SacramENTo Ear, Nose & Throat

Ear Wax NEWS!!!!

2008-09-08T13:08:00.000-07:00

The gooey, golden stuff that builds up inside your ears should stay there, according to national guidelines on earwax removal released today.
"[Earwax] is not intrinsically evil stuff, and consequently does not have to be removed merely because it's present," said Peter Roland, an ear, nose and throat doctor at the University of Texas Southwestern Medical Center at Dallas. "In fact, it serves a function and so if you don't need to take it out, you should just leave it alone."
Roland chaired a panel of doctors in charge of the new guidelines for earwax removal issued by the American Academy of Otolaryngology - Head and Neck Surgery Foundation (AAO-HNSF). The guidelines are intended to serve two purposes: to determine under what circumstances earwax needs to be removed, and to give doctors the scoop on which removal methods work best.

They hope the guidelines won't fall on deaf ears: About 12 million people a year in the United States seek medical care for impacted or excessive earwax. Impaction, they say, can cause pain, pressure, itching, foul odor, ringing of the ears, ear discharge and, in extreme cases, hearing loss.
Good-for-you gooThere's a reason for the goo. Earwax is a self-cleaning agent, with protective, lubricating and antibacterial properties, doctors say.
That's why tiny glands in the outer ear canal constantly pump out a watery substance, which gets mixed with bits of dead hair and skin and together is called earwax or cerumen. Excess earwax normally treks slowly out of the ear canal, with an extra boost from chewing and other jaw movements, carrying with it dirt, dust and other small particles from the ear canal. Then, dried-up clumps of the stuff fall out of the ear opening.
When this natural earwax train malfunctions, or when individuals poke around in their ears with cottons swabs or other foreign objects such as bobby pins or matchsticks, earwax can build up and block part of the ear canal.
"Then there are lots of people wearing earplugs for one reason or another, either because they've got hearing aids or they're transcriptionists at work or because they're addicted to their walkman," Roland told LiveScience, "and that can increase the likelihood that the wax doesn’t come out on its own."
Older adults are more prone to earwax buildup then younger individuals.
"The wax gets much thicker and drier, and plus you actually end up with more hair in your ear, when you're older, and so it traps it," Roland said.
He added, "Unfortunately, many people feel the need to manually 'remove' cerumen from the ears. This can result in further impaction and other complications to the ear canal." He said the saying, "Don't put anything smaller than your elbow in your ear," holds true.
Leave your ears aloneFor the everyday individual, the new guidelines suggest you leave your ears alone unless you experience symptoms that you think are associated with too much earwax.
"If they're going to do something at home, they should probably use drops of some sort," Roland said. The panel found no evidence that one type of over-the-counter drops works better than another, or better than just plain sterile water or sterile saline, he said.
The drops help to loosen the earwax and then the ear often can do the rest, he added.
The guidelines also state that cotton-tipped swabs or other objects should not be used to remove earwax. Oral jet irrigators and the alternative medicine technique called ear candling are also strongly advised against.
Ear candling involves making a hollow tube from fabric and soaking that in warm beeswax, which is cooled and hardens. Once cooled and hardened, the beeswax cone is stuck into the ear. The outer end of the tube is lit and burns for about 15 minutes, a process that supposedly draws the wax out of the ear.
Studies have shown, however, that the drawn-out stuff is material from the candle itself. Doctors have also reported seeing patients who have burned the outer parts of their ears with this method.

If the drops don't relieve your symptoms, or if you dislike drops but still have symptoms, it's time to see a doctor, Roland said.
The panel found that three common techniques for earwax removal at the doctor's office work best, with no single method outshining the others. These include flushing the ear out with a water solution; manually removing the earwax under a microscope using medical instruments; and sending the patient home with ear drops.
While at the doctor's office, Roland urges patients not to be embarrassed by a little earwax.
"I get a lot of people in here who are horrified when I see a little wax in their ear, and then they start apologizing for being dirty and they're just very upset it's present at all," Roland said. "And I think the big message there is that it has a physiological function, and unless there's a reason to remove it, you should just leave it alone. It's OK."
http://www.msnbc.msn.com/id/26443394/

