Distributed Botox Injection for Spasmodic Dysphonia (Rather than Single Injection)

For many patients with spasmodic dysphonia , botox injections to the vocal cords are a regular right of passage every few months towards a clearer voice. Spasmodic dysphonia characterized by spastic or breathy voice breaks while talking causes much problems socially as well as misunderstandings. For many physicians who perform botox injections for spasmodic dysphonia, a single injection is performed to either one or both vocal cords. However a few and perhaps growing number of physicians…

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Making Twitter Work for a Specialty Medical Practice (Like ENT)

I've been asked by a few ENT colleagues how I got Twitter to work for my practice and how in the world I managed to get more than a few dozen followers. I've been at it for about 1 year now (up to 355 followers @FauquierENT ) and here are a few tips to making it work for a medical practice... Just an opinion... And it may not apply to everyone... • When you tweet something, always back it up with a useful link to a webpage using a link shortner like bit.ly or goo.gl . • Tweet a…

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"Sinus Lift" Procedure - The Return of Intra-Oral Sinus Surgery

I saw a patient today who informed me that she underwent a " sinus lift " procedure in the past. This statement made me realize that though ENTs are generally considered the sinus surgery experts, dentists and oral surgeons perform some sinus surgery as well like the "sinus lift" procedure. As far as I know, there is no ENT surgeon that does that specific sinus operation. In essence, the "sinus lift" procedure is when the floor of the maxillary (cheek) sinus c…

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Fauquier ENT Blog Now Published on the Kindle

We are pleased to report that our blog is now published on the Kindle ! As many readers may already be aware, the Kindle  is the top-selling e-book reader sold by Amazon.com . Click here to subscribe to our blog on the Kindle!

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Zenker's Diverticulum Endoscopic Treatment Confusion

Having treated many patients with Zenker's Diverticulum using the endoscopic approach, I've had many confused patients ask me how the diverticulum is treated if it is not removed. For those unfamiliar with this disorder, click here for more information. The basic concept of treating this rare disorder is that there is a common wall that divides the esophagus from the diverticulum pouch. This common wall is endoscopically divided such that the pouch now becomes the new back wall …

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Teaching Dr. Oz About Nosebleeds (Re-Published on KevinMD)

One of Dr. Chang's blog article on nosebleeds  has been re-published on KevinMD , an internationally recognized medical blog and contributor to MedPageToday . The original blog article by Dr. Chang can be read here . The blog article re-published on KevinMD can be read here .

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Do Cell Phone Makers Secretly Know Cell Phones May Cause Health Problems?

Recently, there has been much speculation on whether cell phones pose a health risk. Wikipedia has a nice summary of those concerns. What I find interesting is that the cell phone makers may actually know more about these risks than they are letting on or even have evidence for them. If you look in the small print booklet that comes with your cell phone, cell phone makers state that phones should not be in contact with your body or skin and should be kept a certain distance away when in u…

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Does the Nose Appearance Change After Septoplasty? (Answer: No)

Septoplasty is a surgical procedure to straighten out a deviated septum causing problems with nasal obstruction/congestion . A common question I get asked is whether the nose appearance will change after this surgery. The answer is no (if correctly done). In fact, if the nasal appearance DID change afterwards, you would also have undergone rhinoplasty nose job... or too much was unintentionally removed. The explanation for why the nasal appearance does not (should not) change after septopl…

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Zyrtec (OTC) and Xyzal (Rx) Contain the SAME Active Ingredient? Prilosec (OTC) and Nexium (Rx) Too!

If zyrtec and xyzal ( allergy medications) both contain the same active ingredient ( cetirizine ), why are they "different" and one is sold over-the-counter (zyrtec) and the other available only by prescription (xyzal)? This is also true for reflux medication prilosec (OTC) and nexium (prescription) which contain the same active ingredient omeprazole . It's because of mirror images of the same active ingredient molecule... with one being biologically active and the other inac…

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Are Doctors Required to Obtain Patient Permission For Posting Non-Identifiable X-Rays, CT Scans, Etc Online?

