We have recently produced and uploaded on to our YouTube channel a new video describing how to properly administer ear drops. This video is especially pertinent in patients who have ear tubes.
Watch the video below:
Watch the video below:
October 9, 2009
October 8, 2009
TWO Ear Canals in the Same Ear!
I recently saw a patient who had a complaint of having two ear canals in each of the ears. To my surprise, the patient had exactly that! You can see the second ear canal in the picture below... it is above the normal one and is about 25% the size.
To those in the know, this is due to a congenital birth defect related to the first branchial cleft.
Read more about this birth defect here. Clearly, the way to correct this is surgical.
To those in the know, this is due to a congenital birth defect related to the first branchial cleft.
Read more about this birth defect here. Clearly, the way to correct this is surgical.
October 6, 2009
LA Times: Driving a Convertible May Cause Permanent Hearing Loss!
The LA Times published a story on Oct 6, 2009 entitled "Cruising with the top down? Cover your ears" describing research that assessed noise levels in seven different scenarios where the convertible was traveling at speeds of 50, 60 and 70 miles per hour. Researchers found that drivers were consistently exposed to noise levels between 88 and 90 decibels. Even with the windows up, the noise levels were found to be at 82 decibels.
To keep these findings in perspective, repeated exposure to noise over 85 decibels can result in permanent hearing loss.
To make things even worse, because there is surrounding noise from other vehicles especially in traffic, driving more slowly may end up being just as loud as when driving more quickly.
These findings may be a big bummer for those who love to drive convertibles, but driver beware!!! Perhaps these drivers need to wear ear plugs whenever the top is down.
Read the story here.
NYT: Does Snotty Colored Discharge Require Antibiotics? No!!!
The New York Times published a story on Oct 6, 2009 entitled "The Claim: With a Runny Nose, Green Calls for an Antibiotic." It actually is a pretty good article though I'm not sure how much impact this will have in clinical practice.
The story reports that green discharge from the nose is NOT indicative of a bacterial sinus infection and as such, this symptom should not be the sole reason why antibiotics should be prescribed.
It does reference a research paper that backs this claim up. There are others.
In any case, the last sentence of the story is worth reiterating: "THE BOTTOM LINE: The color of nasal discharge should not dictate the medicine."
Not sure how accepting patients will be of this factoid given how ingrained colored discharge has been equated with sinus infection.
I personally have encouraged saline nasal flushes starting from as early as 5 years old as the main treatment for this issue which some patients have been more accepting than others.
October 1, 2009
Treatment of Chronic Draining Ear Infections Using Antibiotic Powder
Rarely, some unfortunate souls have chronic draining ear infections that do not respond well to oral antibiotics nor antibiotic ear drops. What many people and even physicians are unaware of is that there are alternative ways of addressing the chronic draining ear including use of antibiotics in powder form.
The method I like best is by using the Sheehy-House Powder Insufflator Bulb.
The pharmacy will make up gelcaps containing antibiotics (anti-bacterial as well as anti-fungal) and even steroids (usually hydrocortisone).
One first removes the tip of the insufflator bulb.
Than open up the gelcap such that the powder is all in one side and insert into the insufflator tip compartment.
Than replace the bulb tip.
During an active infection, the powder is "puffed" into the ear twice a day. Once back to normal, one puff weekly prevents the ear from becoming infected again. This method eliminates adding more "moisture" to the ear (as when happens when using antibiotic ear drops) as the powder not only addresses the infection, but the drainage itself becomes a medium for the antibiotic powder to do its thing.
Keep in mind that this method requires a prescription and the gelcaps must be compounded. As such, not all pharmacies may be able to fill and not all health insurances will cover compounded medications.
The method I like best is by using the Sheehy-House Powder Insufflator Bulb.
The pharmacy will make up gelcaps containing antibiotics (anti-bacterial as well as anti-fungal) and even steroids (usually hydrocortisone).
One first removes the tip of the insufflator bulb.
Than open up the gelcap such that the powder is all in one side and insert into the insufflator tip compartment.
Than replace the bulb tip.
During an active infection, the powder is "puffed" into the ear twice a day. Once back to normal, one puff weekly prevents the ear from becoming infected again. This method eliminates adding more "moisture" to the ear (as when happens when using antibiotic ear drops) as the powder not only addresses the infection, but the drainage itself becomes a medium for the antibiotic powder to do its thing.
Keep in mind that this method requires a prescription and the gelcaps must be compounded. As such, not all pharmacies may be able to fill and not all health insurances will cover compounded medications.
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