Hearing Loss, Lack Of Sleep Impair Back-To-School Health

2008-08-25T15:53:00.000-07:00

As the new school year approaches, many parents are preparing their children by buying school supplies, new clothes, and organizing fall sporting events. But in order to help kids get a healthy head start to the school year, the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) also recommends taking a closer look at your child's health for common ear, nose, or throat-related health issues that might affect academic success. "Ear, nose, and throat health problems are among the most common medical conditions that children face," says Jay Youngerman, MD, chief of the Division of Otolaryngology at North Shore Hospital at Plainview in New York. "So in addition to the standard back-to-school physical, parents should also consider whether or not their child would also benefit from seeing an otolaryngologist for additional evaluation." Dr. Youngerman cites the following common ENT health concerns in the back-to-school season: 1. Hearing Loss - Hearing difficulty or loss can greatly impact children's performance in school and their ability to interact with peers, and is increasingly a risk because of the popularity of mp3 players. Most children have their hearing evaluated after birth or in the first few years to determine any congenital conditions. However, as hearing loss is also caused by things like infections, trauma, and damaging noise levels, the problem may not emerge until later in childhood. Monitoring a child's hearing ability on a consistent basis can help a parent take action early if an issue should arise. 2. Pediatric Obstructive Sleep Apnea and other Childhood Sleep Disorders - Obstructive sleep apnea, also known as sleep-disordered breathing (SDB) is not uncommon in children, but can have a profound impact on their educational experience by causing daytime sleepiness, aggravating attention deficit disorder, and other behavioral issues, along with bed-wetting and slowed growth. The number one indicator of SDB is restless sleep and labored breathing. This includes loud snoring that occurs every night, regardless of sleep position; snoring is then followed by a complete or partial obstruction of breathing, with gasping and snorting noises. 3. Facial Sports Injuries - Many children begin the fall with a variety of team and individual sports programs. These activities are great exercise for kids, but they can result in a variety of injuries to the face, including broken noses and facial abrasions. Many injuries are preventable by wearing the proper protective gear. Check with your child's coach to make sure he/she has and is wearing all the necessary protective equipment. Also check with the coach after each practice to see if your child sustained any injuries while playing. Dr. Youngerman says, "Other common issues like chronic allergies and sinusitis can also make a big impact on back-to-school success. Knowing the signs and symptoms will help a parent take quick action should an ENT health issue arise."

Ear Infections May Increase Obesity Risk

2008-08-21T14:57:00.000-07:00

Aug. 14, 2008 -- Are kids with frequent ear infections at increased risk of becoming overweight later in life?
Early research suggests they are, and that damage to the nerves controlling taste may be to blame.
The research was presented for the first time today at the 116th annual convention of the American Psychological Association in Boston.
Taste researcher Linda M. Bartoshuk, PhD, of the University of Florida College of Dentistry, tells WebMD that over time, frequent ear infections may alter taste perception in a way that leads to a heightened preference for high-fat and highly sweetened foods, which, in turn, leads to obesity.
"Ear infections are relevant to taste because one of the most important taste nerves goes through the middle ear on the way to the brain," she says.
Another taste nerve is in the throat, Bartoshuk says, and researchers also presented findings showing an increased risk for obesity in children who have had tonsillectomies.
Ear Infections and Obesity
Bartoshuk says she first suspected a connection between ear infections and obesity about six years ago after analyzing findings from a survey she conducted to explore taste and health.
About 6,600 adults -- mostly academic professionals -- completed the survey, which included questions about past ear infections and current body mass index (BMI), a measure of obesity.
People with a history of frequent ear infections were found to be 62% more likely to be obese than people who reported no history of ear infection.
"We didn't expect to find ear infections associated with BMI, but that is what we saw," she says.
Bartoshuk then began looking for other research databases that included information on ear infection history and weight.
Several of these studies were presented at today's symposium, along with Bartoshuk's original research.
In one study involving middle-aged women tested for taste sensitivity, those who showed evidence of damage to taste nerves were more likely than women without evidence of nerve damage to prefer high-fat and highly sweetened foods. They were also more likely to have larger waists.
In another study, preschoolers with a history of frequent ear infections were found to eat fewer vegetables and more sweets than children who did not have frequent ear infections. They also tended to be heavier.
Epidemiologist Kathleen Daly, PhD, of the University of Minnesota-Twin Cities, reported on her work with children up to age 2, suggesting that chronic ear infections prior to this age are associated with higher BMIs (body mass index) around the second birthday.
"All of this is intriguing, but we don't really know what it means yet," Daly says.
Finally, re-examination of data from a large, national health survey conducted in the 1960s found a 30% increase in obesity risk among children who had tonsillectomies.
'Big Leap of Faith'
The research presented in Boston largely involved reanalysis of existing databases.
All agree that studies designed specifically to examine the question of whether chronic ear infections and tonsil surgery play a role in obesity are needed to prove the hypothesis.
"Given the epidemic of obesity in this country and the fact that children are becoming overweight at younger and younger ages, this really should be something we look at more carefully," Daly tells WebMD.
But ear specialist John W. House, MD, of the House Ear Institute in Los Angeles isn't so sure.
"We see thousands of children and adults with chronic ear infections at our clinic every year," he says. "If this association were real we would see it in our patients, but we don't."
University of Pittsburgh ear, nose and throat physician Barry Hirsch, MD, FACS, tells WebMD that the studies presented at the Boston symposium fall far short of proving a link between ear infections, tonsil surgery, and obesity.
House and Hirsch are both spokesmen for the American Academy of Otolaryngology -- Head and Neck Surgery.
"It is a big leap of faith to say from this type of research that ear problems cause obesity," he says.

