In late Feb 2012, Celine Dion who was to have performed in Las Vegas Feb 22, 2012, cancelled her show at the last minute at the Caesar’s Palace due to laryngitis on the advice of her doctors.
According to media reports, her doctors instructed her to rest for 7 days to ensure full recovery due to vocal cord inflammation caused by a virus.
What does that mean exactly?
When a virus infects the mucosa of the upper airway, it causes inflammation of the mucosa lining including the vocal cords. With inflammation, the vocal cords swell.
That’s why with laryngitis, the pitch of the voice decreases and it becomes more effortful to talk. To use an analogy, think of a violin string where the thicker string has a deeper pitch than a thin string. It also takes more power to play the thicker string. Watch the video below of normal vocal cord functioning:
In order for voice production to occur, the lining of the vocal cords vibrates very quickly when they come together. If the vocal cords are swollen, they don’t vibrate as easily.
Here’s what inflamed vocal cords might have looked like for Celine Dion. Note the slight bend to the vocal cords and overall dull appearance.
Below is what her vocal cords might look like when they are at peak health!
Voice rest is absolutely important for vocal recovery as quickly as possible. With talking/singing during active laryngitis, further trauma may occur to the vocal cord lining promoting even more inflammation and swelling. It may also lead to another vocal disorder known as muscle tension dysphonia.
Given newborns can not communicate whether they can hear or not, such hearing tests depend on the ability to detect nerve signals transmitting sound information from the ear all the way to the brain. This type of test is much like an EKG which can detect the electrical activity of the heart.
In the same spirit of a recent TEDMED talk by Nate Bell and re-published on CNN Jan 12, 2012 whereby he performed various beatboxing noises while stroboscopy was performed, I decided to record a similar video with a person performing various unusual human vocalizations to see what happens.
For those who don’t know what stroboscopy is, click here.
Such vocalizations recorded included various types of human screams and a yodel.
Our office has produced a new video describing “where” snoring comes from determined by a simple procedure known as sedated or sleep endoscopy.
At its most basic definition, snoring is noise produced from a vibrating mucosal surface in the upper airway.
Though snoring can be defined simply, the tough question is WHERE are these vibrating mucosal surfaces? Because unless one can define WHERE the snoring is coming from, successful treatment can’t be pursued definitively.
An office exam performed while a patient is awake is suboptimal as the patient is awake… and not snoring. As such, it is an educated guess where the snoring problem is stemming from.
To this end, there are three main levels where snoring can be produced and the best way to localize a snore is to perform the exam while the patient is asleep (induced by anesthesia) and snoring!
1) Nose
2) Mouth
3) Throat
4) All of the above
Watch the video to see how each of these areas can contribute to a person’s snore as well as treatment options.
Wellcome Film based in London has transferred numerous films dating from the early 20th century related to healthcare and medicine that anybody can view for free. Aside from the historical value, it is amazing that much of what we know and do now is not all that different than what was done in the 1920s. It makes me wonder sometimes what “progress” in healthcare actually has happened over the past century. In some things, tremendous change has occurred whereas in other areas of medicine, time might as well have stood still.
It also perhaps explains why in spite of all our “high-tech” medical equipment and sophisticated tests available in the United States that our health as a nation is still not as good as other nations without these benefits.
Take for example dizziness evaluation and understanding. Here are 3 films from 1925 that goes over dizziness evaluation and physiologic basis for it.
At its essence, nothing has really changed between 1925 and 2011. Sad really… Given this lack of progress, I would so far as to venture (with a straight face and all kidding aside) to say that American rates of dizziness is comparable to ANY other nation in the world with treatment protocols no better or worse too.
I encountered this interesting video of tonsillectomy being performed in a child with sedation (but NO intubation) performed circa 1940s.
Of course, nowadays, tonsillectomy is performed under general anesthesia with intubation for airway protection. Here’s a video of the way it is now done.
That is, unless, you practice in other parts of the world where modern medicine is not up to United States standards. In those nations, tonsillectomy is STILL being performed WITHOUT general anesthesia or any sedation for that matter. In fact, here’s a blog I wrote earlier this year showing a graphic video depicting tonsillectomy being recently performed in a young child WITHOUT any sedation.
On July 17, 2011, Animal Planet aired Swamp Wars “Snake Farm Shootout” where a video made by Dr. Chang was incorporated into the storyline. It was a VERY brief segment of this video clip shown about 30 minutes into the show; specifically, the endoscopic image of the back of the nose. Due to copyright, I can’t show the actual video clip. But, here is the video from which the segment was taken.
