Bee Sting Pain Worst on the Nose (Even More Than the Scrotum and Nipple)

Image by Waugsberg in Wikipedia

A Cornell graduate student took upon himself to figure where a bee sting hurts the most. His conclusion was the nostril... even more than the penis, scrotum, nipple, and 22 other body locations. Each body location was stung 3 times for consistency. [link]

He also determined that the three least painful locations to be the skull, middle toe tip, and upper arm (all scoring a 2.3 out of possible 10). The three most painful locations were the nostril, upper lip, and penis shaft (9.0, 8.7, and 7.3, respectively). Pain was rated on a 1–10 scale relative to an internal standard, the forearm.

The complete list of body locations in rank order can be found here.

Of course, this study was conducted on only one subject (the author) and as such, conclusions may not be entirely valid if done on a larger group of people.

However, I'm not sure how many people would volunteer for this kind of study and it is doubtful IRB would approve of any proposed study that would deliberately sting volunteers to various parts of the body including the genitals.

This may be a "one-of-a-kind" study.

Reference:
Honey bee sting pain index by body location. PeerJ 2:e338 http://dx.doi.org/10.7717/peerj.338

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LeBron James and His Broken Nose

LeBron James suffered a broken nose. He first broke it Feb 2014 when playing against Oklahoma City. He than got hit to the nose again (while wearing a mask) when playing against Houston in March 2014. [link]

Regardless of whether you are an NBA player or not, treatment of most nasal and even facial fractures do NOT require surgical repair.

The key elements that lead towards a decision for facial and/or nasal fracture surgery are the following (not all-inclusive, but general pointers):

- Any functional deficit (i.e., inability to open and close the jaw)
- Change in occlusion (the way teeth come together).
- Double vision (blurry vision does not count).
- Cosmetic deformity due to nasal/facial fracture (bruising and swelling does not count).
- Nasal obstruction not due to swelling.

In any case, when a nose is broken, steps should be taken to further minimize trauma to the nose. For athletes, that usually means wearing a facial mask such that any hits to the face does not connect with the broken nose.

Although LeBron James had his facial mask custom made by Marvel, for us mere mortals, you can buy one on Amazon.

Source:
Just like every other superhero, LeBron has his Kryptonite. Fox Sports 3/5/14

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Normal Appearance After Turbinate Reduction

Normal mucosal blistering (turbinate reduction
done only on right side)

Often, patients become disturbed with the way the inside of their nose looks after a turbinate reduction to improve nasal breathing. However, many of the concerns are unfounded and the appearance though disturbing, is actually normal. It usually takes a FULL 2 weeks for the turbinate mucosa to heal to a more normal (and reduced) appearance. It is around 2 weeks that nasal breathing also markedly improves.

In any case, during the first week, white plaques that may appear on the turbinates (picture below) are actually scabs which when wet turn white. It should be wet (and white) due to the regular use of saline nasal spray and/or flushes along with normal nasal secretions.  The turbinate mucosa may also occasionally even blister (picture above/right) producing a pale appearance like the inside of a grape. These are pictures of what the inside of the nose may look like about 5-8 days after a coblation turbinate reduction.

Be assured that such appearances are NORMAL and will typically resolve to a more normal appearance 2 weeks after the procedure. At that time any residual scabbing is typically removed.

White eschar/plaques (normal).

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Why Do Babies Hate Getting Their Nose and Face Wiped???

I have often been asked this question by parents... and even more so by my wife as we try to clean the snot off our little kids' noses as they shriek as if we're torturing them.

Given it seems ALL young kids have this nose-wiping aversion across cultures and racial ethnicities, it would seem that this reflex reaction is hard-wired into human babies. But why would evolution favor this reaction?

I tried to find an answer to this question to see if any bright researchers actually studied this topic, but was unable to find any. So... here are my thoughts on this topic.

To warn other healthy humans

Evolutionarily, it may have been helpful for the human population as a whole if it was obvious to others when an individual was sick. To see a toddler with snot running out the nose, that would have been a pretty clear sign for other children and their parents to stay away lest they also get sick. This isolation of a sick child would have been nature's way of quarantining to prevent spread of illness to the rest of the human group.