http://children.webmd.com/news/20080814/ear-infections-may-increase-obesity-risk

Central Auditory Processing

2008-07-25T13:27:00.000-07:00

We see many people who complain that they are losing hearing but their usual audiometric tests are normal. In most of these cases, it is felt that they are experiencing an age-related decrease in central auditory processing, which makes it more difficult to understand speech in the presence of background noise,. A recent study from Dr Gates at the University of Washington and described in US News & World Report may shed some light on this problem:

Memory Problems Tied to Sound Processing Disorder
Inability to filter out background noise may be indicator of mild impairment, study says
Posted July 22, 2008

TUESDAY, July 22 (HealthDay News) -- Mild memory impairment may be associated with a sound processing disorder called central auditory processing dysfunction, say U.S. researchers.
People with the disorder have difficulty hearing in complex situations with competing noise, such as making out what one person is saying while many people in a group are talking at the same time.

"Central auditory processing dysfunction is a general term that is applied to persons whose hearing in quiet settings is normal or near normal yet who have substantial hearing difficulty in the presence of auditory stressors such as competing noise and other difficult listening situations," according to background information in the study. "Central auditory testing is important in evaluating individuals with hearing difficulty, because poor central auditory ability, per se, is not helped by amplification and requires alternative rehabilitation strategies."
Previous research has found that people with Alzheimer's disease and other types of dementia have central auditory processing dysfunction.
This new study by Dr. George A. Gates, of the University of Washington, Seattle, and colleagues included 313 people, average age 80, taking part in a dementia surveillance program that began in 1994. Of the participants, 17 had been diagnosed with dementia, 64 had mild memory impairment, and 232 had no memory problems.
Three tests were used to assess the participants' central auditory processing. In one test, nonsense sentences were read over the background of an interesting narrative. In the other two tests, separate sentences or numbers were read into each ear simultaneously.
"These central auditory processing test paradigms evaluate how well an individual manages competing signals, a task that requires adequate short-term memory and the ability to shift attention rapidly," the researchers noted.
Participants with dementia and mild memory impairment scored significantly lower on the tests than those without memory problems. The findings were published in the July issue of the Archives of Otolaryngology -- Head & Neck Surgery.
"Central auditory function was affected by even mild memory impairment," the researchers wrote. "We recommend that central auditory testing be considered in the evaluation of older persons with hearing complaints as part of a comprehensive, individualized program to assist their needs in both the aural rehabilitative and the cognitive domains."

http://health.usnews.com/articles/health/healthday/2008/07/22/memory-problems-tied-to-sound-processing-disorder.html

