Creative Ways to Wear a Scarf for Patients with a Trach or Ugly Neck Scar

[Watch the video below!!!]

Given I operate on the neck not uncommonly... a common fear for a patient is how the incision will look afterwards. For a simple neck mass excision, the incision almost always heals just fine to the point nobody will notice the scar.

However, this concern is multiplied a hundred-fold when a patient undergoes a tracheostomy (hole in neck) for severe obstructive sleep apnea or for some other airway reason. It could even be a laryngectomy where the entire voicebox is removed for cancer reasons. 

Who wants everybody to know that there's a hole in the neck... especially for a woman??? Even if there's no hole, sometimes the scar IS noticeable, especially after thyroidectomy, and therefore undesirable.

Scarring from an incision can potentially be addressed with dermatologic procedures, but if no surgery is desired and honestly, what really can be done with a hole defect in the neck... it really boils down to a scarf of some kind to obstruct the neck from causal view.

I mistakenly thought there's only 2 ways to wear a scarf around the neck.

The video below shows 25 ways to wear a scarf! Even if a patient or an individual decides NOT to wear a scarf ever... you should STILL watch the video. The video editing is AMAZING!!!

The actress in the video is Wendy Nguyen who is a prolific fashion blogger who my wife pointed out to me one day.

Posterior Tongue Tie

An ordinary garden-variety tongue tie (also known as ankyloglossia) is a rare condition whereby the tongue is anchored to the floor of the mouth preventing the tongue tip from moving freely.

Patients with tongue tie have greater difficulty with:

• feeding if infant
• speech if school-age child
• french kissing if young adult

Treatment is tongue tie release which can be done at any time if difficulties arise. In infants and young adults, this procedure can be done in the office under local anesthesia only. In school age kids, it typically requires sedation given lack of cooperation with keeping the mouth open and tongue still.

Posterior Tongue Tie

Though tongue tie is rare, there is an even more rare subtype called submucus tongue tie or posterior tongue tie.

This condition is when the tongue tie is hidden UNDER the mucus lining of the tongue/mouth. You can't see this type of tongue tie, but you can feel it if you run the finger underneath the tongue from side to side where the tongue tie would be. One would feel a tissue band (speed-bump sensation with finger sweep) where the tongue tie would be.

Treatment is a bit more complicated than a regular tongue tie release in that the mucus lining has to be incised in order to expose the tongue tie prior to release. Once the tongue tie is released, the incision is sutured closed.

Given the more complicated steps to address this rare condition, it does need to be performed under sedation.

R&B Singer R. Kelly Undergoes Peritonsillar Abscess Drainage

Reuters on July 20, 2011 reported that R&B singer R. Kelly suffered from a peritonsillar abscess that required emergency drainage.

Peritonsillar abscess is when a pus collection develops within the tonsil causing it to swell. This may occur over a period of 24 hours resulting in a severe sore throat and trouble swallowing. This condition is in contrast to tonsillitis which is when the tonsil itself is infected, but no pus collection is present.

On exam, the affected tonsil may be huge crossing the midline (see picture). The uvula often is pushed to the opposite side and the soft palate may be asymmetrically huge as well.

Treatment is immediate incision and drainage. In an adult, this can be easily performed in the clinic after adequate local anesthesia. The pus is allowed to drain out and the patient often feels much improved within 12 hours. Antibiotics and a short burst of steroids is often prescribed afterwards.

Read the story here.

Read more about peritonsillar abscess management here.