To get eaten by predators

Not to be morbid, but predators tend to feed on the sick. It is nature's cruel way of removing the weakest in an animal population which over time will only strengthen the prey animal population as a whole (Darwin's theory of only the fittest survive). Back in the REALLY old days (caveman era), sick humans would have been just such a prey that would have been targeted by wild predator animals. To be not just a young human, but one that also shows signs of illness would be indicators to a predator of who to go after.

Protect the airway

This is my wife's favorite theory who feels the last idea to be horrible and inhuman (never mind that just because evolution is horrible and inhuman does not make it false). This airway idea is based on the fact that breathing is essential to life. Anything that covers the nose or mouth, even briefly, is a potential hazard that may lead to death. Evolutionarily, this reflex would be favored and strengthened over time... even if avoidance involves just a quick wipe. Who knows? Perhaps SIDS (Sudden Infant Death Syndrome) would be much more prevalent if the nose/face wipe aversion was not present.

Any other ideas? Even better, does anybody know of any studies that actually looked into this topic?

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The Nose is a Jungle of Germs (even in Normal Healthy People)!

A fascinating study was conducted by Stanford researchers on the amount and types of germs found inside the nose in normal healthy individuals, whether they are staph carriers or not.

In a typical nose in a healthy individual without any symptoms, the following "germs" can be found. Keep in mind that ALL these germs have the potential to cause a pathological sinus infection:

• Corynebacterium
• Propionibacterium
• Escherichia-Shigella
• Staphylococcus aureus (including MRSA)
• Staphylococcus (other species)
• Dolosigranulum
• Tomitella
• Moraxella
• Actinobacteria
• beta-Proteobacteria
• Prevotella
• Anaerococcus
• Streptococcus
• Peptoniphilus
• Variovorax

These germs were found not just in the nostril, but also on the middle turbinate located about 1-2 inches into the nose and the sphenoid recess located in the very back upper part of the nose (about 3+ inches into the nose).

The top 2 most common germs found in healthy individuals were corynebacterium and propionibacterium. When these bacterial populations decrease, the presence of staphylococcus increases.

Staphylococcus was also found not just at the nostril where cultures are most commonly obtained, but in both much deeper locations within the nose.

This may explain why in spite of aggressive whole body MRSA body hygiene management and use of bactroban ointment to the nares not uncommonly fails to eradicate staph/MRSA in susceptible patients.

Clearly, more research is needed, especially in how to minimize/eradiacate staph colonization beyond the nostril (but allow for normal, healthy bacteria to remain).

Source:
Staph Germs Hide Out In The Hidden Recesses Of Your Nose. NPR 12/11/13

Reference:
Nasal Microenvironments and Interspecific Interactions Influence Nasal Microbiota Complexity and S. aureus Carriage. Cell Host & Microbe, Volume 14, Issue 6, 631-640, 11 December 2013

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Allergy Sufferers also Have More Severe Migraines

Many people suffer from migraines. Many people also suffer from allergies. What may have been suspected but is now clarified is that those individuals who suffer from BOTH allergies and migraines have much more frequent and severe headaches than those who do not have allergies. [link]

Based on a survey response from 5,849 patients who suffer from migraines, over two-thirds also suffered from allergies. From this group, researchers found that the odds of experiencing more frequent headaches for individuals with allergies and migraines were 33 percent greater than those suffering from migraines without allergies.

When patients were further subdivided based on the type of allergy they had (allergic, non-allergic, or both), those who suffered from both allergic and non-allergic had the most frequent and severe headaches.

Although there appears to be an association between allergies and migraine severity, the question now becomes whether the migraines themselves increase sino-nasal symptoms OR does the sino-nasal symptoms of allergies aggravate or trigger the migraine.

Based on a prior study, it is known that migraine patients under 45 years with allergies who received allergy shots had 52% less frequent and severe headaches than those who did not receive allergy shots. As such, it may be worthwhile to aggressively treat any sino-nasal symptoms in patients who suffer from migraine headaches. Such treatment may involve not just medications, but even surgery if anatomic trigger points are seen.

References:
Chronic rhinitis and its association with headache frequency and disability in persons with migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study. Cephalalgia. Published online before print November 25, 2013, doi: 10.1177/0333102413512031

Allergy and immunotherapy: are they related to migraine headache? Headache. 2011 Jan;51(1):8-20. doi: 10.1111/j.1526-4610.2010.01792.x. Epub 2010 Nov 4.

