Zytaze Dietary Supplementation Enhances Botox Injections?

A patient with spasmodic dysphonia recently asked me whether Zytaze dietary supplement would help enhance the effectiveness of the botox injections I perform to treat spasmodic dysphonia. This dietary supplement contains Zinc Citrate 25mg and Phytase 500mg. Phytase is an enzyme that effectively breaks down phytates commonly found in whole grain products and cereals. Phytase basically enhances zinc absorption in the gut. So what's so special about zinc as it relates to botox ? Theor…

10/18/2019 0

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Expired Epipen Still Effective

Though one should always use an EpiPen that is not expired, it is better to use an expired EpiPen to treat anaphylaxis than to do nothing at all. A few studies published between 2000 and 2017 suggest that epipens have a shelf-life much longer than the printed expiration date. A study published in May 2017 as well as two earlier studies published in April 2015 and May 2000 suggest that even if the epipen is expired, it is still effective and safe for use in severe allergic reactions …

5/08/2017 0

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HPV Vaccine May Help Clear Airway Papillomas

Papillomas on the right vocal cord HPV vaccine like gardasil can be used to help prevent not only genital warts, but also oral warts and warts of the airway. Such warts are known as papillomas and can keep recurring after surgical excision leading to lifelong morbidity. Although gardasil and other HPV vaccines are typically used to vaccinate young tweens, it has been found effective even in much older individuals. In this study , the HPV vaccine decreased the incidence of surgeries for re…

1/31/2017 0

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HPV Vaccine May Help Clear Oral Warts / Papillomas

Contrary to popular belief that it may take years for the HPV vaccine to be truly effective, Texas researchers reported they were able to completely clear all oral papillomas due to the HPV virus in an adult within 3 months of vaccination. Specifically, they reported that a man in his 60s who suffered from recurrent oral papillomas in spite of multiple excisions was clear of all lesions within 3 months after receiving the quadrivalent HPV vaccine. Interestingly, this patient had HPV-32 w…

9/05/2015 1

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Steroid Injection Into the Ear May Help Bell's Palsy

Intratympanic steroid injections are typically performed for sudden nerve hearing loss. However, preliminary research suggests that it may also help resolve facial paralysis due to Bell's Palsy . In this prospective, double-blinded, randomized study , one group of patients received standard treatment with oral steroids and antiviral medications whereas the experimental group received the same medications PLUS intratympanic steroid injection as well. (I should mention that antiviral me…

8/25/2014 0

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Ear Injection of AM-101 May Stop Tinnitus

Phantom ringing of the ears also known as tinnitus is an extremely frustrating condition that afflicts many people. Often triggered by hearing nerve damage, there's no good treatment to fix this condition once it sets in. Until possibly now...  AM-101 made by Auris Medical is an experimental drug containing esketamine hydrochloride embedded within a hyaluronic acid gel formulation. It works by blocking the NMDA receptors of the cochlear inner hair cell. Normally, when there…

7/19/2014 1

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Treatment for Vocal Tremor

Vocal tremor is characterized by a rhythmic undulating vocal quality whenever talking, much akin to vibrato that can not be turned off. In the past, it was felt that use of botulinum toxin type A ( botox ) to treat vocal tremor was not possible nor realistic given the multiple muscle groups involved. This is in contrast to dystonias of the voice (i.e., spasmodic dysphonia ) where only one muscle group is involved and is readily and easily treated with botox injections to the affected vocal co…

7/13/2013 0

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Compact EMG System for Targeted Muscle Injections

An EMG system ( E lectro M yo G raphy) is a critical piece of equipment when it comes to targeted muscle injections in and around the neck, especially when you cannot see or feel the muscle. This scenario is especially true when dealing with spasmodic dysphonia for which targeted botox injections are quite helpful. Given the muscles that need to be injected are contained inside the voicebox and not able to be seen and felt from outside the neck, accurate injection is quite difficult withou…

1/12/2013 1

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FDA Approves New Epinephrine Injector That Talks

Sanofi US has introduced a new epinephrine injector (competitor to the more commonly known EpiPen made by Dey Pharma LP) that is equipped with audio and visual cues that helps a patient or care-giver administer epinephrine in cases of a severe allergic reaction (anaphylaxis). Known as Auvi-Q , it was FDA approved Aug 13, 2012, and should soon become available for purchase by prescription. Just like EpiPen, Auvi-Q comes in two different dosages of epinephrine... 0.3mg for patients who we…

8/22/2012 0

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Intra-Nasal Trigger Point Injections for Facial Headache

Do you suffer from a stabbing headache in the areas denoted in red? Do these headaches seemingly come out of nowhere one day? Perhaps started after a viral upper respiratory infection? You may be suffering from a condition known as  contact point headache  or a type of neuralgia involving one of the nerve plexuses found inside the nose: • Anterior ethmoid neuralgia (Sluder's neuralgia) • Sphenopalatine ganglion neuralgia (Pterygopalatine ganglion neuralgia) This type of headache …

8/14/2012 2

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Vocal Cord Botox Injections to Treat Asthma???

