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Category Archives: ENT

Tongue Brushes and Scrapers

tongue brushes and tongue scrapersTongue brushes and scrapers can be used to treat physiologic halitosis. They are favored by halitophobic patients. The origin of physiological halitosis is often post-nasal drip, gastroesophageal reflux, or poor dental hygiene. If so, treatment for those disorders can reduce or eliminate halitosis.

But, for persistent halitosis, often coming from the back of the tongue, tongue brushing and scraping can be helpful. In addition, mouth rinses with homeopathic solutions free of alcohol, (e.g. Alkalol) can also be used. In general, mouthwashes containing alcohol are to be avoided because they increase the risk of oral cancer. And, chewing gum can produce methyl mercaptan, one of the principal components of oral malodour, leading to persistent halitosis.

Giving Voice to the Voiceless

Those who cannot speak are being given new hope. Six percent of the US population has a voice disorder that, unfortunately, often leads to the inability to speak. Usually arising from vocal cord damage, Harvard and MIT researchers have been tirelessly working on a solution to this vocal cord problem.

Thanks to modern gel technology, they might have found one! A new synthetic gel material can be injected into scarred or damaged vocal cords to help restore their function. By looking at the vocal cords from almost a mechanical standpoint, scientists developed a fix for the scar tissue — rather than a new way to remove it.

The flexible gel material can adapt to a wide range of human vocal cords and helps restore the cords’ ability to vibrate, thus loosening up the stiffened, scarred vocal cords enough to (hopefully) restore voice. Although, if approved, this material would need to be re-injected every six months or so – as it does break down over time – it is a very promising solution to a problem that has long been “silenced.”

Dr. Michelle Yagoda is not only an expert ENT and facial plastic surgeon, but she is a voice specialist as well. If you find you are having problems with your voice, make sure to see the proper doctor: Voice issues have many causes, and their treatments depend on the proper diagnoses.

Get Warm to Block Colds!

Your mom’s advice was right: Put on a sweater. New research indicates that, yes, being warm helps protect against getting a cold. The body does not utilize its immune system as well at lower temperatures according to early studies. This research, being done at Yale on mice, indicates that low temperatures suppress cells’ ability to detect oncoming viruses as well as their ability to warn the immune system. This gives viruses more freedom to replicate — making you sicker!

For the mice kept at a normal, human-body temperature, they were able to fight off the virus easier than those in the cooler temps. Essentially turning the alarm signal of the body off, the virus grew until it became what we know as “the common cold.” Time to bundle up!

10 Reasons to Have a Surgical Rhinoplasty

Considering a rhinoplasty? If you are, you probably have a good reason, whether it is cosmetic or functional. If you are still on the fence about it, read below for Dr. Michelle Yagoda’s expert comments on why her patients choose to have rhinoplasties. There are a lot of them: After twenty years of experience, this list isn’t even totally comprehensive!

