Stem Cells Restore Toddler's Congenital Hearing Loss

In a potentially revolutionary treatment, a two years old toddler born deaf has had her hearing restored after receiving stem cells from her banked umbilical cord blood. (Reported in ABC News)

Madeline Connor at age 1 year old was completely deaf in the right ear and had severe hearing loss on the left. Normally hearing aids or cochlear implant would have been the only options.

However, in January 2012 at the age of 2 years old, Madeline underwent a "simple" experiment whereby stem cells were infused into her damaged inner ear. The stem cells were derived from umbilical cord blood that was banked at the time of her delivery at the Memorial Hermann-Texas Medical Center.

Over the next 6 months, there has been dramatic improvement in her hearing. She is also now talking for the first time.

Madeline also is not the only child who has undergone this revolutionary stem cell treatment. Apparently, there are ten other children who are being followed after undergoing similar stem cell infusion derived from banked cord blood.

It must be stressed that though Madeline's progress is quite amazing, it is still too early to say if this is a "bona fide" treatment for congenital hearing loss.

• Will the improvement continue and more importantly, last over years to decades?
• Will it work for other children?
• What is the expected hearing improvement with stem cell infusion?
• Will it treat ALL forms of nerve-damaged hearing loss?
• Does it have to be stem cells derived from cord blood or are stem cells derived from other sources possible (i.e., skin)?
• Can adults with non-congential hearing loss also benefit?

I eagerly await the outcome of this FDA approved trial which hopefully will be published at some point in the near future.

I also eagerly await the protocol used to obtain and infuse the stem cells. I suspect the infusion of stem cells is similar to that done when steroids are infused into the ear for sudden hearing loss as shown in this video below. However, this is just a guess of mine.

Source:

Cord Blood Stem Cells Restore Toddler's Hearing. ABC News 7/11/12

Katie Couric Gets a Hearing Test

On July 10, 2012, Katie Couric reported on a personal story during which she obtained a hearing test.

In a modern society like the United States, there are many sources for hearing loss with our alarms, lawn-mowers, and loud music.

As the article correctly pointed out, damage due to loud noises is due to two factors: loudness and duration.

The louder something is, the shorter time of exposure before hearing damage can occur. The quieter something is, the longer a person can listen before suffering noise-induced hearing loss.

Otherwise, hearing aids may be in your future... even if you are in your 20s or 30s!

Source:
Am I Going Deaf? Yahoo News 7/10/12

Phone App That Measures How Loudly You Listen to Your Music!

There are plenty of sound meters in the market for iPhone and Android smartphones that tell a user how  loud the surrounding noise is. Many of these apps are free.

However, rather than recording the loudness of the surrounding environment, there is now a new phone app called Safe and Sound (only for Android phones) that measures the decibel level of the sound emitted from headphones and gives the user a clear indication of how loud their music really is. Furthermore, it also records the user's listening history and alerts them when they are close to their daily recommended dose of noise exposure.

It is free as well!

Listening to loud music has become an increasing concern as hearing loss is being seen at earlier and earlier ages with increasing need for hearing aids. Complaints of tinnitus is also present.

Download the app here.

Developer website.

Hearing Loss Reversed by Teeth

When a patient is totally deaf in just one ear (normal hearing on the other side), there are only a few options to help.

• BAHA - Bone Anchored Hearing Aid
• CROS Hearing Aid - Stands for Contralateral Routing Of Signals.

With BAHA, it does require surgery given the hearing aid is literally mounted on a post that is directly drilled into the skull on the deaf ear side. Total cost about $10,000.

With CROS, two hearing aids are required; one on the deaf hear which picks up sound, and another on the good ear where the sound is transmitted to. Total cost about $2,500.

Well, for many folks, having surgery is not palatable and wearing two hearing aids when one ear is perfectly good is also not acceptable.

There's now a third option called SoundBite (cost about $6,800).

With SoundBite, a hearing aid is placed in the deaf ear to pick up sound which is than wirelessly transmitted to a mini-retainer like device placed around the back molars. This special retainer vibrates the teeth which in turn vibrates the skull which sends sound waves to the good ear allowing a patient to hear.

And preliminary results show that patients like it the best among the three options.

However, nothing is all good...

