Category Archives: Ear Nose Throat

Travel CPAP

Not your father’s CPAP

We’ve come a long way with this life-saving device.

CPAP machines have been steadily improving since the first commercialized CPAP was introduced in the 1980s. The devices have become much smaller, quieter, much more comfortable, and more effective in treating sleep apnea. To see just how far CPAP technology has come, let’s peek back in time.

CPAP technology was first conceived by Dr. Collin Sullivan, an Australian physician. He was testing the idea of positive pressure to open the airway, but his research was initially only conducted on dogs. One day a patient came to his lab with signs of severe sleep apnea. This patient became the first human subject to be tested using continuous positive airway pressure.

The first machine was quite rudimentary. Dr. Sullivan fashioned the mask from plastic tubes and a silicone sealant. He fabricated the compressor in one afternoon and tested the device by increasing and decreasing the pressure to find the ideal level. After several hours of treatment, the patient reported restful sleep upon waking. Dr. Sullivan knew he was onto something with tremendous potential.

Dr. Michael Friedman, medical director at Chicago ENT was around for the advent of CPAP. He has treated more than 30,000 sleep apnea patients over his 30-year career.

“When I first started practice, there was no treatment for sleep apnea. There was no CPAP and there was no surgery. When CPAP came out, it was almost inconceivable to me that a patient would accept CPAP. And it was a rare patient that would even be willing to try it. When we would tell a patient that they were going to sleep with a mask on their face and there would be a machine pushing air, they thought we were out of our minds, and I often couldn’t believe that patients were willing to use it.

Feeling good is addicting.

“I had a good friend that had been working with sleep apnea patients, and I asked him, ‘How do you get patients to accept CPAP?’ And his answer was, ‘Feeling good is addicting, and once patients wake up and they feel 20 years younger, and they wake up not feeling like they need eight hours more sleep, they do not ever want to go back to that feeling.’ So, CPAP when it is used successfully, has amazing effects. It’s so common now that I almost never find a patient who doesn’t have a friend, a colleague, a family member, spouse – somebody who uses CPAP. Most patients are very willing to try CPAP.

“CPAP technology has really changed across time. There used to the notion of a big mask covering your face that looks like Darth Vader. That idea is gone. The new masks are soft, comfortable, often very low profile with a small amount of tubing that goes into the nose. Also, the size is much smaller. The size of a unit used to be as large as a suitcase and now they can be as small as a deck of cards.

“People also wonder about travelling with CPAP. My friend I mentioned earlier used to say, ‘If you can take your toothbrush, you can take your CPAP.’ CPAP is so common that a lot of the TSA lines instruct you to keep your CPAP separate for the x-ray machine. It’s also not counted as one of your carry-on bags. It’s a free bag.  

“One of the other improvements is how quiet they’ve become. There is a common misconception that CPAP machines are noisy and disruptive. But I have yet to meet a bed partner who does not prefer the CPAP over snoring. It’s generally a quiet and soothing sound and is usually not a problem.

“There are also ‘smart’ models that can sense whether the CPAP is being used or if it’s sitting in a closet. It can also tell if the mask is properly secured or if there is a leak. In addition, it will know if obstructive events are occurring, and will supply a report with a sleep score and a summary of how the patient performed during the night with their CPAP. These data are crucial to fine-tuning the pressure settings, the comfort, and the type of mask that a patient will use.”

What’s next for CPAP?

According to the National Sleep Foundation, rates of sleep apnea are rising in the US and many people go undiagnosed. The real number of people with the disorder may even be as high as 30 million. CPAP remains the gold standard in sleep apnea treatment, and manufacturers are continually making changes to the masks to make them more comfortable. One of the more recent design improvements include built-in humidifiers that keep air moist, and full-face masks for people with beards.

It’s important to know that there are many alternative therapies, from an oral appliance to Inspire, an implanted device that works with your natural breathing rhythm to deliver mild and painless stimulation to keep your airway open during sleep. Chicago ENT currently offers 21 distinct treatments to control sleep apnea. To see one of our sleep specialists, call 773-296-5500.

Doctor checking thyroid of a young patient

Dr. Friedman answers frequently asked questions about thyroid cancer

Dr. Michael Friedman is one of the worlds’s leading thyroid and parathyroid experts and surgeons. He has authored and published numerous articles and textbooks, and has lectured on thyroid and parathyroid surgery all around the world.  Dr. Friedman has performed more than 5200 thyroid procedures. Here are some of the questions patients often ask.

Does a thyroid tumor affect my thyroid function?

Thyroid tumors almost never affect function. Patients with a thyroid nodule will usually have normal function. The nodule is something removed because of the risk of malignancy.

Continue reading Dr. Friedman answers frequently asked questions about thyroid cancer
Image of girl plugging ears

Custom earplugs = protection + comfort

Ahhh …. summer. The great outdoors. Picnics, swimming, sports, festivals, fireworks! It’s a fantastic time of the year, especially for us Midwesterners. But with all the fun and fanfare, it can be easy to forget the “hidden dangers,” that is, the sounds of summer. Lawn mowers, concerts, cheering crowds – prolonged exposure to all of these can result in hearing loss or deficit. Even a chorus of cicadas can approach 100 decibels, which is as loud as a freight train!

