daVinci Surgical Robot Makes Paper Airplane... Yawn!

A blog reader of mine informed me about this YouTube video of a surgeon, Dr. James Porter, making a paper airplane using a daVinci surgical robot.

For those unawares, the daVinci robot is used to assist the surgeon in "difficult-to-reach" procedures. It is used in the fields of urology, ENT, gynecology, and general surgery.

There is much debate whether the daVinci robot really is worth it.

This paper airplane video is a perfect example of why it is NOT worth the $1.3 million price tag.

Why?

Because I can make a paper airplane with my own two hands that is just as good as the one made by the robot... and I can do it faster and WAY more cheaply.

I should also point out that the paper airplane made by the robot couldn't even fly...

NOW... what would have been a much more impressive video and would highlight specifically what the daVinci robot can do that a human would not have been able to do is to make a paper airplane INSIDE of a wine bottle.

Synthetic Vocal Cords [video]

Synthetic vocal cords being under development at MIT and Harvard... Very good video!

What are some of the vocal cord problems that may benefit from such a synthetic gel? Vocal cord paralysis, vocal cord surgery to address polyps, cysts, nodules, granulomas, etc.

As an FYI... the synthetic vocal cord gel portrayed in the video is still under development and not available for patient use yet...

Video on Zenker's Diverticulum Surgery (Endoscopic Staple Diverticulostomy)

Our office has produced a new video describing Endoscopic Staple Diverticulostomy to treat Zenker's Diverticulum.

We have the unusual honor of having treated patients throughout the United States for this rare condition. Patients we have successfully treated have come from as far away as Oregon, New York, Florida, Pennsylvania, Louisiana, Arizona, etc.

For more information, please visit us here.

Video of Eustachian Tube Popping Open with Valsalva

Ever wonder what the eustachian tube looks like when the ear pops open with valsalva maneuver? Valsalva is accomplished by trying to blow air out a nose that is pinched closed. The eustachian tube is a tunnel that goes from the back of the nose to the ear.

Well, here you go! Video provided courtesy of Dr. Vijay Anand.

Watch this video to see where this eustachian tube is exactly located.

Read more about ear popping and when one is NOT able to pop the ears, a condition called eustachian tube dysfunction!

Celine Dion Cancels Shows Due to Laryngitis

In late Feb 2012, Celine Dion who was to have performed in Las Vegas Feb 22, 2012, cancelled her show at the last minute at the Caesar's Palace due to laryngitis on the advice of her doctors. According to media reports, her doctors instructed her to rest for 7 days to ensure full recovery due to vocal cord inflammation caused by a virus.

What does that mean exactly?

When a virus infects the mucosa of the upper airway, it causes inflammation of the mucosa lining including the vocal cords. With inflammation, the vocal cords swell.

That's why with laryngitis, the pitch of the voice decreases and it becomes more effortful to talk. To use an analogy, think of a violin string where the thicker string has a deeper pitch than a thin string. It also takes more power to play the thicker string. Watch the video below of normal vocal cord functioning:



In order for voice production to occur, the lining of the vocal cords vibrates very quickly when they come together. If the vocal cords are swollen, they don't vibrate as easily.

Here's what inflamed vocal cords might have looked like for Celine Dion. Note the slight bend to the vocal cords and overall dull appearance.

Below is what her vocal cords might look like when they are at peak health!

Voice rest is absolutely important for vocal recovery as quickly as possible. With talking/singing during active laryngitis, further trauma may occur to the vocal cord lining promoting even more inflammation and swelling. It may also lead to another vocal disorder known as muscle tension dysphonia.


Source:
Celine Dion cancels act: laryngitis. UPI 2/26/12

New Video on Newborn Hearing Testing

Given how often we see newborns in need of hearing testing, we have produced a video showing how the two main types of non-verbal hearing tests are performed today: Auditory Brainstem Response (ABR) and Otoacoustic Emission (OAE).

