Synthetic vocal cords being under development at MIT and Harvard... Very good video!

What are some of the vocal cord problems that may benefit from such a synthetic gel? Vocal cord paralysis, vocal cord surgery to address polyps, cysts, nodules, granulomas, etc.

As an FYI... the synthetic vocal cord gel portrayed in the video is still under development and not available for patient use yet...

Compared to nearly all other animals, humans have the weakest sense of smell. You would think that humans and our closest evolutionary cousins (chimpanzees, apes, etc) would have similar sense of smell, but humans still have a much weaker olfactory sense.

Why might that be?

Well, research from Karolinska Institutet have discovered that humans are the ONLY mammals whereby no new neurons are formed in the olfactory bulb after birth. Or if there is any, it is VERY little.

In all other mammals including apes, new neurons are constantly being formed in the olfactory bulb which might explain why all mammals with the exception of humans have a superb sense of smell.

How did scientists figure out the absence of neuron growth in humans?

They looked at Carbon-14 levels within the DNA of the olfactory bulb. Carbon-14 levels in the atmosphere increased significantly due to nuclear bomb testing during the Cold War.

As such, IF new neurons were being formed, one would expect Carbon-14 levels which gets incorporated into developing DNA, to be similar to current atmospheric levels. Or at least find a certain turn-over percentage of both "old" and "new" neurons reflective of the Carbon-14 atmospheric levels at time of neuron development.

However, what researchers have found was Carbon 14 concentrations that corresponded to the atmospheric levels at the time of birth of the individuals establishing that there is very limited, if any, postnatal neuron development in the human olfactory bulb.

Reference:

The age of olfactory bulb neurons in humans. Neuron. May 24, 2012, 10.1016/j.neuron.2012.03.030

Famed movie director John Woo apparently is being treated for throat cancer. The director of such movies including Mission: Impossible II is apparently undergoing treatment in the United States.

Details are sparse.

However, he apparently "has been admitted into a hospital for 4 months" which leads me to think that his throat cancer is late-stage which usually requires both radiation and chemotherapy for definitive treatment. Surgery may or may not be required, though hard to say without more information.

Source:

Woo reportedly suffers from throat cancer. China.org.cn 5/26/12

It is not unusual for an ENT or an Emergency Room physician to see a patient with a very bad nosebleed... the kind that can potentially be life-threatening given how much active bleeding is occurring.

Once fully inserted into the nose, it is than inflated using a standard syringe. Enough air is inflated into the device such that the pressure exerted by the balloon exceeds the blood pressure of the vessels within the nose.

He not only won one Olympic Gold Medal, but two in men's platform diving in 1948 and 1952.

Dr. Sammy Lee also won bronze medal in the 3 meter springboard and coached Bob Webster and Greg Louganis to their Olympic medals.

In terms of his medical career, he studied pre-med at Occidental College followed his MD from University of Southern California (USC) Medical School in 1947. He than went on to become an ear, nose and throat specialist.

Yeah!

I must clarify that I never really like TV show House for reasons explained here... but patients who love watching House have alerted me to some episodes this season that touched on ENT problems.

So... here goes...

Episode 21 (Season 8): Holding On

Diagnosis: Persistent Stapedial Artery

19 years old cheerleader was admitted after suffering from dizziness, massive nosebleed, and auditory hallucinations. It was ultimately determined that he was suffering from a persistent stapedial artery.

This artery is a congenital defect of the inner ear that should have obliterated during fetal development. However, if persistent, is typically found going through the stapes bone of the middle ear.

It CAN cause symptoms of dizziness as the pulsations of the artery can transmit through the stapes footplate and into the vestibule via the oval window. It can also cause auditory hallucinations by pressing against the nearby temporal lobe as well as a nosebleed. If the artery ruptures, it can only drain through the eustachian tube and out the nose.

However, if the patient presented to the ER with nosebleed and dizziness, a complete physical exam would have been performed and a clearly seen blood-filled middle ear cavity (hemotympanum) would have been seen that even a medical student would have found. That would have indicated an ear issue causing both the dizziness and nosebleed.

From that point, the differential diagnosis is actually quite small and would have been obtained relatively easily.

Fun hearing facts collected from a variety of sources...