HPV and Head and Neck Cancer Survival

2008-07-08T15:58:00.000-07:00

Researchers at the University of Michigan Comprehensive Cancer Center have found a series of markers that indicate which patients are more likely to survive cancers of the base of the tongue and tonsils (Journal of Clinical Oncology, July 1, 2008).
Most notably, they found that cancers linked to HPV, or human papillomavirus, are the most responsive to current chemotherapy and radiation treatments, while tumors that express high levels of a certain growth factor receptor are the least responsive and most deadly.
The researchers call these and other markers a promising step in the direction of tailored, individualized treatment for a type of cancer that can have dramatic impact on essential abilities such as swallowing and speaking.
"The chemotherapy and radiation therapy we use to treat this type of cancer is very aggressive. If we can identify those patients most likely to respond, we could reduce the intensity of the therapy for those likely to have the best outcomes," stated Thomas Carey, PhD, professor and distinguished research scientist at the U-M Kresge Hearing Research Institute and co-director of the head and neck oncology program at the U-M Comprehensive Cancer Center. "At the same time, we hope to identify new treatments that specifically target those tumors that we know are not responding to current therapies." Dr. Carey was the senior author on both papers.
Cancers of the tonsils and the base of the tongue have increased in recent years, in what Dr. Carey calls an "epidemic" of HPV-induced head and neck cancer. This has occurred at the same time that declines in smoking rates have led to a decrease in the incidence of other types of head and neck cancers. HPV is the virus that can cause cervical cancer and is the target of a new vaccine.
"The biggest challenge is how best to treat patients with tumors that stem from tobacco and alcohol use as opposed to tumors linked to HPV. We now know they're two different cancers," said study author Francis Worden, MD, assistant professor of internal medicine at the U-M Medical School.
In this study, researchers treated 66 patients with advanced oropharyngeal cancer, which includes cancer of the tonsils and the base of the tongue. Study participants were given an initial course of chemotherapy to gauge the tumor's response. Those whose tumor was reduced by more than half of its original size received a full course of chemotherapy and radiation given simultaneously. Patients whose tumors did not respond were referred for surgery.
Fifty-four of the 66 participants responded to the initial chemotherapy. Of that group, 62 percent are alive today without evidence of cancer, and 73 percent fully preserved their organs.
Participants whose cancer did not respond to the chemotherapy and radiation went on to receive surgery. The researchers found that even with surgery, only 4 of 11 patients survived.
"For most patients, the chemoradiation was very effective. But a subset of patients still do not do well. Our next step was to look at the biomarkers to see if we could determine which patients were responding to treatment, based on the tumor biology," said Dr. Carey, who is also associate chair and professor of otolaryngology and pharmacology at the U-M Medical School.
By looking biopsies taken before treatment, the researchers found 64 percent of the tumors were positive for high-risk strains of HPV. Almost all of the HPV-positive tumors responded to initial chemotherapy and 78 percent of those patients survived with their organs preserved. Of the HPV-negative study participants, only four of 15 survived. In addition, the researchers found that patients whose tumor expressed a marker called EGFR had worse outcomes.
"The combination of markers was an important indicator. Patients whose tumors expressed high levels of EGFR did poorly. But those who had high EGFR and were also HPV-positive had some protection. Patients with high EGFR and low HPV fared the worst. This is a step in the direction of affecting future treatment," said Bhavna Kumar, a research laboratory specialist who was the lead study author.
The researchers also found that tumors with low expression of a protein called p53, combined with high expression of another protein, BCLXL, also had poor outcomes. These markers provide additional targets for potential new therapies.
About 35,300 Americans will be diagnosed with head and neck cancer this year, according to the American Cancer Society.
Additional study authors were Julia S. Lee, Gregory T. Wolf, Kitrina G. Cordell, Jeremy M.G. Taylor, Susan G. Urba, Avraham Eisbruch, Theodoros N. Teknos, Douglas B. Chepeha, Mark E. Prince, Christina I. Tsien, Nisha J. D'Silva, Carol R. Bradford, Huong H. Tran, Kun Yang, David M. Kurnit, Joshua A. Bauer, Nancy Wallace, Tamara Miller, and Heidi Mason.

http://speech-language-pathology-audiology.advanceweb.com/editorial/content/editorial.aspx?cc=117403

Pacifier ("Dummy") may aggravate ear infections!!

2008-06-26T15:22:00.000-07:00

From the BBC and the Dutch...

Dummy use link to ear infections
By Emma Wilkinson
Health reporter, BBC News
http://news.bbc.co.uk/2/hi/health/7463911.stm
Parents should avoid using a dummy (i.e. pacifier) in infants who are prone to ear infections, research suggests.

In a five-year study of almost 500 Dutch children, researchers found almost double the risk of recurrent ear infections in those who used a dummy.

Writing in the Family Practice journal they said doctors should advise parents of the risk.

Scientifically known as acute otitis media, ear infections are very common in young children.

