Posts for tag: austin
What are Nasal Polyps?
Nobody wants to hear they have polyps in their nose. This is not your garden variety nasal issues. Most of the time caused by allergy, polyps are a chronic condition that is not often cured with surgery. Usually an allergist is going to provide the best long-term control. But there are times when surgery is needed, even repeatedly in the most extreme cases.
Polyps grow in response to nasal inflammation. They are relatively discrete mounds of incredibly swollen nasal mucosa (lining). Most of the time it is something in the air that stimulates them to grow. At times, it is a sinus infection that provides the impetuous for their existence. No matter the cause, polyps are disruptive to nasal airflow and tend to cause secondary sinus infections.
Epidemiology and differential diagnosis of nasal polyps.
Chaaban MR, Walsh EM, Woodworth BA - Am J Rhinol Allergy (2013 Nov-Dec)
Surgery is needed for polyps if medical management can’t keep them at bay and an allergist can’t help you control the environmental reaction that started them in the first place. It is by no means the first choice of treatment unless they are, sometimes quite literally, hanging out of your nose.
Adult-onset woakes' syndrome: report of a rare case.
Schoenenberger U, Tasman AJ - Case Rep Otolaryngol (2015)
The problem with surgery is it is not a permanent fix most of the time. Think about mowing the grass – it just keeps coming back.
When someone has a significant enough polyp issue to require an ENT to take them to the OR, the surgery should be a part of the process. Combining surgery with aggressive medical management pre- and post-op is often the best way to keep you and your nose healthy.
Mark T. Brown, MD, FACS
It’s true. We are going deaf.
Research from Johns Hopkins School of Medicine has determined that hearing loss is a growing problem in the US. They project that by 2060 2/3 of older people will have hearing loss.
The tragedy is that much of this can be avoided by protecting your ears from loud sounds. An ounce of prevention (ear plugs) is better than a pound of cure (hearing aids). The time to start protecting your hearing is now.
The jury is still out about the use of electronic nicotine delivery systems. Their manufacturers have proposed them as a “safe” alternative to tobacco smoke. But are they? A recent review of the scientific and medical literature on the subject (Palazzolo DL (2013) Electronic cigarettes and vaping: a new challenge in clinical medicine and public health. A literature review. Front. Public Health 1:56. doi: 10.3389/fpubh.2013.00056) didn’t reveal much. There is no evidence yet of harm reduction. There definitely is no sign that they decrease cigarette smoking or increase quit rates.
We don’t even know what happens to the lungs when this vapor is inhaled. Do the flavorings cause harm, or not? What is the level of inhaled nicotine relative to cigarettes? Is second hand vapor better or worse than second hand smoke? All of these questions remain to be answered. And likely over time they will be.
I hope that vaping does turn out to be a safe alternative to tobacco smoking. But, in the long run, neither is your best bet. As hard as it may be to quit, your life and health improve in the absence of nicotine.
Mark T. Brown, MD, FACS
Image from Alice's Adventures in Wonderland by Lewis Carroll (1869)
Q Tips are bad!
Somebody finally confirmed what ENT’s and audiologists have been telling you all along. Quit cleaning your ears. That wax is not “dirty” but is important to your ear canal skin. It helps the ear canal stay healthy, repels bacterial invaders, and filters our dust and dirt that might otherwise get stuck in there. I know, it feels REALLY good. But you are more likely to cause a problem than solve one with a Q-Tip (apologies to Johnson and Johnson).
Check out the USA Today article here. http://www.usatoday.com/story/news/nation/2017/01/05/now-hear-stop-cleaning-your-ears/96193598/
Mark Brown, MD, FACS
In October 2015, PCAST (President’s Council of Advisors on Science and Technology) delivered a letter report to the President detailing hearing loss, implications should it go untreated, the current hearing aid “market,” and recommendations to increase accessibility of amplification. While I could talk for 18 years about the implications hearing loss has on a patient the longer it is not addressed (increased fall risk, increased risk for developing dementia, withdrawal from social interactions… I mean, the list goes on), that’s for another day. It is within the recommendations made in this letter that a serious problem arises: PCAST wants to treat hearing aids like a commodity, a cute pair of shoes you can purchase and wear without any further thought behind it.
(Obtained from: http://www.thebrainydeafsite.com/p3.html)
NEWSFLASH: HEARING AIDS ARE NOT GLASSES FOR YOUR EARS!
Hearing aids do not treat hearing loss in the linear way that eyeglasses address vision impairment. Rather than presenting hearing aids as something we can window shop for, we should be calling for them to be seen as a medical solution! Hearing aids ARE treatment options for those suffering from hearing loss-a medical condition that varies between individuals. They ARE NOT an over-the-counter remedy that works universally.
PCAST’s first recommendation within the aforementioned letter presents the idea that hearing aids for mild to moderate hearing loss should be approved by the FDA for sale over-the-counter WITHOUT a single evaluation performed by or consultation with an audiologist or hearing aid dispenser. Imagine self-deciding that you need to wear a full mask CPAP machine every night for the rest of your life without undergoing a sleep study or a consultation with a board certified sleep medicine doctor? You wouldn’t! Or I hope you wouldn’t…
Additionally, PCAST calls for audiologists and hearing aid dispensers to provide a simple programmable profile based on a diagnostic hearing evaluation for such OTC hearing aids. Here’s an example that highlights the most glaring issue here: 3 people may present with the exact same audiogram, but process sound inputs completely differently. Picture these 3 individuals with the same allergy to mold and oak (hello springtime in Central Texas!)-the treatment of each person will vary based on patient need. A single dose of Flonase in the morning may offer relief to one patient and have zero effect on another. Hearing aids are extraordinarily similar: one manufacturer with one prescribed programming strategy will not work for all patients.
Hearing aids are therapy tools-treatment devices that should be adjusted based on patient need. Success with amplification requires an honest relationship between patient and provider. An audiologist is not a shoe salesman! We don’t help you pick out the pair you like and send you on your way, never to be heard from again. It’s an ongoing relationship to ensure proper treatment of a patient’s hearing loss and improvement in quality of life. For that, don’t expect some OTC device to provide the same level of success. Don’t go see a dentist for Lasik eye surgery. Don’t trust your auto mechanic to manage your banking portfolio. See an audiologist to improve your hearing health. Demand better.