Given newborns can not communicate whether they can hear or not, such hearing tests depend on the ability to detect nerve signals transmitting sound information from the ear all the way to the brain. This type of test is much like an EKG which can detect the electrical activity of the heart.

Watch the video to see how ABR and OAE hearing testing works in infants (as well as adults)!

What is the Voicebox Doing When You Scream? Yodel?

In the same spirit of a recent TEDMED talk by Nate Bell and re-published on CNN Jan 12, 2012 whereby he performed various beatboxing noises while stroboscopy was performed, I decided to record a similar video with a person performing various unusual human vocalizations to see what happens.

For those who don't know what stroboscopy is, click here.

Such vocalizations recorded included various types of human screams and a yodel.

Check it out here...

New Video on "Where" Snoring Comes From and Treatment

Our office has produced a new video describing "where" snoring comes from determined by a simple procedure known as sedated or sleep endoscopy.

At its most basic definition, snoring is noise produced from a vibrating mucosal surface in the upper airway.

Though snoring can be defined simply, the tough question is WHERE are these vibrating mucosal surfaces? Because unless one can define WHERE the snoring is coming from, successful treatment can't be pursued definitively.

An office exam performed while a patient is awake is suboptimal as the patient is awake... and not snoring. As such, it is an educated guess where the snoring problem is stemming from.

To this end, there are three main levels where snoring can be produced and the best way to localize a snore is to perform the exam while the patient is asleep (induced by anesthesia) and snoring!

1) Nose
2) Mouth
3) Throat
4) All of the above

Watch the video to see how each of these areas can contribute to a person's snore as well as treatment options.

The Illusion of Healthcare Progress

Wellcome Film based in London has transferred numerous films dating from the early 20th century related to healthcare and medicine that anybody can view for free. Aside from the historical value, it is amazing that much of what we know and do now is not all that different than what was done in the 1920s. It makes me wonder sometimes what "progress" in healthcare actually has happened over the past century. In some things, tremendous change has occurred whereas in other areas of medicine, time might as well have stood still.

It also perhaps explains why in spite of all our "high-tech" medical equipment and sophisticated tests available in the United States that our health as a nation is still not as good as other nations without these benefits.

Take for example dizziness evaluation and understanding. Here are 3 films from 1925 that goes over dizziness evaluation and physiologic basis for it.

At its essence, nothing has really changed between 1925 and 2011. Sad really... Given this lack of progress, I would so far as to venture (with a straight face and all kidding aside) to say that American rates of dizziness is comparable to ANY other nation in the world with treatment protocols no better or worse too.

Tonsillectomy Circa 1940s [video]

I encountered this interesting video of tonsillectomy being performed in a child with sedation (but NO intubation) performed circa 1940s.



Of course, nowadays, tonsillectomy is performed under general anesthesia with intubation for airway protection. Here's a video of the way it is now done.

That is, unless, you practice in other parts of the world where modern medicine is not up to United States standards. In those nations, tonsillectomy is STILL being performed WITHOUT general anesthesia or any sedation for that matter. In fact, here's a blog I wrote earlier this year showing a graphic video depicting tonsillectomy being recently performed in a young child WITHOUT any sedation.

YouTube Ranks Fauquier ENT as Most Viewed for Medical Videos

I was informed that our practice's YouTube channel has been ranked as one of the most viewed channels related to medicine in the world!

As of Oct 6, 2011, our channel which contains 52 videos has received 198,064,840 views. We currently average over 500,000 views a day!

We far surpass other more "prestigious" medical organizations with a YouTube channel.

