Why Do We Have Earwax?

This question was addressed in today's Washington Post.The question itself wasn't really addressed, but the article did contain good general information.Read more about earwax here.Read the Washington Post article here.Watch a video of earwax being removed by an ENT specialist under the microsco...

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A Crime For Doctors to Ask About Guns?

When I saw this report on ABC about a Florida politician wanting to make it a crime if a physician asks about guns in the home or else face 5 years in jail and up to $5 million fine, I could not believe it.Who cares that more children die of accidents than of diseases. It is standard practice for pediatricians to provide guidance on a variety of unintentional injury-prevention counseling for infants, preschool-aged children, school-aged children,...

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Link Between Oral Sex and Head & Neck Cancer

USA Today published a pretty accurate article regarding the rise of certain head & neck cancers with the increased popularity of oral sex and number of sexual partners.The factor that creates this link is the HPV virus which is associated with tonsil and tongue cancer. Alcohol and tobacco use is more highly linked with such oral cancers, but HPV does appear to be an independent risk factor.A 2007 study in the New England Journal of Medicine found...

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Allegra Going Over-The-Counter March 2011!

For allergy sufferers, the prescription anti-histamine, Allegra, will be going over-the-counter on March 4, 2011.And not just Allegra, but the full family of Allegra including those formulations for kids as well as Allegra-D which contains sudafed.Click here for more info.Allegra joins claritin and zyrtec which also used to be prescriptions but went over-the-counter in 2003 and 2007 respective...

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Bottles / Vials for Allergy Drops (Under Tongue) Immunotherapy

We have received a number of requests of where one can obtain allergy vials for use in SLIT (sub-lingual immunotherapy) whereby a drop is placed under the tongue to try and achieve allergy cure. This mode of treatment is an alternative to the more traditional allergy shots.Our office provides both modes of immunotherapy.Regarding the allergy vials themselves, you can obtain them from Edge Pharmaceuticals. They offer a number of different vial types...

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Dr. Chang a Northern Virginia Top Doctor for 2011

Northern Virginia Magazine published their annual list of Top Doctors for 2011 in their February 2011 edition. Dr. Chang was listed as one of Northern Virginia's Top Doctor in the field of Otolaryngology (page 68).Of note, Dr. Chang was nominated by his doctor peers opposed to nomination by a small pan...

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Migraine Headaches Associated with Allergies & Response to Allergy Shots

A recent study published this month in the journal Headache reported an association of migraine headaches with allergy severity and response to allergy shots... but only in those less than 45 years of age.The study suggested that lower "degrees of atopy" (or allergy) were associated with less frequent and disabling migraine headaches in younger subjects while higher degrees were associated with more frequent migraines. The administration of allergy...

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Patulous Eustachian Tube Video

In perhaps one of the most flagrant cases of patulous eustachian tube I've ever seen, the New England Journal of Medicine published a video showing the eardrum moving with respiration.Normally, the eustachian tube (which extends from the back of the nose to the ear) is closed unless one pops the ears (like when flying in an airplane). As such, one does not normally see the eardrum moving to and fro with breathing.Symptoms this poor patient with patulous...

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Fauquier Hospital Now Offers 24 Hour Multichannel pH and Impedance Testing for Reflux!

As far as we know, Virginia Hospital Center's Heartburn Center in Arlington, VA and now Fauquier Hospital are the only places in Northern Virginia that offers 24 hour Multichannel Intraluminal Impedance (MII) testing to look for non-acidic reflux. Oftentimes, this test is combined with pH probe testing and manometry to measure the more traditional acid reflux as well as esophageal motility.  These tests are important when...

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Woman Undergoes Successful Voicebox Transplant

USA Today published a story on January 20, 2011 about a courageous woman who underwent a voicebox transplant October 2010. The surgery took over 2 days and was led by a team of doctors at the University of California, Davis Medical Center and included experts from England and Sweden.The first voicebox transplant took place at Cleveland Clinic in 1998 on Timothy Heidler after a motorcycle accident and who now talks completely normally.Read more of...

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Videos on Visual Illusions

Bumming around one early morning, I came across these fascinating videos on YouTube of visual illusions reminiscent of Escher's optical illusions... except these illusions are made of cardboard and without use of any magnets or editing (video or computer generated)... just VERY clever use of camera angles. Be sure to watch the end of the videos to see what is REALLY going on.Much credit goes to the artist who started it all, Kokichi Sugihara. Here...

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New Video on Vocal Cord Surgery Produced

Our office has created a new video on how vocal cord surgery is performed. The video has been uploaded to our YouTube channel. Read more about vocal cord surgery he...