The disadvantage with the SoundBite is battery life. The ear piece battery only lasts about 12-15 hours and the teeth retainer piece about 8 hours. Also, the teeth retainer needs to be fitted by a dentist.

Also, not everybody is a candidate for SoundBite. In order to quality, a patient must have:

1) Good teeth and gums
2) Deaf in only one side with normal hearing on the other. A comprehensive hearing test is required obviously.

Source:

Using Teeth to Help Restore Hearing in One Ear. WSJ 7/10/12

Hearing Aid Styles and Colors - There Are Many!

It is not uncommon that a patient with hearing loss interested in hearing aids mistakenly believe there's only TWO hearing aid styles.

The kind that goes in the ear and the kind that goes behind the ear.

Although that is true, there are more different variations of both types that catches many people by surprise.

Image taken from NIH

There also seems to be a generational gap in what style is preferred by patients.

"Older" folks in their 60's or older prefer the styles that go in the ear, mostly because of the stigma associated with hearing loss and use of a hearing aid that reinforces and reminds them of their age. Also, because they remember the large skin-toned BTE that used to be the only option.

The "younger" generation typically prefer the min-BTE that go behind the ear. It probably helps that so many people use wireless bluetooth earpieces almost like a status symbol.

Beyond where hearing aids go, they now come in different colors and patterns for further personalization! Skin-tone is no longer the only color option.

Dr. Chang on Front-Page News

Dr. Chris Chang made the front page news of today's newspaper Fauquier Times-Democrat for his social media efforts. Click on the image to enlarge the article.

Fauquier ENT Reaches 5 Million Web Visits

It is with some amazement that a certain milestone was reached this past week...

Fauquier ENT's online presence received over 5,000,000 web visits since first coming into existence in 2004. This number includes practice website and blog.

There has been exponential growth year over year with daily web visits now averaging close to 8,000 hits per day with some occasional peak days exceeding 10,000 views.

Our YouTube channel has done even better on its own with over a QUARTER BILLION VIEWS since we first established it in 2007. As of today, our videos have collectively received over 228 million views, averaging 45,000 views per day.

Thanks for all the online support!

Magic Ears Club Founded by Fauquier ENT Hosts Halloween Party

The Magic Ears Club kicked off its existence with a first ever Halloween Party on October 29, 2011 where over 15 kids from elementary to high school ages who wear hearing aids co-mingled and played games while their parents talked amongst each other their experiences. Prizes and free hearing aid goodies were also distributed.

Dr. Catie Chalmers, audiologist with Fauquier ENT who founded the Magic Ears Club, stated that the purpose of the club is to help parents, as well as their hard-of-hearing children, connect, share, and provide support for each other.

Being a member of this unique club means being able to participate in practice-sponsored parties as well as meeting new friends who also have "magic ears" (aka, hearing aids).

Furthermore, members can participate over the internet in either open or closed forums hosted by Fauquier ENT where members can ask questions or provide other meaningful support to each other wherever and whenever they wish.

The open forum is through Facebook which is open to all who support our goals whereas the closed forum is hosted through Yahoo Groups and limited to ONLY those individuals who are patients of Fauquier ENT.

For more information, go to http://www.MagicEarsClub.com

Fauquier ENT Now Participates with Chase Health Advance Flexible Payment Options

Due to popular demand, our office now participates with Chase Health Advance. This plan is for those patients without insurance coverage or to help pay for uncovered procedures/services. Flexible payment options are offered only if total charges exceed $1000 (cost can be as low as $48 per month over 24 months). Depending on the promotion offered by Chase Health Advance, there may even be no interest charged! Click here to calculate your monthly payments.

Fauquier ENT Now Participates with Optima Health Insurance

For those patients who have not yet heard...

Fauquier ENT now participates with Optima Health insurance with one caveat... We only participate with the PPO plan only.

For the full list of health insurance policies we participate with, click here.

Fauquier Hearing Aid and Hearing Testing Services Offered at Fauquier ENT

Even though our office has been offering hearing tests and hearing aid services in Fauquier County for over a decade, many people are still surprised when they learn they can get hearing tests, hearing aids, ear plugs, and other ear & hearing services in our office. The additional benefit is having a ENT specialist also present in the same office.