Sources:

The National Institute for Occupational Safety and Health (NIOSH) 

Binge Listening: Is exposure to leisure noise causing hearing loss in young Australians? [pdf] – Australian Hearing, National Acoustic Laboratories

Occupational Noise Exposure. OSHA

Almost everybody at some point in their lives have attended a loud concert or loud nightclub.

Almost everybody will also recall a temporary reduction in their hearing with or without ringing afterwards for a short period of time.

This phenomenon is called temporary threshold shift (TTS) whereby the affected person has a temporary hearing loss that may last hours to days due to temporary damage of the outer hair cells of the cochlea.

If loud nose exposure happens enough times, permanent hearing loss can occur.

For some, permanent hearing loss may occur after attending numerous loud concerts whereas in other more "susceptible" individuals, it can happen after a single loud concert.

It doesn't even have to be a loud music concert. ANY loud noise exposure can do including shooting guns, listening to a portable music player like the iPod, fireworks, playing in an orchestra/band, etc.

However, loud concerts are of particular interest given how many individuals are exposed all at once and provided a unique research opportunity which was presented on May 21, 2012 at the American Otologic Society Meeting in Los Angeles.

The researchers (led by Dr. Jennifer Derebery of the House Ear Institute) essentially took hearing test before and after the concert of 29 teenagers.

72% suffered objective hearing loss after the concert though only 53% reported subjective hearing loss. 25% reported new onset tinnitus after the concert.

Of note, hearing ear plugs were offered to the study subjects, but only 3 accepted them.

Adult researchers who sat with the teenagers under investigation measured sound levels throughout the concert. During the 26 songs played during the three hour concert, sound levels ranged from 82 to 110 decibels with an average of 98.5 decibels. The mean level was greater than 100 decibels for 10 of the 26 songs.

As a reference, ear pain occurs at 125dB. Jet engine noise is at 140dB. Sustained loud noise exposure of 90-95dB can result in permanent hearing loss. 

OSHA (Office of Safety and Health Administration) mandates workers to never be exposed to sound levels of 100dB for more than 2 hours per day (no more than 4 hours per day at 95dB).

Clearly something more needs to be done to protect teenagers' hearing, especially given how few accepted hearing ear plugs. A fundamental cultural shift would most likely have to occur with encouragement from not only the musicians but also parents and teachers...

OR, the music volume at concerts should be turned down... No boos please.

Reference:

Teenagers Hear Worse After Attending Concert. LiveScience 5/21/12

Can EYE drop medications be used in the EAR for ear problems like ear infections?

For the most part, absolutely.

For pretty much any EAR drop preparation, there is an equivalent EYE drop preparation which can be used safely in the ear.

Why does this matter?

It's because it may be cheaper for the patient if the EYE drop medication is prescribed rather than the EAR drop medication. Often, it is not unusual for a brand name ear drop medication to be available in generic eye drop form.

NOW... EAR drop medications should NOT be used in the EYE because preservatives used in eye drop preparations are much gentler than those used in ear drops due to the eyeball being much more sensitive compared to the ear. As such, it may burn if ear drops are used in the eye... but not vice-versa.

• Floxin (Ear) equivalent to Ocuflox (Eye)

• Ciprodex (Ear) equivalent to Ciloxan (Eye) without the steroid dexamethasone

• Cipro HC (Ear) equivalent to Ciloxan (Eye) without the steroid hydrocortisone

• Cortisporin (neomycin-polymyxin-hydrocortisone) is available in both eye and ear preparations

• Tobradex (Eye) can be used in the ear and is imprecisely similar to Cortisporin (Eye/Ear).

It has recently come to my attention that actress Reese Witherspoon's dad is an eminent otolaryngologist!

John Witherspoon, MD has practiced with a Nashville, TN otolaryngology group for over 30 years and is an instructor in this specialty at Vanderbilt University Medical Center.

He went to medical school at University of Tennessee Health Science Center College of Medicine and completed his residency at Tulane University Hospitals and Clinics.

He unfortunately has come under recent scrutiny from the media which hopefully will pass over quickly!

I wonder if Reese Witherspoon used her dad as a role model in the romantic comedy movie "Just Like Heaven" when she played Elizabeth, a workaholic doctor.