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Cancer Drug Has Potential To Treat Chronic Ear Infections

I read with astonishment that a class of cancer drugs known as VEGF Inhibitors (ie, Avastin and Erbitux) used to treat colorectal, lung, breast, and kidney cancers can also be used to potentially treat a type of chronic ear infection known as glue ear… at least in theory and in mice. Glue ear is when an individual suffers from repetitive ear infections or upper respiratory infections to the point where the fluid in the ear turns into a maple syrup consistency. It’s thick, sticky and tough to get rid of with standard antibiotic medications. Standard treatment to address glue ear is placement of ear tubes to allow ventilation and drainage of the ear as well as antibiotic/steroid ear drops.

British researchers using the mouse model have determined that Read more »

*This blog post was originally published at Fauquier ENT Blog*

Antibiotic-Resistant Glue Ear And A Potential New Treatment

Glue ear is the layman’s term for thick mucoid effusion of the middle ear, usually due to chronic ear infections.

The fluid itself is like maple syrup and usually treated with ear tube placement followed by suctioning as much of the fluid out as possible. However, given there is always some residual present, antibiotic ear drops with steroids is often prescribed.

Unfortunately, these patients are at higher risk of requiring repeated sets of tubes after the body spits them out.

Why? Read more »

*This blog post was originally published at Fauquier ENT Blog*

Why Do Physicians Conduct Complete Physical Exams When You Have A Localized Complaint?

One June 20, 2011, NPR aired a great story about how a person may not “see” a person getting beat up on the side of a jogging path when they are focused on a task (pursuing another jogger)… even if they pass RIGHT BY THE FIGHT!!!

In fact, only a third of the subjects reported seeing this mock fight when the experiment was conducted at night. Even more surprisingly, broad daylight didn’t improve the statistics (only 40% noticed the fight).

Though the situation and circumstances do not exactly correspond, there is a lesson to be learned here that applies to a medical visit.

As an ENT, I often see patients for a very specific complaint…

“My right ear hurts.”
“I have a bad cough.”

No matter what the complaint, unless it is for a specific task (there is earwax… can you remove it), I most always still do a complete ear, nose, and throat exam no matter the complaint.

Why??? Read more »

*This blog post was originally published at Fauquier ENT Blog*

A Promising New Treatment For Blocked Ears

Eustachian tube dysfunction is a phenomenon whereby a person is unable to pop their ears to relieve symptoms of ear pressure, clogging, or fullness. It is much akin to the ear pressure a person experiences when flying, but at ground level. Traditionally, treatment of this condition involved medications like steroid nasal sprays and prednisone along with active valsalva. Once medical treatment has failed, ear tube placement has been the step of last resort.

However, a promising new treatment called eustachian tube balloon dilation has been described in March 2011 to address eustachian tube dysfunction at the source surgically rather than indirectly with tube placement across the eardrum. In essence, a balloon is inserted into the eustachian tube and than inflated thereby opening it up (the balloon is “popping” the ear for you). The balloon is than deflated and removed. Read more »

*This blog post was originally published at Fauquier ENT Blog*

When An Ear Is A Hot Potato

Recently a plastic surgeon I know was called out to fix a lacerated ear. It is the domain of plastic surgeons pretty much all over the world. But in my neck of the woods it may be tricky to extricate a plastic surgeon from his warm bed on a cold night. Let me also say that back in those days all registrars of all disciplines earned the same overtime each month. Even opthalmologists and dermatologists and pathologists earned exactly the same overtime as surgeons. They weren’t complaining. We, however, were.

As calls went it was fairly standard for us general surgeons. I had found a moment to empty my bladder which was a nice change, but other than that one reprise there had not been a moment to even realise that I hadn’t eaten all day. At least there hadn’t been any lethal disasters…yet.

Somewhere in the madness the house doctor asked me to evaluate a patient with a lacerated ear. He had had half his ear detached in a bar brawl. It was hanging precariously from what still connected it to the body. Now at this time in that hospital there was a policy that once a patient had been referred by a casualty officer they would not take the patient back. If the referral was erroneous then we would be required to refer further as appropriate. So when I heard my house doctor had accepted the patient I was not impressed.

“You suture his ear.” I told him. Poor guy, he hadn’t studied at our university and therefore wasn’t used to our sink or swim approach to medical training. He freaked. My level of being impressed dropped even more. I’d have to phone the plastic surgeon myself.

The plastic surgeon was not keen. By that I mean he basically said he was not coming out. By the tone of his voice I assumed he was getting a back rub from his significant other under the warm duvet on his bed. Who could blame him. If you’re not in the trenches why would you want to go into them, even for a short while to suture an ear.

“Anyone can suture an ear. you’re there now. I’d have to come in to the hospital. You just do it.” I considered telling him that I’m at the hospital because I have so much bloody work to do and that he is drawing the same overtime that I am and that it is his bloody job and not mine. But I knew that at that stage, even if I walked on water and then turned it into wine he was not going to come out. I hung the phone up. my house doctor looked at me questioningly. He had already told me he couldn’t do it. But he was not from our neck of the woods. I needed a student. One walked past, unsuspectingly.

“You! have you ever sutured an ear back on?”


“When I ask this same question tomorrow, you will answer yes. Come with me.”

He did quite well.

*This blog post was originally published at other things amanzi*

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