Antibiotics do not generally work and the infection tends clear on its own within a few days but some children are prone to repeated bouts.

"This is a very useful piece of research that shows use of dummies in children under the age of four who have a history of ear infections is not a good idea," stated Professor Steve Field, Royal College of GPs.

The researchers from University Medical Center, Utrecht said some studies before had found a link between dummy use and ear infections but they had not been very accurate.

Their research followed 476 children aged under four years, 216 of whom used a dummy.

There was a 90% increased risk of recurrent ear infections in those who sucked a dummy compared with those who did not.

Susceptibility

The researchers said results suggested that the first infection may increase susceptibility to future ear infections.

And using a dummy may allow bacteria to more easily migrate from secretions in the nose to the middle ear, they suggested.

Study leader, Dr Maroeska Rovers, said: "Paediatricians and GPs can use this information in their daily practice - they can dissuade parents from using a pacifier [dummy] once their child has been diagnosed with acute otitis media to avoid recurrent episodes."

Professor Steve Field, chair of the Royal College of GPs said there had been previous studies but they had not been put together very well.

"This is a very useful piece of research that shows use of dummies in children under the age of four who have a history of ear infections is not a good idea.

"There's no need to panic but - in those children - not using a dummy is likely to prevent recurrence."

We are now on Google Maps and Streetview!!!

2008-06-19T17:24:00.000-07:00

So Google sent people driving around and photographing the views from many streets in many areas. If you go to Google maps you can see that the streets with the blue line have the street view available. Now our office maps correctly and you can even see our building!

View Larger Map

Common Sleep Problem Linked With Memory Loss

2008-06-14T14:41:00.000-07:00

Common Sleep Problem Linked With Memory Loss
Brain scans reveal that the mammillary bodies, shown in box and circled, of a sleep apnea patient (right)are smaller than those of a healthy control subject (left).(U.C.L.A./Harper Lab)
The part of the brain that stores memory appears to shrink in people with sleep apnea, adding further evidence that the sleep and breathing disorder is a serious health threat.
The findings, from brain scan studies conducted by researchers at the University of California, Los Angeles, show for the first time that sleep apnea is associated with tissue loss in brain regions that store memory. And while the thinking and focus problems of sleep apnea patients often are attributed to sleep deprivation, the scans show something far more insidious is occurring.
“Our findings demonstrate that impaired breathing during sleep can lead to a serious brain injury that disrupts memory and thinking,” said principal investigator Ronald Harper, professor of neurobiology at the David Geffen School of Medicine at U.C.L.A. The data appear in the June 27 issue of the journal Neuroscience Letters.
Sleep apnea occurs when the muscles in the throat, soft palate and tongue relax during sleep. They sag and narrow the airway and the tongue slides to the back of the mouth, blocking the windpipe and cutting off oxygen to the lungs. The sleeper gasps for air, wakes up briefly and falls back to sleep in a cycle that repeats itself hundreds of times per night. The result is loud snoring and chronic daytime fatigue. The disorder also is linked to a higher risk of stroke, heart disease and diabetes. An estimated 20 million Americans have sleep apnea.
The study focused on structures on the underside of the brain called mammillary bodies, so named because they resemble small breasts. The researchers used magnetic resonance imaging to scan the brains of 43 sleep apnea patients. Compared to images of 66 control subjects, the brains of the sleep apnea patients had mammillary bodies that were nearly 20 percent smaller, particularly on the left side.
The structures also are known to shrink in patients who have other forms of memory loss related to alcoholism or Alzheimer’s disease.
The researchers don’t know why the sleep disorder affects brain tissue but theorize that it’s related to repeated drops in oxygen. During an apnea episode, the brain’s blood vessels constrict, starving its tissue of oxygen and causing cells to die. The inflammatory process, also linked with heart disease and stroke, further damages the tissue.
“The reduced size of the mammillary bodies suggests that they’ve suffered a harmful event resulting in sizable cell loss,” Dr. Harper said. “The fact that patients’ memory problems continue despite treatment for their sleep disorder implies a long-lasting brain injury.”
The data show the importance of early diagnosis and treatment of sleep apnea. Unfortunately, the most effective treatment is a continuous positive airway pressure, or CPAP, machine that many patients find unwieldy and uncomfortable. In a future study, the U.C.L.A. researchers will explore whether vitamin B1 supplements might help restore memory in sleep apnea patients by moving glucose into cells and preventing cell death.