Furthermore, we offer a comprehensive suite of other related services including non-sedated ABR (auditory brainstem response) hearing testing to specialized custom ear plugs for hunters and musicians.

We evaluate all different ages from 1 day old infants to the 99 year old hearing impaired patient.

The full list of Fauquier Hearing services we provide include:

Comprehensive Hearing & Audiometric Evaluations

• Hearing Testing from Birth to Adult
• Newborn Hearing Screening and Follow-up
• Otoacoustic Emmission Testing (OAE)
• Auditory Brainstem Response Testing (ABR)
• Tone Burst Auditory Brainstem Response (TB-ABR)
• Bone Conduction ABR Auditory Brainstem Response (BC-ABR)
• Auditory Steady State Response (ASSR)
• Electrocochleography (ECoG)
• Central Auditory Processing Evaluations (CAPD)

Hearing Aid Services

• Hearing Aid Evaluations and Consultation
• Hearing Aid Dispensing
• Advanced Digital and Wireless Hearing Aid Technology
• Aural Rehabilitation Counseling
• Hearing Aid Service and Repair
• Hearing Aid Accessories and Batteries
• Resources for Parents of Deaf and Hard of Hearing Children

Balance Evaluations

• Electronystagmography (ENG)
• Vestibular Evoked Myogenic Potentials (VEMP) for Meniere's Disease
• Vestibular Rehabilitation Counseling
• Canalith Repositioning 

Hearing Conservation

• Custom Swim Plugs
• Custom Hearing Protection
• Musicians Filtered Earplugs
• Earplugs for Hunters
• Custom Earmolds for iPods, Cell phones, Headsets
• Assistive Listening Devices and Technology 

For more information, please go to our webpage here.

New Video Produced on Non-Sedated ABR/OAE Testing

Our office has produced a new video on non-sedated ABR/OAE hearing testing. Such testing traditionally required sedation as the patient was required to be absolutely still and quiet in order to obtain accurate test results. However, new technology now enables such testing to be performed without sedation. Furthermore, given the testing can be performed wirelessly, the patient can stand and walk around. Absolute quiet is also no longer necessary and the patient can actively play and even eat while testing is going on.

Read more about non-sedated ABR/OAE testing here.

Watch the video here.

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 Journal of Medicine. A patient’s nonclinical experience inspires clinical productivity, drives improved clinical outcomes, and improves overall patient satisfaction.

Not that such reports are a big surprise. It's something I think all major non-healthcare corporations have already realized for decades. Just walk into any Abercrombie & Fitch or Toyota car showroom. Such businesses hit all of our senses to the 10th degree... There's the visual stimulation of models (human or otherwise). Popular music playing in the background to stimulate the ears. Lovely perfume smells in a clothing store or fresh leather in a car showroom to stimulate the nose. And oh yes... freshly baked cookies or candies to bring some zing to the taste buds.

How can you NOT like what you see/hear/taste/smell??? And, buy some things along the way given you have been stimulated into such a good mood?

Indeed, it's surprising why hospitals weren't the FIRST institutions to maximize the senses to bring peace to mind/body/soul and... to also provide medical treatment.

SO... it is with great satisfaction that our practice is affiliated with a hospital that subscribes to the importance of these non-clinical factors. Fauquier Hospital has:

• Private patient hospital rooms
• Family and friends can drop by any time, day or middle of the night
• Food that's actually good
• Patient friendly architectural features including:

• built-in sleeping accommodations for family members
• carpeted corridors and additional windows
• lamps have replaced overhead lighting
• halls have been carpeted to keep down noise or are finished in faux wood for a warmer feel
• community artwork hangs on the walls
• barriers between patients and staff, such as those sliding-glass windows that close nurses off from patients and the public, have been removed
• elevators for patients and the public are separate
• no constant paging over the intercom system, either; instead, unobtrusive music plays all the time.

• Also, a culture fostering patient care is presented.

Come check out Fauquier Hospital here!

Read the NYT article here.

Read the New England Journal of Medicine Article here.

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 like this will become the future. Clearly, procedures and other types of medical treatments that are not covered by insurance will be applicable.