  1. Fix a broken nose: After a nasal trauma occurs, the repercussions are not just cosmetic. Oftentimes, functional problems cause nasal airway obstruction and difficulty breathing. Although broken noses and fractures are common, they are not always easy to fix. Nasal bones need to be reset or repositioned, and the septum might need to be straightened. Additionally, the trauma from the broken nose needs to be corrected as well: Blood can become trapped in the soft tissues of the nose, compressing cartilages on the septum or the tip of the nose. Severe compression can cause the cartilage to lose its shape, strength, and even die off!
  2. Raise nose bridge: If you have a low nose bridge, you might just have to blame your genetics! Certain ethnicities and ethnic groups are more prone to low and flat noses, but, luckily, Dr. Yagoda is very proficient in addressing this cosmetic problem. When a patient wants to cosmetically address a low-bridged nose, Dr. Yagoda makes sure their “new nose” will be more balanced with their facial features. Sometimes this can be done with non-surgical rhinoplasty as well! Ever have the problem of your glasses constantly sliding off your face when you look down? This can be fixed!
  3. Lower nose bridge: On the opposite end of the spectrum, those with high-bridged noses want to make sure their nose isn’t the only facial feature they see! Again, due to certain heritages and/or genetics, noses with high bridges cause more than just cosmetic problems. Ever see two high-bridged nosed lovers try to share an intimate moment? It can get awkward!
  4. Narrow the nostrils: Although genetics and ethnicity can cause the nostrils to be wide and flat, nasal trauma can also cause them to flatten and widen. At first glance this may just seem like a cosmetic issue, but, in reality, the nostril size is very important for proper breathing. The triangle shape of the nostril contributes to the nose’s “nasal valve,” which is the “gatekeeper” of the nose. This important gatekeeper either lets enough air in, or, if the valve is compromised or collapsed, limits airflow.
  5. Change your profile: This is pretty self-explanatory! If you are not happy with how you look in the mirror, a rhinoplasty can help. Whether you’d like to change the nose you already have or correct an aging nose (perhaps it is drooping?) always ensure you and your surgeon are on the same page about what you’d like. There is nothing better than looking in the mirror and loving what you see!
  6. Make a nose smaller: Just because a nose is large does not mean it works well! Large noses and nostrils do not necessarily equal large valves, and bigger noses can have the same breathing problems as smaller noses. So, not only will you make your nose more in-line with your other facial features, you will probably breathe better!
  7. Make a nose larger: Those with short or small noses are the result of genetics or, sometimes, medical problems that are not often seen today in the United States. Because nose-lengthening cosmetic surgery entails augmenting tissue and not merely excising it, it’s one of the most challenging procedures in rhinoplasty. As you might imagine, it’s far easier for a facial plastic surgeon to remove an excess of cartilage and bone than it is to add to it. If you’re contemplating this cosmetic procedure, you’ll need the skills of a true rhinoplasty specialist such as Dr. Yagoda!
  8. Fix a breathing problem: Functional rhinoplasties can be done by themselves or in combination with a cosmetic procedure. Almost everyone knows that a deviated septum needs to be corrected, and abnormal turbinate repair is pretty common knowledge, too. However, not many know that the actual position of the nose bones can cause restricted breathing! To fix this, the surgeon needs to move the bones slightly out to allow adequate air passage.
  9. Fix a cleft nose: Cleft noses are genetic defects that occur in-utero. Treatment requires a team approach with multiple staged procedures and a skilled plastic surgeon to correct structural defects and asymmetrical features. Although the process is very long and involved, the positive results are always worth it.
  10. Fix a skin cancer: Skin cancers on the nose get tricky. They are much more complicated than other body cancers because they can be deceiving: What looks like a superficial skin cancer might actually be very deep! These deep skin cancers end up into the planes of fusion of two facial bones, i.e. the nose with cheek, nose with upper lip, or the nose with the eye. As a result, skin growths that appear to be small can cause significant destruction of the cartilage and mucus membrane below it. Although the removal of skin cancer is typically done during a MOHS surgery, oftentimes the repair requires a skilled rhinoplasty surgeon.

Sea AND Land Sickness?

Your all-inclusive cruise might not be all-inclusive after all! Although seasickness is nothing new for most people, few know about a much rarer side effect of — at least what should be! — a relaxing cruise, plane flight, or car trip: Mal de Debarquement syndrome. Those afflicted with Mal de Debarquement syndrome end up paying for their trip long after they return to land.

Little is truly known about what causes Mal de Debarquement syndrome, but it is a disorder of the balance system set off by exposure to motion.  By definition, it is the sense of imbalance and/or movement that persists for more than two days after a cruise, plane flight, car trip, train ride, or other “ride.”  Interestingly, there is usually NO accompanying nausea.

Although “sea legs” are common after prolonged exposure to motion, they should last less than two days.  Unfortunately, there are no documented preventive measures for Mal de Debarquement syndrome, but those prone to motion sickness may benefit from taking motion sickness remedies to prevent or mitigate these symptoms from the initial moment they step into a car, plane, train or ship.

Those suffering from Mal de Debarquement often feel as if they are rocking and swaying while steady on land. This can cause dizziness and headaches, and sufferers might become anxious and depressed.  Thus, early diagnosis is very important! The most effective treatments have included Cawthorne vestibular strengthening exercises and vestibular rehab training.

As an expert ENT, Dr. Michelle Yagoda works hand-in-hand with audiologists to help educate, diagnosis, and treat those with Mal de Debarquement syndrome. As the official Mal de Debarquement awareness month approaches in June, she hopes to raise more awareness of this little-understood phenomenon.