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Wireless and Cell Phones Increase Risk of Brain Tumors

In an ongoing controversy regarding whether cell phones and wireless phones can lead to brain tumors like astrocytoma, malignant gliomas, and benign acoustic neuromas, several recent studies published since 2009 containing long-term (10+ years) follow-up have lent support that it does.The group at greatest risk for development of brain tumors have the following characteristics:1) Use of cell/wireless phone younger than age 20 (the younger the age...

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Dr. Chang Now a Contributing Author to Better Health Web Network

Dr. Chang was recently invited to become a regular contributing author to Better Health and its syndicate partners which include Harvard Health Publications, The ACP Advocate, ACPHospitalist, ACPInternist, Healthline, and MedHelp.Better Health and its partner sites reaches approximately 10 million unique users per month and is growing.Look for his contributions soon!Dr. Chang is also a contributing author to KevinMD along with more traditional sources...

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Updated Google App Translates English<->Spanish Conversation in Real-Time

Earlier this month, Google released an incredible app (only for the Android market at this time) that can translate English to Spanish as well as Spanish to English in REAL-TIME allowing for a somewhat stuttered conversation with translations on the fly.At this time from what I hear, it can understand English pretty good, but understanding Spanish is not quite as good. With time, I expect the accuracy to improve to the point that potentially, this...

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ENT Robotic Surgery

There has been increasing interest in using robots to help the surgeon perform complex surgical procedures within small spaces thereby saving the patient more invasive incisions. Especially in the world of ENT, surgery that may have required large incisions to the face and/or neck can now be accomplished without any incisions by using robotics to perform the same surgery, but entirely through the mouth.Such robotic surgery performed through the mouth...

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U.S. Rep. Gabrielle Gifford Gets a Tracheostomy After 7 Days of Intubation

U.S. Rep. Gabrielle Gifford who is recovering from a gunshot wound to the head 7 days earlier had her breathing tube removed and a tracheostomy tube placed on January 15, 2011.Many people will wonder why a tracheostomy tube was placed when she's been intubated for only 7 days and even though she has been able to breath on her own since Tuesday. Along with the trach tube, a stomach feeding tube was also placed.A tracheostomy tube is a small tube placed...

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What is the Perfect Tablet Computer for Healthcare?

Many would argue (as I have) that the Apple iPad is THE perfect tablet computer for healthcare professionals. And for many of the mundane tasks of looking up or inputting information into an electronic medical records, that may be true. (Watch a video using the iPad to access MediTech as well as PACS here.)However, there is a vast area of healthcare that the iPad just does not work at all.That area is connecting to surgical equipment. Especially...

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Tongue Piercing Infections

It seems that tongue piercing is slowly becoming more popular than ever... and correspondingly, there seems to be even more tongue infections than ever before due to the piercing.If tongue piercing MUST happen, it is recommended that you avoid studs made of metal which increases the risk of infection, at least according to a recent study in the Journal of Adolescent Health.The study demonstrated that studs made of steel might promote the development...

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Fauquier ENT Is Now Searchable on Trunk.ly!

What in the world is Trunk.ly???It is in essence a search engine for links shared on Twitter (or Facebook or Blog, etc). At least for us, we have elected to share on Trunk.ly only our Twitter account for now. At current count as of January 16, 2011, we have tweeted over 1081 links of interest on a variety of topics related to ENT.Even we can't remember all the interesting links we have shared with the world on Twitter. Trunk.ly allows anyone to find...

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Chronic Hives Due to Vitamin D Deficiency

It seems that there is more and more research being published indicating that vitamin D deficiency leads to allergy exacerbation (and by supplementation, the severity can be reduced). Particularly problematic given so many people are vitamin D deficient as a possible byproduct of working indoors for so many of us (including physicians).The most recent research out of Nebraska suggests that chronic urticaria in adults may be due to reduced vitamin...

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Dr. Chang Receives Patients' Choice Award for 2010

For the year 2010, Dr. Christopher Chang was given a Patients' Choice Award. Apparently, only a handful of physicians receive this honor (less than 6% out of 720,000 active physicians). This honor is determined based on ratings provided by actual patient ratings.Read more about Dr. Chang he...

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Dr. Chevalier Jackson, Laryngologist Extraordinaire

On Jan 10, 2011, the New York Times published an article on Dr. Chevalier Jackson, a pioneer in the field of laryngology, who is perhaps best known for his extensive collection of foreign bodies he removed from patients, young and old, with little or no anesthesia. His genius is documented in a new biography called "Swallow" by Mary Cappello.Among other achievements by Dr. Jackson was passage of the Federal Caustic Poison Act of 1927, esophageal...