For example... here are some medical treatments/services I am considering to discount on Groupon:

1) Injection snoreplasty for snoring
2) Botox injections for facial wrinkles
3) Hearing services and products including hearing aids
etc

Click here to check out Groupon and create an account!

Refresh of ENT Videos to High Definition Quality on YouTube

Our office produced our first ENT-related video in November 2007 on Trans-Nasal Endoscopy. At the time, YouTube did not support high definition video and the overall video quality was clearly sub-par with blurry images and pixelation with movement. However, since than, YouTube has added HD quality video support and we have taken the time to re-upload the majority of videos, but in high-definition.

You can browse the full list of refreshed HD videos here.

Watch our very first video upload before HD support as well as with HD support.

Before HD:

After HD:

INOVA Health System ER Wait Times iPhone App

A reader informed me that INOVA Health System has developed a free iPhone app called InovaER that provides wait times of all 9 emergency rooms within its health system throughout Northern Virginia. The app was released Aug 4, 2010.

Pretty cool! Hopefully other hospital systems including Fauquier Hospital will join with other regional hospitals (Culpeper, Warren, Prince William, Haymarket) to create a similar program.

Download the app here.

Positive Patient Feedback

Dr. Chang received a bonsai tree from Fauquier Hospital for having received positive patient feedback for the past 4 consecutive quarters. How nice!

Read other patient testimonies here.

Convert Your iPhone/iPod Into A Hearing Aid With EarTrumpet App!

This fascinating iPhone app called EarTrumpet was developed in collaboration with the Department of Otolaryngology Head and Neck Surgery at University of California Irvine. The app claims to convert your iPhone/iPod into a hearing aid of sorts (hearing enhancer app is the term they use) via headphones with a built-in microphone (the ear buds that come with the iPhone work just fine). In essence, the microphone will pick up the surrounding sound and the app will instantly amplify the sound and play it into the headphones. The degree of amplification is customizable via the app.

Hearing testing is also available.

As per the manufacturer website, the EarTrumpet features include
• use of the built-in microphone on the supplied iPhone ear buds
• allows the user to select which frequencies to boost.
• choose the left or right ear to amplify
• store custom profiles once balance and equalization settings have been selected

You can download the app here which sells for $1.99 (much less than traditional hearing aids which go for $1000 and higher). Watch the tutorial of how the app works below.

On a further note, EarTrumpet was created by Allen Foulad, a medical student.

Fauquier Hyperbaric Oxygen Chamber

On June 9, 2009, Fauquier Hospital opened a wound center that included two hyperbaric oxygen chambers. Hyperbaric oxygen, also known as HBO, has a long and close-knit history with ENT.

What hyperbaric oxygen treatment does, in a nutshell, is provide higher concentrations of oxygen to the bloodstream which allows for faster healing of chronic wounds as well as treatment of carbon monoxide poisoning and "the bends" when SCUBA diving.

The higher concentrations of oxygen is achieved by increasing the surrounding pressure of the patient with higher oxygen concentrations... it is simply not good enough to provide oxygen... it needs to be administered at elevated pressures too.

In order to achieve elevated pressures, the patient needs to be completely enclosed inside an airtight chamber while they "pump" oxygen in. Here's a couple views of the HBO chamber used in the Fauquier Wound Center. And yes... that's a TV on top... a single treatment lasts a few hours!

As the pressure increases, the patient needs to "pop" their ears constantly, much like if you were flying up in an airplane or diving into deep water.

If a patient is unable to pop their ears easily, ENT can surgically place ear tubes so that the patient doesn't have to pop their ears... the tubes pop the ears for the patient automatically!

It is not unusual that I get "urgent" same-day consults for barotrauma sustained during a HBO dive. Ear tubes get placed and the patient is able to immediately resume HBO treatments without delay!

Check out the Fauquier Wound Center here.

Fauquier Hospital VIPeds Medical Camp Program on Channel 9 News

It was quite cool to see Fauquier Hospital's innovative VIPeds Medical Camp program featured on Channel 9 news. This unique hands-on program is for teenagers to learn more about the health profession and opportunities found inside a hospital.

Local teens learn to apply a cast, to harvest a cornea (I personally have no idea how to do that!), to suturing a wound closed. No ENT related procedures however...

Check out the video segment here.