Mayo Clinic Channel Channel
4,936,943 views

University of Maryland Medical Center Channel

2,047,260 views

CDC Channel 

4,173,563 views

Massachusetts General Hospital (Harvard) Channel 

33,994 views

Children's Medical Center Channel 

318,688 views

Duke Medical Center Channel 

1,571,694 views

Medical University of South Carolina Channel 

699,002 views

UVA Health System Channel 

29,922 views

Stanford Medical Center Channel 

132,303 views

British Medical Journal Channel 

216,331 views

Penn State Hershey Medical Center Channel 

46,688 views

Scripps Health – San Diego Channel 

212,848 views

Tongue Acrobatics

Impressive tongue acrobatics... Not much more to say! Watch the video here.

100 Years of Style and Dance

A random post for those who appreciate dance and fashion...

Video Made by Dr. Chang Shown on Animal Planet

On July 17, 2011, Animal Planet aired Swamp Wars "Snake Farm Shootout" where a video made by Dr. Chang was incorporated into the storyline. It was a VERY brief segment of this video clip shown about 30 minutes into the show; specifically, the endoscopic image of the back of the nose. Due to copyright, I can't show the actual video clip. But, here is the video from which the segment was taken.

New Video on Esophageal Manometry and 24 Hour Multi-Channel pH and Impedance Testing

Our office has created a new video describing what a patient goes through when they undergo esophageal manometry as well as 24 hour multi-channel pH and impedance testing.

This test is often ordered when a patient is suspected to be suffering from reflux, whether acid or non-acid, or is possibly suffering from abnormal muscle activity of the esophagus.

Symptoms that a patient may experience that may lead to such testing include:

- phlegmy throat
- lump sensation in the throat
- chronic throat clearing
- chronic cough
- difficulty swallowing

Watch the video here!

Whooping Cough Video by Mayo Clinic

Chronic cough that lasts for months?

Coughing that occurs in groupings to point where vomiting occurs? Loses breath?

You may have whooping cough... Check out this video from the Mayo Clinic.

Cartoon Video of What Happens After Decision for Surgery Made

A very common question our practice gets from patients is what happens next after a decision is made to pursue surgery. What do or should they do next? What do we do?

Well, our office created a video cartoon to describe this somewhat intimidating process in a way that is understandable and benign.

Watch it here!

New Video on Endoscopic Vocal Cord Mass Injection & Bronchoscopy Without Sedation

We have produced a new video demonstrating how vocal cord masses can be injected with medications (like steroids) under endoscopic guidance without the need for any sedation. This video also includes bronchoscopy that was performed at the same time (also without any sedation).

Check out the video here!

Video of Endoscopic Salivary Stone Removal (Sialendoscopy)

The Doctors TV show actually produced a great (and accurate) segment on a relatively new procedure called sialendoscopy. This procedure allows a surgeon to remove a stone that may be blocking your spit gland from draining saliva into the mouth. This is analogous to a kidney stone which blocks urine from draining from the kidney into the bladder resulting in painful swelling of the kidney (causing flank pain).

How does a person know if they have a salivary gland blockage due to a stone? There is a painful swelling located right in front and/or below the ear if the parotid gland is affected, or under the jawbone if the submandibular gland is blocked.

If the blockage persists long enough, it may lead to an infection of the gland itself (sialadenitis).

Traditionally, if the stone doesn't pass on its own with conservative measures, stone removal required surgical removal of the entire gland or making an incision and removing the stone like it's a tumor mass.

Watch the video of this procedure being performed as shown on The Doctors here.

At this time, the only local surgeon I am aware of who offers this unique procedure in the mid-Atlantic region is Dr. Arjun Joshi.

Dr. Arjun Joshi (George Washington University Hospital in Washington DC)
2021 K St NW, Ste 206
Washington, DC 20006
Office Number: 202-741-3250
www.dcheadandneck.com

Watch Deaf Baby's Reaction When Hears Mom's Voice for First Time!

This video is of an 8 month old child born deaf who underwent a cochlear implant. This special device allows hearing to be restored to children (and adults) who would otherwise be deaf.

Watch the expression and reaction of the child when the implant is turned on and the child hears his mom's voice for the first time!