Monthly Archives: October 2015

Middle Ear Treatments

There was an interesting study on the middle ear volume, and it ended up being about 1.4 ml in non diseased individuals. In reality, you rarely get a full ml of fluid into the middle ear when you inject it. There is a number of reasons we put medications directly into the middle ear, such as Meneir’s Disease, sudden sensorineural hearing loss, etc… We are typically using an anti inflammatory such as dexamethasone or an ablative medication such as Gentamycin. Sometimes we combine the agents. When I use the Dexamethasone, I do no dilute, and I put in as much as the middle ear will handle. I typically anesthetize the ear with phenol or EMLA and have patient stay laying in the injection position without swallowing for 20 minutes if possible.

Moisturizing Nasal Treatments

Tongue Tie (Ankyloglossia)

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I am reposting this because of a social media interest in what is termed “posterior tongue tie”. It is described as a fibrous banding deep in the floor of mouth that causes feeding difficulties. It seems to be a problem mostly manufactured by those wanting to exploit others. Most of us think of being tongue-tied as a situation where we find ourselves too excited or nervous to speak. Actually, tongue tie is a term for a relatively common physical condition that limits the use of the tongue, medically called “ankyloglossia”.

Before we are born, a strong cord of tissue (the frenulum) that guides development of mouth structures is positioned in the center of the mouth. After birth, the frenulum continues to guide the position of incoming teeth. As we grow, it recedes and thins.

This frenulum is visible and easily felt if you look in the mirror under your tongue. In some children, the frenulum is especially tight or fails to recede and may cause tongue mobility problems.

The tongue is one of the most important muscles for speech and swallowing. For this reason, having tongue tie can lead to eating or speech problems, which may be serious in some individuals. Posterior tongue tie is a nebulous term that lacks a clear definition or treatment.

Topical Nasal Treatments

The nasal sinuses and passages are such a unique set up. They are essentially air containing spaces lined with mucous membranes designed to warm, filter, and humidify the incoming air for our lungs. The mucous membranes have cilia on them to move the secretions back towards the throat. There are bacteria and fungi throughout the nasal cavity and sinuses termed normal flora, so the difference between infection and colonization is really detrimental symptoms.

Moisturizing Nasal Treatments

Our nose makes over a liter of secretions per day. To warm, filter and humidify the incoming air in preparation for the lungs is one of the major functions the nose is responsible for.

Bactroban (Mupirocin) ointment is a water miscible ointment that out performs all others in the anterior nose.