Large Bumps in the Back of the Tongue

At least once a week, a patient comes into the office concerned with large bumps in the very back of the tongue. This finding usually is first noticed during a sore throat which prompted an unusually careful look in the back of the mouth. The stereotypical appearance of such bumps of concern is shown in this picture. Fortunately, these bumps are NORMAL... We all have them and I often like to show patients my back-of-tongue-bumps in order to reassure that I too have them... and am not conc…

5/23/2018 0

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What is Found in Normal Nasal Fluid in a Healthy Human Being?

Table from this Reference Contrary to common belief, normal nasal fluid is not water... It is in fact more similar to sweat than water. Nasal fluid is normally produced by submucosal glands, seromucous glands, goblet cells, transsudation of blood plasma, mucosal tissue fluid, and tear fluid. The table shown is a description of what electrolytes are contained in normal nasal fluid produced by a normal, healthy human being. Along with these electrolytes, nasal fluid also contains glycopro…

12/22/2017 0

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Is 1 Liter of Nasal Fluid Produced a Day Truly Normal?

Ask any ENT how much nasal drainage is normally produced by a healthy human nose every day and you will be told 1 liter. But that's not what this blog article is about. Rather, HOW was this amount determined? What is the research behind this volume? The answer is surprisingly difficult to find and still up in the air... If any readers can do some sleuthing beyond what I report below, I would be much appreciative! The vast majority of references found on simple google searching are quot…

12/15/2017 0

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What is the Normal Body Temperature? The Fact and Alternative Fact

1800s Wunderlich Thermometer (the thermometer is over 12 inches long) If you said 98.6°F, you are wrong... Of course you are just parroting back what you were told by your teachers, family, friends, colleagues... well pretty much everybody since 1871. That year, Dr. Carl Wunderlich at Leipzig University in Germany published a book called " On the Temperature in Diseases: A Manual of Medical Thermometry ." Dr. Wunderlich took the temperatures of over 25,000 patients under his ca…

1/28/2017 0

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Normal Radiological Appearance After Endoscopic Treatment of Zenker's Diverticulum (ESD)

Patient's who suffer from Zenker's Diverticulum report significant difficulty in swallowing , food regurgitation, aspiration, noisy swallowing, etc. These symptoms all stem from the abnormal presence of a "pouch" in the throat where food and liquids get trapped during swallow. The main way of diagnosing a Zenker's Diverticulum is a radiological test called the barium swallow . Endoscopic staple diverticulostomy (ESD) is a minimally invasive procedure to eliminate th…

1/07/2017 0

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Breastfeeding Ultrasound

Although breastfeeding is something humans have provided longer than written history, it is only recently through ultrasound that we are only just discovering what actually is going on within the infant mouth. Here is a video showing the complex motion that tongue makes in order to obtain milk from the nipple. The key point is that the tongue moves both horizontally as well as vertically to achieve an effective and painless breastfeeding. Check it out here !

5/18/2015 0

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Normal Appearance After Turbinate Reduction

Normal mucosal blistering (turbinate reduction done only on right side) Often, patients become disturbed with the way the inside of their nose looks after a  turbinate reduction to improve nasal breathing . However, many of the concerns are unfounded and the appearance though disturbing, is actually normal. It usually takes a FULL 2 weeks for the turbinate mucosa to heal to a more normal (and reduced) appearance. It is around 2 weeks that nasal breathing also markedly improves. In any c…

1/04/2014 0

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The Nose is a Jungle of Germs (even in Normal Healthy People)!

A fascinating study was conducted by Stanford researchers on the amount and types of germs found inside the nose in normal healthy individuals, whether they are staph carriers or not. In a typical nose in a healthy individual without any symptoms, the following "germs" can be found. Keep in mind that ALL these germs have the potential to cause a pathological sinus infection : • Corynebacterium • Propionibacterium • Escherichia-Shigella • Staphylococcus aureus (including MRSA…

12/12/2013 0

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What is Considered a Normal Number of Reflux Episodes?

Depending on whether one is talking about GERD (gastroesophageal reflux disease) or LPR (layrngopharyngeal reflux) , I believe the answer is completely different. As it pertains to GERD and what literature, doctor, or testing equipment is used, 73 plus or minus some change is what is considered a normal number of reflux episodes a typical adult may experience in a 24 hour period of time. What exactly does this number mean? This number describes how many times stuff in the stomach regurgit…

5/14/2011 0

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New Video Produced on How/What a Normal Swallow Looks Like

Our office has produced a new video on what/how a normal swallow looks like from BOTH an x-ray as well as endoscopic view. In order to best illustrate the swallowing mechanism, a modified barium swallow test is shown. The video has been uploaded to our YouTube channel and can be watched here . Watch the video below as well as the slow motion action of what the epiglottis does from the inside during a swallow!

10/23/2010 0

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You May Have a Condition Called Local Allergic Rhinitis Even If Allergy Testing Negative!!!

Image from Wikipedia A recent study was published describing a condition called " Local Allergic Rhinitis ." This condition is when a patient appears to have sino-nasal allergies, but yet, have negative allergy test results whether on skin prick or RAST . Up to 40% of patients with negative allergy test results may have this condition. In order to diagnose this condition, it requires the detection of local antigen specific IgE in nasal secretions during natural exposure to aer…

1/13/2010 0

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Botox for Spasmodic Dysphonia: Side Effects and Normal Voice

To What Degree Does Botox Dosage Affect Duration of Side Effects and Duration of Normal Voice After Injection for Adductor Spasmodic Dysphonia? For many patients who suffer from spasmodic dysphonia , botulinum toxin type A or Botox, injection to the vocal cords is a ritual treatment undergone several times a year to keep the spasms in their voice away. The amount of Botox injected varies from patient to patient. Regardless of the patient and their specific dose, it is intuitive to many patien…

9/08/2007 0

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