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Scientists Study The Shape Of The Nose And Its Relationship With Climate

The basic function of the human nose is to warm and humidify the air before it reaches the lungs. Because of the wide variation of human habitats from the polar cold and dry air to the equatorial hot and humid weather, one would expect the nose to accommodate to these climate extremes accordingly through evolutionary pressures.

In essence, logically one would expect the nose to change shape to enhance time that air is in contact with the warm and moist nasal interior in cold and dry climates compared to the opposite environmental extreme.

German scientists evaluated this hypothesis through Read more »

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

Asthma Treatment Used For Chronic Sinus Infections

Many people are already aware of nebulizer treatments to help with breathing during asthma attacks and other pulmonary conditions.

What many people may not be aware of is that such nebulizer treatments can also potentially be used for chronic sinus infections. One of the best known companies offering such treatment is Sinus Dynamics.

Using one of several different nebulizers, compounded liquid medications (antibiotics and/or steroids) selected by the physician are nebulized/atomized which the patient then breathes into the nasal passages. The small size of the particles allow medication to theoretically move through the tiniest of sinus openings directly onto the infected tissue. Treatments are quick generally lasting 3 – 5 minutes (depending on medication and device). Here’s a video demonstrating how it is used.

Sinus Dynamics™ specifically is contracted by over 14,000 insurance companies across the nation, which means that most patients are able to receive their treatment for little to no cost out of pocket.

Most ENT doctors are already familiar with this product.

Personally, I prescribe Read more »

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

Kids, Upper Respiratory Viruses, And Ear Infections

According to a new study published this month, more than 20 percent of young children with colds or other upper respiratory viruses will develop middle ear infections.

This finding isn’t that surprising. Eear symptoms along with a viral upper respiratory infection (URI) are common, including ear fullness and difficulty popping the ear. Although adults tend to be able to keep their ears clear by swallowing, chewing gum, yawning, or ear popping, most kids don’t know what to do when their ears feel full.

Whether in adults or kids, when the ears don’t ventilate or clear properly it can lead to ear problems including fluid buildup and middel ear infection. Why does this occur?

With a viral URI the lining of the nose swells, leading to symptoms of runny nose, nasal congestion, and sometimes nasal obstruction. This swelling doesn’t just occur in the nose, but also in the eustachian tube, which connects the back of the nose to the middle ear. When the ear “pops,” the eustachian tube opens to allow pressure and fluid to drain from the ear into the back of the nose. This is why yawning, swallowing, or noseblowing can cause an ear to pop normally.

When the lining in the eustachian tube swells up, the tube becomes blocked and prevents the ear from popping, leading to symptoms of ear pressure and fullness, fluid buildup, clogging, and often ear infections.

Read more about eustachian tube dysfunction here.


Clinical Spectrum of Acute Otitis Media Complicating Upper Respiratory Tract Viral Infection.” Pediatric Infectious Disease Journal. February 2011, volume 30, issue 2, pp 95-99.

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

Whispering: Is It Bad For Your Vocal Cords?

Is whispering bad for your vocal cords? For most people, the answer is yes according to research publicized in a recent New York Times article.

In the mentioned study, out of a group of 100 patients, 69 percent exhibited increased supraglottic hyperfunction with whispered voice (i.e. it was bad for the voice.) Eighteen percent had no change and 13 percent had less severe hyperfunction.

As such, though whispering is not bad for everybody, it is for most people and as such, the safest thing to do if the vocal cords are damaged whether by infection or trauma is to rest your voice. If you have to talk, do not whisper, but rather talk in a soft voice.

The best way to think about injured vocal cords is to talk in an analogy. Laryngitis is like a badly sprained ankle. In this scenario, talking is like walking and screaming is like running. So just like you would rest the sprained ankle and not walk on it in order for it to recover as quickly as possible, you should refrain from talking in order for the laryngitis to recover as quickly as possible. Where does whispering fall in this analogy? Probably equivalent to running on a sprained ankle.

Read more about voice problems here.

REFERENCE: “Laryngeal hyperfunction during whispering: reality or myth?J Voice. 2006 Mar;20(1):121-7.

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

The Link Between Oral Sex And Head And Neck Cancer

USA Today published a pretty accurate article regarding the rise of certain head and neck cancers with the increased popularity of oral sex and number of sexual partners.

The factor that creates this link is the human papillomavirus (HPV) 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 that younger people with head and neck cancers who tested positive for oral HPV infection were more likely to have had multiple vaginal and oral sex partners in their lifetime. Having six or more oral sex partners over a lifetime was associated with a 3.4 times higher risk for oropharyngeal cancer — cancers of the base of the tongue, back of the throat, or tonsils. Having 26 or more vaginal-sex partners tripled the risk. The association continued to increase as the number of partners in either category increased.

Of greater concern is that “French” kissing may also potentially be a mode of transmission.

The good news (if you’re a young non-smoker diagnosed with HPV-positive tumors) is that about 85 percent of non-smoking people with HPV-positive tumors survive. That number drops to 45 or 50 percent in people who smoke and are HPV-negative. Read more »

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

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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