Yup... It's true... A clinical trial  is under way in Australia to see if botox injections to the vocal cords can improve the shortness of breath some asthmatics have. Though nobody disputes that asthma is a pulmonary problem, it is not uncommon that the vocal cords in asthmatics may be dysfunctional exacerbating the breathing problem. What is meant by dysfunctional? It's when the vocal cords come together when the person is trying to breath. It is also known as paradoxical vocal …

6/29/2011 3

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Home Allergy Shots

DISCLAIMER: This post is not meant to condone or promote allergy shots to be given at home. It is meant to promote discussion and make patients aware of the issues involved. Allergy shots , unlike medications like claritin and flonase , offer patients with significant allergies a way to potentially be cured of their misery without the need for daily medication use. However, there is a small, but substantial risk for anaphylaxis and even death with allergy shot administration. After all, a…

3/20/2011 0

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Physician Marketing Using Groupon

For those not in the know, Groupon is a website that offers coupons and other savings on local merchandise and services. Groupon also has recently rejected a takeover bid by Google . I recently encountered this amazing deal on Groupon offered by an ENT colleague, Dr. Ghaheri : " $149 for Four Laser Hair-Removal Treatments at The Center for Aesthetic Medicine at The Oregon Clinic (Up to $1,000 Value) " I wonder if such marketing and medical discount offerings like this will b…

12/04/2010 0

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Distributed Botox Injection for Spasmodic Dysphonia (Rather than Single Injection)

For many patients with spasmodic dysphonia , botox injections to the vocal cords are a regular right of passage every few months towards a clearer voice. Spasmodic dysphonia characterized by spastic or breathy voice breaks while talking causes much problems socially as well as misunderstandings. For many physicians who perform botox injections for spasmodic dysphonia, a single injection is performed to either one or both vocal cords. However a few and perhaps growing number of physicians…

11/25/2010 1

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New Video Created on Intra-Tympanic Steroid Injection for Sudden Hearing Loss

A new video has been uploaded to our office's YouTube Channel on Intra-Tympanic Steroid Injection used to treat patients who suffer sudden sensorineural hearing loss . The steroid injection is usually with decadron, though other types of steroids including methylprednisolone has been used. Watch the video here on YouTube or below.

10/12/2010 2

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Age Influences Botox Response in Patients with Spasmodic Dysphonia

Dr. Chang recently published a book chapter discussing how age influences response to botox injections in patients suffering from spasmodic dysphonia . Introduction Spasmodic dysphonia is a dystonia (muscle spasms) involving the muscles of the voicebox resulting in involuntary attacks of a strangled sounding voice. Treatment is botox injection to the involved muscles resulting in a decrease of such spasms thereby resulting in a more smooth-sounding voice. Unfortunately, there are si…

9/14/2010 0

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WP Medical Mystery: Sudden Hearing Loss

The Washington Post on 7/27/10 published a story in its Medical Mystery segment describing a patient who had sudden onset of hearing loss in one ear with tinnitus (or buzzing in the ear). This sudden hearing loss is known as sudden sensorineural hearing loss and is considered an urgent issue for which a patient needs to see an ENT as soon as possible. Why? Because treatment is most effective if given within 4 weeks of hearing loss onset. Treatment is with either high dose prednisone and/…

7/27/2010 0

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New Video on Botox Injection for Spasmodic Dysphonia

A new video has been created and uploaded to our practice YouTube Channel describing botox injection for spasmodic dysphonia . Two views are shown in the video... the first is what a patient sees as well as another view of what it looks like from inside the throat. Check it out! Dr. Chang performs botox injections for spasmodic dysphonia every Friday afternoon. He also performs botox injections for facial wrinkles, torticollis, migraine headaches , TMJ , etc. Click here to see the …

6/04/2010 2

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Doctor Sentenced to 5+ Months Jail For Using Non-FDA Approved Botox on Patients

A Houston physician, Dr. Gayle Rothenburg, was sentenced to 5½ months in federal prison on April 16, 2010 for injecting patients with a Botox product not approved by the Food and Drug Administration for human use. Read the full story here . She did this in order to save money at the expense of patient safety. Please note that in our office, we use ONLY the brand-name BOTOX made by Allergan Corporation . In fact, we purchase our BOTOX directly from Allergan Corporation and not through a th…

4/18/2010 0

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WSJ: FDA Approves Gardasil for Boys (and Girls)!

This was reported by the Wall Street Journal on Oct 16, 2009. Why is this significant from an ENT perspective? Well, gardasil is supposed to vaccinate people from getting HPV related diseases like genital warts which would help both genders when individuals become sexually active. Of more note, it has been specifically shown to help prevent cervical cancer in females which is a big killer of women. However, it may potentially prevent other types of HPV related disorders involving the head…

10/17/2009 0

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