, 2015. He is expected to return to work as planned on Jan 6, 2015. In the vast majority of cases, most  facial fractures  do NOT require surgical repair. As such, Mr. Reid most likely will not require any surgical in…
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January 01, 2015

How Alcohol Intoxication Causes Inner Ear Dizziness ("The Spins")

Image courtesy of thephotoholic at  FreeDigitalPhotos.net Alcohol can affect a person's balance via poisoning brain receptors especially in the cerebellum as well as altering the density of fluids within the inner ear. Given this is an ENT blog, the following discussion focuses mainly on alcohol's affect on the inner ear causing dizziness . Normally, blood that enters the inner ear has the same density as the endolymphatic fluid that is normally contained within the inner ear com…
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