Can You Hear Me Now?

... If you use that cell phone too much, you might not be able to hear me later.

American Academy of Otolaryngology-Head and Neck Surgery Foundation’s Annual Meeting & OTO EXPO
http://www.entnet.org
Sept. 16-19, 2007
DC Convention Center

Who: 10,000 medical experts who know what’s going on in your head, ears, nose, and throat -- and that pain in your neck.

Insider insights:

* Hold the Phone. Long-term use of cell phones may cause inner ear damage and can lead to high frequency hearing loss, according to a new study. In a study that tracked 100 mobile phones for a year found increases in hearing loss. Also: those using cell phones 60-plus minutes a day had a worse hearing threshold than those with less use.

High frequency hearing loss is characterized by the loss of ability to hear consonants such as s, f, t, and z, even though vowels can be heard normally. Consequently, people hear sounds but cannot make out what is being said.

Recommendations: Watch for symptoms such as ear warmth, ear fullness, and ringing in the ears (tinnitus) as early warning signs of auditory problems. Consider using earphones, found by researchers to be safer than holding a mobile phone up to the ears.
Study: Audiological Disturbances in Long-Term Mobile Phone Users. Conducted by Naresh Panda,, Sanjay Munjal,, Jaimanti Bakshi.

* Hump Be Gone: What question do rhinoplasty doctors hear most from patients who need medically necessary nose surgery for health conditions and injury? “While you’re at it, doc, can you get rid of my hump?”

* Voice Lessons from Superstars: Among dozens of fascinating wisdom from this expert panel of doctors and vocal coaches who work with rock stars, opera masters and top theater performers: While it’s good to keep hydrated, continually swigging of bottled water actually throws the throat’s delicate moisture balance off-kilter. Washing away mucous affects the voice – among modern occupational risks faced by singers, actors and other performers.

* To Tube or Not to Tube: Media reports based on outdated studies have conveyed the misimpression that tube-insertion treatment of children suffering from ear infections is ineffective.
One researcher reported study results suggesting the usefulness of antibiotics in treated acute otitis media in young children, but that those beyond age 2 can benefit from a “wait-and-see approach.” Parents of children having speech and language problems reported improvements after tubes were inserted, while parents of children without developmental problems generally did not.

Another researcher noted that the decrease in use of antibiotics for trating otitis media has helped reduce the need to insert tubes. Attendees were reminded that the overuse of antibiotics leads to the individual – and international – problem of drug-resistant microbes.

* Snore-Free without Surgery: 45% percent of adults snore occasionally and 25% are habitual snorers. Snoring can cause sleep deprivation for the snorer and lead to daytime drowsiness, irritability, lack of focus, and decreased libido. Treatments include weight loss, use of specialized devices and surgery.

New study results suggest dental splints can be more effective than breathing mask. For many people, disruptive snoring can be managed effectively without surgery.

* Hum to Easily Diagnose Hearing Loss: Hearing evaluations usually employ the Weber tuning fork test: The tuning fork is hit, causing it to vibrate, then placed on the midline forehead. Patients are asked if the sound forms in only one ear, or is midline. Those with normal hearing hear the sound in the midline, but some forms of hearing loss will cause the sound to be heard predominantly in one ear.

But now there’s a test that people can do at home. New research shows that the hum hearing test is a reliable alternative to the fork. The test involves simply humming to oneself, determining if the hum is heard in one ear, or in the middle.
The hum test requires just minimal instruction and no instruments, so it can easily be conducted at home, eliminating needless office visits. Diagnosis can be made over the phone by an otolaryngologist or even the family physician.

* Taking Things at E-face Value: New research concludes that using internet-based facial beauty rating can aid beauty analysis - a boon to plastic and reconstructive surgeons.

* Polluting Sense of Smell. Based on a study of 211 subjects measured using a computer-driven olfactometer, olfactory receptors suffer pathological effects when exposed to air pollution.