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Cigarette Ad Blast From the Past

A reader forwarded this ad to me... My how times have changed...

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Singulair May Help Reduce Tonsil and Adenoid Enlargement

Singulair is a medication often prescribed for asthma as well as allergies and works by blocking the leukotriene receptor. This mechanism is different than that found in common allergy medications like claritin and benadryl which work by blocking the histamine receptor (anti-histamine).Singulair has also incidentally been found to possibly help reduce the size of tonsils and adenoids. Given this beneficial affect, singulair may be a helpful intervention...

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Twins Die after Tonsillectomy and Adenoidectomy

Twin Ohio boys, 3 years old, both died on April 19, 2006 after both kids underwent tonsillectomy & adenoidectomy (T&A) less than 48 hour earlier. Both children were discharged home on the same day of surgery. Read the story here.On Aug 6, 2010, A malpractice suit was found against the otolaryngologist who performed the surgery, based on the assertion that if the surgeon "kept the children in the hospital overnight - something within...

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How to Use an EpiPen??? There's An App for That!

No kidding...The makers of the EpiPen have created an app that works on the iPhone, iPad, and iPod Touch called MyEpiPenApp.Within this app, you’ll find:• A video demonstrating how to use an EpiPen Auto-Injector• A quick slideshow (User Guide) to help you visually walk someone through the three steps of an EpiPen injection• The ability for you and your healthcare professional to create multiple allergy profiles listing allergens to avoid and symptoms...

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Clinical Guidelines For Tonsillectomy in Children Published

This month, the American Academy of Otolaryngology-Head & Neck Surgery published clinical guidelines for tonsillectomy in kids. No big surprises in the guidelines, but everything is nicely summarized in one document.In summary:• Strong recommendation that clinicians should administer a single, intraoperative dose of intravenous dexamethasone to children undergoing tonsillectomy.• Strong recommendation against clinicians routinely administering...

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Avoidable Pediatric Radiation Exposure

Children and teens often get diagnostic tests that expose them to radiation, increasing the risk of cancer later in life. Over just a 3 year span, 42.5% of kids got some form of ionizing radiation from a diagnostic medical procedure whether it be a chest x-ray, CT scan, dental scan, etc. Click here to calculate the cumulative risk of cancer with each type of test.It also estimated that 1/3 of CT scans are unnecessary and that by limiting CT scans...

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Surgery Costs for Self-Pay Patients

Surgery is expensive... there are no doubts about that. However, there are a few things a patient without insurance who desires surgery can do to minimize the costs as much as possible. Before going into cost-cutting measures, you first need to understand where the costs come from.In rank order, the costs of surgery come from (highest to lowest):• Hospital Charges (MOST expensive charges)    a) Use of OR Room    b) Paying...

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Cocaine the Soft Drink Being Sold in the United States

It was a little bit disturbing to me when I found out there is a soft drink being sold in the United States called "Cocaine". Made by Redux Beverages, LLC, they have a very aggressive marketing campaign using the tagline "Cocaine is a hell of a drug!" with a website DrinkCocaine.com, YouTube channel, Twitter feed, and a Facebook page (over 3500 fans).It is marketed as an energy drink high on caffeine and packs 750 grams of taurine like most...

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Simple Rubber Device Mimics Complex Birdsongs & Implications for Human Voice

A team of US researchers at Harvard has developed a simple rubber device composed of two pieces of rubber replicating the 'vocal tract' and a motor that replicates the action of a contracting muscle. With this device, the researchers have been able to EXACTLY mimic the birdsong of a variety of species including the bengalese finches and vireos.Given complex birdsongs have been faithfully reproduced with such a rudimentary device as shown here, it...

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Anesthesia Sleep is Actually a Coma and Implications for Snoring Evaluations

On December 30, 2010, the New England Journal of Medicine published a paper titled "General anesthesia, sleep, and coma". The article goes on to describe normal sleep as well as sleep induced by anesthesia at time of surgery. What researchers have found is that anesthesia-induced sleep actually is more like a deeply unconscious coma patient than someone sleeping.This actually makes sense to me... When a person sleeps, they can be aroused if noxious...

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Should You Have Surgery Far From Home???

I am in the fortunate position of seeing patients who live locally as well as a handful who travel across one or more state lines to see me on a weekly basis, as well as the sporadic few who come from even other countries.When patients travel great distances to see a doctor, this puts the physician in a particularly humbling position. However, it also places additional strain on how care can be provided efficiently and reasonably when geography logistically...

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