Thyroidectomy (Thyroid Surgery) Risks

Thyroid removal (either total or only one side) is a common surgery performed by general surgeons as well as ENTs for thyroid cancer or masses suspicious for cancer.Though I no longer perform this surgery, I often get asked for my opinion regarding this surgery. Rationale for why surgery should be done or not, I leave to others as it would literally take a textbook, especially given the controversy regarding when to observe and when to surgically...

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ENT Problem at the Biblical Wall of Jericho

Many people may be aware of the Sunday School story regarding the Wall of Jericho in the Bible. In this story, seven priests blew 7 trumpets of rams' horns resulting in the collapse of the wall of Jericho (Joshua 6:4-5) allowing the Israelites to conquer the city."4: And seven priests shall bear before the ark seven trumpets of rams' horns: and the seventh day ye shall compass the city seven times, and the priests shall blow with the trumpets....

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How Does Coblation Work?

Coblation is a unique technology that cuts and stops bleeding simultaneously using radiofrequency plasma technology. This technology is used in many ENT procedures including turbinate reduction, tonsillectomy, adenoidectomy, respiratory papilloma excision, cryptolysis, etc. The benefit of this technology over cauterization which does the same thing is that coblation occurs near room temperature opposed to cauterization which may produce temperatures...

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Pacemaker To Cure Obstructive Sleep Apnea (OSA)?

The Huffington Post on Dec 27, 2010 published a story about a potential new treatment whose goal is  obstructive sleep apnea cure (OSA) cure using a pacemaker made by Inspire Medical... for the tongue. The New York Times also published a similar story more recently about the same device on 1/8/2014.The device works by stimulating the nerve going to the tongue (hypoglossal nerve) to contract with every breath a person takes while sleeping.Why...

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Santa Claus, A Sick Patient Needing Medical Care

ENT Journal published in December 2003, a humorous paper on Santa Claus as a patient with numerous medical problems. Given it is Christmas Eve, it is probably worth revisiting the article which lists among his many medical problems:• Allergies to woodwork (sawdust and varnish) and materials used in preparing teddy bears, dolls, and other gilts.• Asthma exacerbated by reindeer exposure as well as the hay and straw in the stable which makes his nose...

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Can Placebo Be Used to Help People Instead of Drugs?

On my way to work On December 23, 2010, I heard a great story on NPR regarding how placebos can potentially be used to help people... EVEN if they know it's a placebo!Based on research done at Harvard, they found that a placebo helped patients with irritable bowel syndrome 59% of the time compared to a similar group that received nothing. Of greater significance... the treatment group with placebo KNEW they were getting a placebo.Given that many...

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Can Humming Ease Sinus Problems?

Well... according to a recent New York Times article published Dec 20, 2010, the answer is yes...Apparently, humming can keep air moving through the sinuses and nasal cavity which suggests improved ventilation. Good sinus ventilation means healthy sinuses.Their conclusion is based on two studies listed under the references below. Unfortunately, the conclusion can't extend to stating humming prevents sinus infections. The only way to evaluate that...

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ICD-10 Coding Primer for Otolaryngologists

If you are a physician... you probably already know what I am talking about...ICD is the "International Statistical Classification of Diseases and Related Health Problems" used by physicians to code a given medical problem whenever a patient sees a doctor. This "code" is what is submitted to insurance companies along with medical charges.Periodically, ICD undergoes an update and in the United States, it is about to undergo a MAJOR update come October...

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Google Body Browser (Google Maps of the Human Body)

Google released a new "map" so to speak of the human body. In the same spirit and controls as the venerable Google Earth, Google Body Browser allows a user to zoom in and out as well as pan across the human body. Here is a window capture of a session when I was checking it out.Currently, this internet-based program only works with Google Chrome which you can download for free here.Access Body Browser here after you have Google Chrome instal...

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Robotic Surgery for Oral Cancer

I encountered these amazing pictures in the Archives of Otolaryngology-Head & Neck Surgery Dec 2010 edition in an article titled "Transoral Robotic-Assisted Surgery for Head and Neck Squamous Cell Carcinoma". This surgery was performed at Mayo Clinic as well as University of Alabama.Of note, there are also some YouTube videos of robotic surgery for thyroidectomy you can watch below or here.Reference:Transoral Robotic-Assisted Surgery for Head...

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Patient Experience Just As Important As Clinical Expertise

I read with great interest an article in the New York Times "How Does Your Hospital Room Make You Feel?" regarding how a patient room... how a hospital appears... private rooms... may play just as important a role in where a patient goes for treatment as the clinical expertise of its doctors.Indeed, amenities are a critical part of the patient experience and possibly even a more valuable component of patient-centered care as reported in the New England...