The blunt answer is no... as long as there is no way the patient can be identified by looking at the image. (in other words, anonymous). Dr. Ves Dimov at CasesBlog has written a very good article regarding this very question and the guidelines used to determine whether patient permission is required or not. Read his blog article here .

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Bilateral Lateral Hypopharyngocele (Cervical Esophageal Diverticulum)

I recently was asked to review this interesting (and rare) disorder in which a diverticulum or pouch has formed on both sides of a patient's upper esophagus. This condition which I'll call bilateral lateral "hypopharyngocele" is even more rare than Zenker's Diverticulum which is also not very common. Check out the barium swallow which shows a barbell like image. The "barbell" part is the abnormal pouch and is found on both sides. A paper was actually wri…

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Hotels Offering Hypoallergenic Rooms

Recently, a few hotel chains including Hyatt, Wyndham, and NYLO have introduced hypoallergenic rooms for those suffering from asthma, allergies , or just want a room with a clean breathing environment. At least for Hyatt, the rooms are called "Respire" and as per their website : "Respire by Hyatt rooms undergo an additional six-step process to reduce airborne particles and minimize the presence of potential irritants. This process includes installation of a state-of-the-art a…

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Large Metal Hook In Person's Head (No Kidding)

An ENT colleague brought this x-ray to my attention. Apparently, there was an accident during which a large hook got embedded in this patient's head.

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Wearable Camcorders for Video-Recording Surgeries From the Surgeon's Viewpoint?

An avid snow-boarder, I had the bright idea of using the ContourHD wearable camcorder I purchased to record snow-boarding runs... to instead video-record surgical cases. This wearable type of video-recording has many advantages over traditional camcorders which requires an assistant to shoot the video. First, the angle of a wearable camcorder is from the surgeon's viewpoint and has minimal distraction impact. Having an assistant video-recording over the surgeon's shoulder during a …

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Allergy Shots in Britain Require a LONG Waiting Period Afterwards

I recently heard that one reason why allergy shots  are rare in England (and why sublingual "under-the-tongue" drops aka SLIT , are so common) is that British patients are required to wait under observation for anaphylaxis as long as ONE HOUR after each and every injection!!! In fact, initially the waiting period was as long as TWO HOURS when the British Committee for Safety of Medicines became alarmed with some deaths that followed allergy injections in 1986. Subsequently, the safe…

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Nosebleeds... It's That Time of Year Again!

With the fall season, the air becomes cooler and dryer... Families start turning on the heat which further dries the air leading to a potent environmental situation ideal for nosebleeds . What can you do to minimize nosebleeds ? Use a humidifier in the bedroom and keep the door closed to prevent the humidity from escaping. Use a nasal emollient like ponaris . Ponaris is a wonderful product to alleviate the dry, irritated, and sometimes burning sensation in the nose. It is also a great p…

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Teenager Dies From Tonsillitis

A teenager in the United Kingdom died from an unfortunate missed diagnosis of tonsillitis . Apparently, her primary care doctor thought she had swine flu and was prescribed tamiflu... an anti-viral medication. For bacterial tonsillitis , treatment is with anti-bacterial antibiotics like amoxicillin, penicillin, etc. The tonsil infection spread into her blood, seeded her lungs, and eventually caused multi-organ failure and death. Read the full story here .

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Gaviscon Advance by Reckitt Benckiser

Our office has received a number of inquiries on where one can purchase Gaviscon Advance or Gaviscon Double Action made by Reckitt Benckiser (not available in the US which only carries the plain Gaviscon without the " advance "). This product, sold in the United Kingdom, is only available through online pharmacies. The Gaviscon Advance made by Reckitt Benckiser actually maintains a list of online pharmacies that carry this product here : http://www.gaviscon.co.uk/resources/us…

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