Newborn hearing screening does more good than harm!

2008-06-12T14:35:00.000-07:00

Parents unharmed by 'false-positive' hearing test

By Amy Norton
NEW YORK (Reuters Health) - Parents do not seem to suffer lingering anxiety after routine newborn screening falsely suggests their child may have a hearing problem, a study has found.
In the U.S. and Europe, infants are screened soon after birth for potential hearing problems. If the screening test suggests they may have hearing loss, further testing is done to confirm or rule out a problem.
Newborn hearing screening is considered beneficial because without it, children's hearing problems would typically go undetected until they are between 1 and 2 years old, at which point their language development would already be delayed.
The problem is that this screening, like all medical screening tests, can yield "false positive" results. In fact, most infants who "fail" their hearing screening test are shown to have normal hearing when more-extensive diagnostic testing is done.
To see whether such false-positives cause parents lasting anxiety, Dutch researchers surveyed 442 parents six months after their infant had undergone routine hearing screening.
The group included 288 parents whose newborn had passed the first test and 154 whose infant had inconclusive or positive screening results; in all cases, these infants were later shown to have normal hearing.
Overall, the study found, parents in the two groups had similar results on a standard test of chronic anxiety -- suggesting the false-positive test results did not do parents lasting harm.
The finding adds to evidence that "the advantages of the universal newborn hearing screening are larger than the disadvantages," lead researcher Dr. Kitty van der Ploeg, of the research institute TNO in Leiden, the Netherlands, told Reuters Health.
She and her colleagues report their study results in journal Archives of Disease in Childhood.
Despite the generally positive findings, though, some parents were concerned by their child's false-positive screening results. Six months after the test, the researchers found, 10 percent to 15 percent of these parents said they were worried about their child's hearing, versus 4 percent of parents whose newborn had passed the screening test.
Van der Ploeg said that while false-positives cannot be eliminated, it might be possible to reduce them. In this study, infants with false-positive results were slightly older than those who passed the screening test. Other research has similarly suggested that the odds of false-positive results depend partially on an infant's age.
In the Netherlands, van der Ploeg noted, it is generally recommended that newborns have their hearing screened when they are between 4 and 7 days old.
But since there will always be some false-positives, she added, screeners should explain the hearing screening process to parents in a way that would minimize their worries.
SOURCE: Archives of Disease in Childhood, June 2008.

Long-term bouts with hay fever worsen ability to breathe through your nose

2008-06-05T14:42:00.000-07:00

Alexandria, VA – New evidence for the first time suggests that people suffering from hay fever (allergic rhinitis) will over time experience a progressive worsening of their nasal passage functioning, depending on how long they have the disorder, according to a new study published in the June 2008 edition of Otolaryngology – Head and Neck Surgery.
The study, authored by researchers in Italy, discovered that in 100 patients (50 with short-term rhinitis, and 50 with long-term), those who experienced longer bouts with the disorder (on average, nine years) had significantly lower airflow in their nasal passages. Furthermore, 72 percent of the patients with long-term rhinitis had “severe” nasal obstruction.
Allergic rhinitis, commonly referred to as hay fever, occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, and animal hair, among others. This causes skin redness and swollen membranes in the nasal passages, combined with sneezing and congestion. It is estimated that between 10 and 20 percent of the American population suffers from hay fever, and accounts for approximately 2 percent of all visits to a doctor’s office.

This new data reinforces the importance of diagnosing and treating your nasal allergies.

Sleep Apnea patients at increased risk while flying

2008-05-23T08:39:00.000-07:00

This is an interesting study reported in The New York Times which highlights the effects of sleep apnea on the overall physiology of the body and again highlights the importance of diagnosis and treatment.

