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.

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image of the word otolaryngology

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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.

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I did WHAT last night?

Parasomnias can pose a real danger.

A teenager is found sleeping in a tower crane 130 feet above the ground, having walked across a narrow metal beam to get there. A man gives his roommate a nightly play-by-play of his dreams as they occur. A sleeping man drives across town, chokes his stepfather and stabs his stepmother to death. These are all true stories—examples of extreme parasomnias.

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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.

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Man vs. Machine

Can an algorithm outperform an experienced physician? The answer might be, “yes,” but with a caveat.

Findings from a recent study (Zhang, B, et al.) published in Thyroid suggest that a machine learning algorithm could be superior in specificity and accuracy than an experienced radiologist using ultrasound technology in diagnosing thyroid nodules in patients. Machine learning is an application of artificial intelligence (AI) that provides systems the ability to automatically learn and improve from experience without being explicitly programmed.

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