The good news is that proper ear protection can help prevent hearing loss. Most of us are familiar with the common, disposable foam earplug. While using these is better than nothing, they still have their drawbacks when it comes to durability, fit, comfort and quality of sound. Custom ear plugs are superior than disposable options in all these measures.

chart of common sounds, decibels and exposure time
Common sounds, decibels and exposure duration

Cost-effective and eco-friendly

You might be surprised, but custom earplugs are more cost-effective than disposable options. Let’s suppose you wear earplugs for work, 5 days a week for 52 weeks per year. At $.20 each that adds up to more than $50 per year! Given that the price of custom earplugs is around $150, you can see the cost savings over time. And they’re eco-friendly. That’s a lot of ear plugs that won’t end up in a landfill.

Perfect fit means best sound reduction

For those who are going to loud environments such as a shooting range or an Indy car race, it is vital to have an earplug that provides the greatest sound reduction possible to prevent hearing loss and/or tinnitus. A custom earplug does this because it is a perfect fit to your ear. For those who have a history of chronic ear infections or tubes, or who have eardrum perforations, it is imperative to have a properly fitting earplug to prevent water from getting in and causing an infection. Custom swim plugs float, offer an excellent fit and are a great option that are also available at our office. 

For those who appreciate music, custom ear plugs with filters can help preserve the integrity of music through high-fidelity filters that reduce the “noise” and allow the music to come through. They help retain sound quality while lowering the volume of your surroundings.

Quick and comfortable

Perhaps the biggest advantage custom designs have over off-the-shelf earplugs is the comfort. Properly placing a foam earplug can sometimes be difficult and tedious. Using something custom ensures a quick and proper fit because they’re especially designed for you, not mass-produced at a factory. This makes them ideal for musicians, swimmers, light sleepers, or anyone who needs a comfortable, custom fit. For children or people with small ear canals, they’ll stay in place. No more pop-out plugs!

There are numerous different types of earplugs that we can make or order at our office, whether it be for work, lifestyle, or recreation. Please contact audiology with any questions – we’re happy to help! 

To schedule a hearing check or to be fitted for custom ear plugs, call 773-296-5500.

Under pressure: Tiny tubes can cause big discomfort

The eustachian tube (named after Italian physician Bartolomeo Eustachio) is a small passage extending from the back of the nose to the middle ear. You have one for each ear. Its function is to regulate pressure between your ear and the external environment. Ideally, the pressure is balanced. The eustachian tube opens when you swallow or yawn in order to equalize pressure. The other function is to allow any fluid that has accumulated in the middle ear to drain into the back of the nose. At rest, it remains closed to prevent reflux (back-flow) from the nose into the middle ear space.

Continue reading Under pressure: Tiny tubes can cause big discomfort
image of the word otolaryngology

oh/toe/lair/in/goll/oh/jee

Let’s just say “ENT”

Think about your routine interactions with the environment. Could you breathe easily today? Were you able to walk a straight line? Was it no trouble to talk with and listen to your friends? We usually don’t think about such things unless there’s a problem. Issues with our ears, nose and throat, even when relatively minor, can have a large impact on our quality of life.

Otolaryngologists, or ENTs, are specialty physicians who treat disorders of the ears, nose and throat (ENT). After medical school, doctors pursuing a career in ENT complete 5-8 years of additional training. Physicians certified by the American Board of Otolaryngology are the most reputable and knowledgeable in the field.

Continue reading oh/toe/lair/in/goll/oh/jee

Research leads to new surgical guidelines for parathyroidectomy.

Tertiary hyperparathyroidism occurs more than primary or secondary hyperparathyroidism but it is rare and is seen in patients with renal disease and post kidney transplant. Because it is a rare problem, guidelines for surgical treatment and prognosis have not been well repeated in the past. This study establishes guidelines for parathyroid surgical intervention.

In a scholarly and systematic review, Dr. Michael Friedman and associates studied outcomes of hundreds of patients with tertiary hyperparathyroidism who underwent a parathyroidectomy (removal of the parathyroid gland). Control of symptoms and hypercalcemia cure rates were as high as 94% in many studies.

Continue reading Research leads to new surgical guidelines for parathyroidectomy.

Could that pain in your mouth be a salivary stone?

While most everyone is familiar with kidney stones and gallstones, salivary stones (also called) sialoliths are also a real disorder. They are caused by a buildup of calcium in the salivary gland or duct Salivary stones may remain in the gland, unnoticed. They become problematic when they partially or totally block the natural flow of saliva into your mouth, causing pain and inflammation, and can even lead to infection. Sialoliths most often occur in the submandibular glands, found under the jaw. Less common are stones in the parotid and sublingual salivary glands.

Continue reading Could that pain in your mouth be a salivary stone?