* Asthma-Tonsil Connection: A new study found a reduction in asthma symptoms following tonsil/adenoid removal surgery.

* Changing Reasons for Tonsillectomy: Historically, tonsils have been removed in kids with chronic throat or tonsil infections. A new study reveals new reasons that have emerged since the 70s, primarily sleep-disordered breathing (snoring, restless sleep, obstructive sleep apnea).

In 1970, 9 out of 10 tonsillar surgeries were done because of infection; in 2005, only about 3 in 10 surgeries were done exclusively for infection. Girls aged 18-22 were 3 times more likely than boys to have chronic infections that required the surgery. The findings suggest that more than ever, parents and physicians are recognizing the signs and symptoms of sleep-disordered breathing in children and are opting for surgery as their treatment of choice.

* Rhinosino-Asthma Connection: Doctors reported on the implications of research proving a link between rhinitis, sinusitus and asthma. Nasobronchial reflex – mechnical, chemical or allergic irritation – cause broncho-constriction. Chronic rhinitis (inflammation of the nasal mucosa) affects more than 50 million Americans and accounts for 20 million doctor visits a year. The forum stressed the need to evaluate both upper and lower respiratory systems – and to persuade asthma patients to manage their symptoms, since asthma “remodels the lung,” causing irreversible damage. If you’re awakening from sleep due to asthma symptoms and/or using bronchial dilator such as albuterol 2 or more times a week, the condition “must be brought under control” with regular use of anti-inflammatory meds such as inhaled corticosteroids, leukotriene modifiers, and, in rare cases, mast cell stabilizers – not only the brochodilater – to avoid damage.

As for sinitis, sprays are being recommended to irrigate the nose. Note that old-school antihistamines cause problems because they throw off the mucosal balance.

* Doing the Right Thing ... in Otolaryngology: Dr.Serge Martinez, Professor of Surgery and Ethics at the Institute for Bioethics, Health Policy and Law at the University of Louisville School, examined ethical behavior in an age of plentiful, deep-pocketed and powerful Big Pharma representatives. What should a doctor or researcher do when offered all-expenses-paid attendance at professional events? Lucrative speaking opportunities? An exciting deep-sea fishing trip with the only attached string of hobnobbing with drug reps? Doctors claim that such inducements do not result in changed therapies, prescriptions, regimens. But some studies have suggested that even low-value freebies such as logo-stamped Rx pads exert subtle influence.

Dr. Martinez referenced a June 27, 2007 New York Times article revealing: “...psychiatrists earned on aggregate the most in Minnesota, with payments ranging from $51 to $689,000. The Times found that psychiatrists who took the most money from makers of antipsychotic drugs tended to prescribe the drugs to children the most often.” And, “Over all last year, drug makers spent $2.25 million on marketing payments, fees and travel expenses to Vermont doctors, hospitals and universities, a 2.3 percent increase over the prior year, the state said.”

Education is often given as a reason to accept drug company offers. However, Dr. Martinez noted the distinction between “education” and “information” -- and how they influence decision-making on conscious and subliminal levels. Sometimes, even a most educated person can get sucked into a web of hyperbole.

So how can doctors strike a more ethical balance and learn about new drugs, tools and therapies while resisting undue influence? Rx for resisting drug makers’ influence include:

Legislation to restrict drug company offers to medical personnel. New legislation is being formulated in Vermont, Maine, Wisconsin, West Virgina and DC.

Restrict drug rep access.

Designate a special area within hospitals for demos of drugs and devices.

Physicians must think each time they write a prescription. Is this the best course for the individual patient? Patients can ask, similarly, what are the alternatives, be it generic medications or alternative therapies, and why is the one being recommended in their case.

More info:

http://www.nytimes.com/2007/06/27/health/psychology/27doctors.html?ex=1190174400&en=3f26489c9400c851&ei=5070

http://louisville.edu/bioethics/faculty/faculty-pages-bios/martinez.htm