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Dr. Chris Chang Mentioned in a Medical Blog

Dr. Chris Chang and his blog was mentioned in an article in another medical blog "Dr. John M" on December 14, 2010."---One of the best ways to know something well is to teach it. Dr Chris Chang from the blog of the Fauquir ENT Consultants of Virginia writes about why he keeps a blog. His first reason is that it keeps him highly informed. No doubt about that. Could we bloggers get some CME credit, please?" Click here to read the whole st...

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New Video on Septoplasty to Correct Nasal Obstruction Due to a Deviated Septum

A new video has been created and uploaded onto our YouTube channel depicting how a deviated septum causing nasal obstruction is corrected by a septoplasty surgery.Watch the video below or on our YouTube chann...

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Has Evidence-Based Medicine Gone Too Far?

Although there is no question that evidence-based medicine is a very important development in the evolution towards higher quality healthcare, the demand for evidence for a given treatment can go too far.The following abstract is an ACTUAL published article in the British Medical Journal describing the lack of evidence that parachutes are effective when falling out of a plane.Parachute use to prevent death and major trauma related to gravitational...

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Dr. House Video Clip Illustrating Doctor-Patient Communication Problems

In this classic video clip, Dr. House interviews a patient with asthma. Their interaction illustrates the problem of communication between doctor and patient that unfortunately too often occurs.Errors in doctor-patient communication as shown by this video clip:Doctors assume that patients know how to use medications (or understand treatments) when they don't.Patients assume that they know how to use medications (or understand treatments) even if...

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Different Types of Immunotherapy for Allergy Cure

Most people are already familiar with allergy shots and even sublingual (under the tongue) allergy drops as treatment to try and achieve cure (or tolerance) to the things they are allergic to.However, there are other forms of immunotherapy that may one day provide just as good if not better allergy cure rates. These include (most currently under research):- Intra-Lymphatic Injections (ILIT): Rather than weekly shots in the arm, one research paper...

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Can A Person Have Allergies Even if Allergy Testing Comes Back Negative?

YES!!! But how can that be?!! Well, here is the simplified answer. When allergy testing is performed whether by skin prick or blood testing (RAST), one is testing to certain specific proteins known to cause allergic reactions in majority but not all patients (these are called major allergen).Patients need to remember that for a given allergy like CAT (or tree, mold, dust, etc)... there are millions of proteins (minor allergen) that have the...

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Will.i.am Suffers From Tinnitus

And yet another celebrity reports suffering from bad tinnitus or ringing of the ears. Black Eyed Peas' Will.i.am spoke with Britain's the Sun stating that the only time it doesn't bother him is when there's loud music. Read the news report here.Prevention is by far the best way to avoid suffering from this debilitating condition. How does one prevent this problem? Protect your ears from loud noises!!! Wear ear plugs if loud noise exposure is...

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Extremely Discounted Blood Tests for Cash-Paying or Uninsured Patients

Through the cooperation of Summit County Medical Society, LabCorp, and PrePaidLab, patients are now able to get lab tests done for a small fraction of the normal cost via the medial society website. Anyone near a LabCorp location nationwide is able to use this website to obtain the same low-cost blood tests.For example, a lipid panel (cholesterol test) can cost as much as $148 for an uninsured person. The same test is available for less...

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Physician Marketing Using Groupon

For those not in the know, Groupon is a website that offers coupons and other savings on local merchandise and services. Groupon also has recently rejected a takeover bid by Google.I recently encountered this amazing deal on Groupon offered by an ENT colleague, Dr. Ghaheri:"$149 for Four Laser Hair-Removal Treatments at The Center for Aesthetic Medicine at The Oregon Clinic (Up to $1,000 Value)"I wonder if such marketing and medical discount offerings...

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Strange But True Allergies People Suffer From (Sex, Kissing, Water, etc)

As shown on CBS news here, these things can cause an allergic reaction in the rare unfortunate individual:1) Water can cause hives in some people (aquagenic urticaria)2) Sunlight3) Kissing (a person has recently eaten a food substance that the person being kissed is allergic too)4) Sex (some women are allergic to seminal fluid)5) Hops and barley can cause an allergic reaction6) Low temperatures7) Cell phones (due to Nickle content)8) Pressure (too...

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What Makes A Great Surgeon or Doctor?

Or for that matter, a great violinist? As many psychologists suggest (regardless of whether one is talking about sports, music, painting, astronomy, physics, etc), it entails:Focused practice (at least 10,000 hours according to many)Good coachingGreat role model to provide motivationDoes this apply to surgeons or doctors? I believe it absolutely does. Any person who puts in enough good training hours under the tutelage of a great teacher...

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New Video On Performing a Tracheostomy

A new video on performing a surgical tracheostomy has been created by our office and uploaded onto our YouTube channel. Watch the video here or bel...

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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...

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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...

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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)...

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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 hereto subscribe to our blog on the Kind...

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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...

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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 he...

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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...

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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 nosejob.The explanation for why the nasal appearance does not change after septoplasty is actually...

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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...

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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 he...

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