Bifid Uvula

I recently saw a patient with a most impressive bifid uvula. For those who don't know, the uvula is the midline dangling thing in the back of the mouth. Normally, there's only one, but in this patient, there are 2.

If the clefting extended not only through the uvula, but also the palate, than that would be called a cleft palate. In other words, a bifid uvula is a birth defect that almost became a cleft palate.

A bifid uvula has no impact on swallowing or talking and no further intervention is required.

"Smoking Kills" Doctor Warned in 1606!!!

On Sept 19, 2009, the BBC published a story "Tobacco Warning from 17th Century" in which a physician, Dr. Eleazar Duncan, wrote a letter published in 1606 stating that tobacco "is so hurtful and dangerous to youth that it might have the pernicious nature expressed in the name, and that it were as well known by the name of Youths-bane as by the name of tobacco."

It goes to show you that physicians have been trying and still trying to get people to stop smoking for over 4 centuries given its ill effects.

Read the BBC story here.

How Does A Deviated Septum Cause A Nosebleed?

Over the years, I have been asked by a number of patients with deviated septums why that would make them more prone to nosebleeds.

Well, this blog article is to answer that very question. First off, a little anatomy...

A nasal septum is a wall that separates the right nasal cavity from the left side. Normally, this septum should be perfectly straight.

However, in some people, the septum may be deviated causing not only nasal obstruction, but increases the risk of nosebleeds.



When the septum is straight, nasal breathing proceeds such that the air smoothly enters the nose without creation of any turbulence.



However, if the septum is deviated, turbulence is created when the air hits the "curve" of the septum. When this happens, the lining of the septum becomes dried out resulting in cracking and increased vascularity which increases the risk of a nosebleed.



The lining of the nose in this situation is much like when a person's lips become so dried out to the point that it cracks and bleeds.

Surgical correction of the deviated septum would result in a more long-lasting "cure" of nosebleeds as it would eliminate this curve decreasing turbulence.

For more conservative management of nosebleeds, click here.

Webpage on Epistaxis (Nosebleeds) Updated!

Our practice website has updated our nosebleed (otherwise known as epistaxis) webpage to include more information on procedural treatment of nosebleeds including silver nitrate cauterization, electrocautery, nasal packing, and surgery. The webpage still includes information on conservative treatment as well as causes.

Click here to read more!

Oral Appliance Can Help With Obstructive Sleep Apnea

In the September 2009 edition of Archives of Otolaryngology Head & Neck Surgery, there was a research paper entitled "An Investigation of Upper Airway Changes Associated with Mandibular Advancement Device Using Sleep Video Fluoroscopy in Patients with Obstructive Sleep Apnea" where use of an oral appliance was found to significantly improve obstructive sleep apnea. The oral appliance increased retropalatal and retrolingual spaces as well as decreased the length of the soft palate and the angle of mouth opening.

Increased retropalatal space and decreased length of the soft palate is similar to what is accomplished by the surgical procedure uvulopalatopharyngoplasty (UPPP).

Increased retrolingual space is similar to what is accomplished by the base of tongue reduction surgery.

Click here to read more about this research.

Click here to read more about OSA and its treatment.