There's Always Someone With a Bigger Mouth

Continuing the spirit of Halloween with semi-relevant ENT random news...

Someone forwarded me this picture of a TEN foot great white shark which was bitten by an even bigger great white shark. Apparently, the poor shark was still alive when it was captured in Australia.

Click here to read the story and watch a video!

Crazy Pumpkin Carvings Related to ENT

In celebration for Halloween today, I have found a few crazy pumpkin carvings courtesy of Extreme Pumpkins.




Here is the one that I carved, complete with snotty tissues:




If you have another relevant one, please comment and include a link to a picture. Enjoy!

Nasal Endoscopy to Evaluate Hoarseness on Dr. Oz Show!

On Oct 23, 2009, Dr. Oz (his show) with the assistance of Dr. Jonathan Aviv, demonstrated a procedure called Nasal Endoscopy which is the main method of evaluating a patient with hoarseness. A pretty good and accurate demonstration I may add.

Watch the video clip here.

Of course, I have produced a few video clips of the same of which one can be viewed below. Click here to watch one being performed on a child. Read more about this procedure here as well as what happens when the voice doesn't sound normal here.

Why Does Brain Freeze Occur With Eating Ice Cream and Other Cold Treats?

Believe it or not, this has been the topic of research in the past and even has a medical diagnosis called "sphenopalatine ganglioneuralgia". To sum it up, there are two theories behind this phenomenon:

1) Blood vessel phenomenon: Blood vessels constrict when any part of the body is exposed to cold temperature and dilates when it gets hot. This simple fact can be applied to the biological cause of brain freeze as well. Upon contact with ice, the blood vessels in the roof of the mouth begin to constrict, making the vessels in the head to expand, and thus creating a headache.

2) Trigeminal nerve factor: The trigeminal nerve, or cranial nerve 5 (CN5), is responsible for facial sensation. As a result of eating cold foods, this nerve in the palate of the mouth becomes overstimulated. Stimulation of the nerve causes neurons to fire pain signals to the brain, producing a headache.

Is there a cure? Avoid the culprit cold treat that triggers the pain or eat is slowly. Should you suffer from a brain freeze or sphenopalatine ganglioneuralgia, drink warm fluid or just wait!

Read the research behind these theories:
• Ice cream headache--site, duration, and relationship to migraine
• Ice cream evoked headaches (ICE-H) study: randomised trial of accelerated versus cautious ice cream eating regimen

Possible Dystonia (Rare Neurological Condition) After Flu Shot

Desiree Jennings, a former Redskins cheerleader, received a seasonal flu shot on Aug 23, 2009 and has suffered from a possible dystonia reaction from the flu vaccination resulting in difficulties in eating, talking, and walking.

Here is a link to a video where Dr. Stephen Grill (neurologist) is interviewed by Fox News regarding Desiree's condition.

Here is a video/article of the initial story.

This story is a case of a VERY unfortunate EXTREMELY rare side effect (if true) of the flu vaccine. People should still get the flu vaccine, but be aware that it is not 100% benign in all cases.

However, it seems that Desiree's flu shot reaction may have been psychogenic (and not a true side effect of the vaccine at all). Read this blog article which goes into this in more detail.

Regardless, people have developed rare neurological conditions called laryngeal dystonia otherwise known more commonly as spasmodic dysphonia. The way Desiree talks (from what I can hear from the videos) is distinctly different from patients who suffer from classic spasmodic dysphonia. Click here to hear what laryngeal dystonia/spasmodic dysphonia sounds like.

(Of note, I received both the seasonal and the H1N1 vaccine and have encouraged all my friends, family, and patients who inquire to do so as well.)