Sleep Disorder Raises Heart Risks While Flying
People with obstructive sleep apnea may be at greater risk for heart troubles during air travel, a new study shows.
Travelers with sleep apnea face higher heart risks. (Noah Berger/Associated Press)
Sleep apnea is a common condition characterized by temporary breathing interruptions during sleep, often due to an upper airway obstruction. People with sleep apnea often snore loudly and gasp for air during sleep.
In a new study, Australian researchers looked at oxygen levels and breathing patterns in healthy people and in 22 people with severe sleep apnea during a simulated flight. All study subjects were awake, and the conditions in the simulator mimicked oxygen and pressure levels typically found on commercial airline flights.
The researchers found that people with obstructive sleep apnea had lower levels of oxygen in their blood before and during the simulated flight. People with apnea experienced higher heart rates, physiological stress and demand for oxygen than healthy people, according to the findings, presented this weekend at the American Thoracic Society’s 2008 International Conference in Toronto.
“We addressed obstructive sleep apnea because it is becoming so much more common as obesity increases and there are greater numbers of obese passengers on commercial flights,'’ said lead researcher Leigh Seccombe, a senior scientist in the department of thoracic medicine at Concord Repatriation General Hospital in Sydney.
The results suggest patients with obstructive sleep apnea are at higher risk for heart problems during air travel, and raise questions about whether patients with severe apnea should travel with supplemental oxygen, the way patients with lung diseases do.
http://well.blogs.nytimes.com/2008/05/19/sleep-disorder-raises-heart-risks-while-flying/

Spring is here!

2008-05-08T13:33:00.001-07:00

This bee is very busy collecting pollen. Luckily he is not allergic to it. If you are not so lucky, then we can help...
SacENT has a fully equipped allergy department and our doctors are well versed in the most up to date allergy medications. There are some new very effective agents available to control your miserable allergies.

(photo by Dr Evans in his backyard just before a sneeze which aggravated said bee).

Difficult to treat high blood pressure may be due to sleep apnea

2008-05-08T12:55:00.000-07:00

The American Heart Association has issued consensus guidelines for treating resistant hypertension, a common, difficult-to-manage condition. Hypertension is called resistant if a patent's blood pressure remains elevated despite taking three medications to lower it, guideline chair David A. Calhoun, M.D., of the University of Alabama , and colleagues reported online in Hypertension. Resistance is also established if hypertension is controlled but it's taken four or more drugs to get there.

The committee's diagnostic advice:
1. Confirm treatment resistance. In addition to use of medications as noted above, office blood pressure, taken with good technique, should be greater than 140/90 or over 130/80 in patients with diabetes or chronic kidney disease;
2. Rule out the "white-coat effect" by use of ambulatory monitoring, if necessary;
3. Identify and reverse contributing lifestyle factors, such as obesity, physical inactivity, excessive alcohol ingestion, high salt and low-fiber diet;
4. Discontinue or minimize interfering substances, such as non-steroidal anti-inflammatory agents, diet pills, decongestants, stimulants, oral contraceptives, licorice, and ephedra;
5. Screen for secondary causes of resistant hypertension, such as obstructive sleep apnea, renal artery stenosis, primary aldosteronism, Cushing's syndrome, aortic co-arctation, and pheochromocytoma.

Our office treats many patients with obstructive sleep apnea. Typical symptoms include daytime sleepiness, falling asleep when you shouldn't, or a headache upon awakening in the morning. Patients with sleep apnea typically have snoring and sleeping partners may observe pauses in the breathing pattern. If any of these apply to you, then the only way to diagnose this condition with certainty is with a sleep study.

The new signs are up! The new signs are up!!

2008-04-09T14:01:00.000-07:00

We should now be a little easier to find as our new signs are up. We have signage on the front of the building facing the parking lot as well as on the side of the building which faces Exposition Blvd. Hopefully this will make us easier for you to locate!

Where are you guys, anyway?

2008-04-09T13:58:00.000-07:00

One of the problems with a brand new office development is that we do not yet show up on any of the Internet map sites or in your GPS navigation system. If you follow those you will be taken to the wrong place. We are across Exposition Blvd from REI and Costco. There are 7 new buildings and we occupy the only 2 story building. We are next to the railroad tracks.

New building, new blog, new year

2008-04-07T11:19:00.000-07:00

Now that we are finally ensconced in our new building (the signs are even up) and everything seems to be working we have decided to update our website. Nowadays that seems to mean having a blog. We felt that there are many things that may be of interest to our patients that may not even directly relate to ENT (the osteoporosis and sleep apnea connection, for example). Placing these on our website did not seem totally appropriate so what better way to share this information than with a blog... Stay tuned.

This would seem like a good place to reiterate our disclaimer:

Please note that this website provides information of a general nature. It is not intended to create a doctor-patient relationship. We cannot respond to inquiries requesting specific advice on patient care. The information presented is not intended as a substitute for consultation with a doctor.