Can’t Sleep? Try a Sleep Buddy!

Couple’s Feet in Bed — Image by © Radius Images/Corbis

Having trouble sleeping? You aren’t alone! More than a third of US adults do not get enough sleep. Insufficient rest doesn’t just make you tired – it has many other associated health risks. If you are looking to improve your quality of life and sleep, then try resting both your mind AND body!

Getting enough sleep is an important component of reducing stress and tackling the day’s challenges. If you are sharing your bed with a companion, chances are you may think his or her presence can be disruptive to your “beauty sleep.” Worry not! As long as it isn’t snoring or sleep apnea waking you up, then sharing your bed is actually beneficial! Of course, if it is sleep apnea (a disruption of breathing) you should seek treatment. Those with allergies, deviated septums, enlarged turbinates or chronic sinus disease can all benefit from a doctor’s attention.  Whether through traditional or endoscopic surgery, fixing sleep apnea and snoring problems will ensure a more peaceful slumber.

However, if you find yourself waking up often — or just do not feel energized in the morning! — consider getting a sleeping buddy! Research shows that the “love hormone,” oxytocin, is released in greater quantities when your nighttime habits include cuddling. Oxytocin not only has physical benefits – it reduces stress, decreases blood pressure, and promotes healing – but it increases our feelings of affection for healthy relationships.

Why is this? Well, we are social creatures! Having a “protector” nearby increases sleep neurotransmitters, and it is these chemical signals that help foster a good night’s rest. So, to be the most outwardly beautiful and healthy person you can be (heaven forbid you have the face of sleep deprivation!), start with ensuring long-term health through good sleeping habits. Just don’t let your sleeping buddy hog the sheets!

Listen Up! Your Headphones Could be Causing Hearing Loss

Did you know approximately 15 percent of Americans ages 20 to 69 have high-frequency hearing loss that may have been caused by loud noise exposure? Frequent exposure to loud sounds can wear down the hair cells of your ear’s cochlea, which can ultimately cause hearing loss or tinnitus (ringing in the ear).

Researchers claim medical and genetic factors play a role, and some people are more at risk than others. However, anything louder than 85 decibels can cause damage after extended exposure. Interestingly, sounds made by household objects such as hair dryers and kitchen blenders can go past 85 decibels. The rule to go by is if you have to raise your voice to be able talk to someone an arm’s length away. If this is the case, the nose is probably above 85 decibels.

When you consistently listen to your headphones at a high volume, you risk doing permanent damage. The good news is you can take steps now to prevent noise-induced hearing loss in the future.

Girl Power!

In honor of Women’s History Month, we’re celebrating the accomplishments of these 50 inspirational women who helped shape the health care industry. These female doctors and researchers have had the greatest impact in medicine and health research and deserve to be recognized for their contributions to society. Natural birth, radiation therapy, and lifesaving blood transfusions are health innovations that would not be possible without these brilliant women in medicine. Now that’s girl power!

Who on this list inspires you? Let us know; we’d love to hear from you!

How to Look Your Best This Allergy Season

Well, it’s that time of year again. Allergy season is coming and as the pollen is building up, many of you may be beginning to experience the familiar and unwanted itchy eyes, sneezing, and stuffy nose.  And unfortunately, performing at 100% may be difficult when you don’t feel your best. The good news is you can still look your best even when allergies may be getting the best of you.

Jennifer Lawrence looked stunning at the SAG Awards when she accepted her award for Best Female Actress. You would never know that she was battling allergy symptoms. Here are some beauty tricks to mask the toll that allergies take on your eyes and nose.

Junk Food Linked to Asthma and Eczema in Children

As many of you know, eating processed food can lead to obesity, heart disease and diabetes in adults. But you may be surprised to learn the harmful effects of junk food on children. A recent study revealed that kids who eat junk food three times a week have a higher risk of developing asthma and eczema.

Researchers studied 50 countries and found that teenagers who ate fast food such as burgers three times a week or more were 39 percent more likely to get severe asthma. Younger kids were 27 percent more at risk. It is believed that the high saturated fat levels in food such as burgers lower children’s immune systems.

Want to know what foods can protect against these diseases? Read this article to find out more.