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ENT Doctor iPhone App Games

This was bound to happen sooner or later… thanks to @hobsonent who brought this to my attention.

This Nose Doctor iPhone app game basically is to try and remove nasal hair as well as boogers from different characters' noses using different instruments.

Another iPhone app game is Ear Doctor which deals more with ear problems (obviously).

Although these iPhone apps makes a game out of it, do ENT doctors actually professionally remove boogers, earwax, and nasal hair? We do… Regularly… For real… We are indeed professional ear and nose-pickers.

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Death From a Severe Nosebleed

Image by RIs from Wikipedia

Attila the Hun was one of the most feared enemies of the Roman Empire. Ruler of the Huns from the year 434 until his death in 452, his empire stretched from Ural River to the Rhine River and from the Danube River to the Baltic Sea.

Although there are numerous theories as to how he died, the conventional account is that he died from a severe nosebleed on his wedding night.

Some may scoff that only people in historical times die from nosebleeds... but it unfortunately still even happens in the present.

Yes... a life-threatening nosebleed can be fatal whether a historical figure like Attila or a modern day individual. And I am talking in people who are otherwise completely healthy (no hemophilia, ITP, Osler-Weber-Rendu, etc).

Indeed, a Seattle lawyer died from a nosebleed in 2008.

Two British individuals died from a nosebleed in 2008 and in 2011.

And those are just the ones that are reported in the media.

It is estimated that in 1999, 4 out of 2.4 million deaths in the United States was due to a nosebleed [link].

Fatal nosebleeds in a normal healthy individual are almost always due to an arterial bleed, notably the sphenopalatine artery located in the back of the nose. Other less common fatal nosebleeds may be attributable to the ethmoid arteries located in the top of the nasal cavity.

Treatment of such life-threathening nosebleeds depends on the situation, but may include:

• Nasal packing
• Embolization
• Surgical

Cautery as shown in the video below is rarely successful.

Sources:
Man died after suffering two-hour nose bleed. Mirror News 11/24/11

Man Dies From Severe Nosebleed. ABC News 12/2/11

Woman sues hospital after her husband dies of nosebleed. KOMONews 5/4/13

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Popular Nasal Decongestants Associated with Birth Defects

Researchers have discovered that there is a very small, but significant association between birth defects and use of nasal decongestants in the first trimester of pregnancy. Unfortunately, decongestants (ie sudafed, afrin, etc) are also one of the most popular medications purchased over-the-counter to treat symptoms of nasal congestion, runny nose, and allergies.

In particular, three strong associations were found:

• Phenylephrine and endocardial cushion defects
• Phenylpropanolamine and ear defects
• Phenylpropanolamine and pyloric stenosis

Although these associations were related to ORAL decongestant use and first trimester intake, it was also found that intra-nasal decongestant use during the first trimester was associated with pyloric stenosis and tracheo-esophageal fistula.

Taken in summary, it is perhaps ideal that women in their first trimester of pregnancy avoid decongestant use due to a possible association between birth defects and medication usage. This association accounts for a VERY small percentage increase in birth defects and as such more study is needed.

For example, the baseline prevalence of endocardial cushion defect is 0.34 per 1,000 live births. Phenylephrine exposure increases this risk 8-fold resulting in 2.7 per 1,000 live births. That's an overall increased risk of only 0.27%.

Keep in mind that all these over-the-counter products contain a decongestant ingredient:

• Afrin
• Sudafed
• Tylenol Cold Multi-Symptom Nighttime
• Alka-Seltzer Plus Cold
• Delsym Night Time Multi-Symptom
• Tylenol Cold Multi-Symptom Severe
• Tylenol Cold & Flu Severe
• Vicks Dayquil Cold & Flu Relief
• Benadryl Allergy Plus Sinus Headache
• Theraflu Warming Relief Nighttime Severe Cold & Cough
• Vicks Nyquil Sinus
• Acutrim
• Dexatrim
• Afrin
• Zicam
etc, etc, etc

So what is a pregnant woman to do if her nose gets all stuffed up and wants to avoid decongestant medications to eliminate any possible risk of birth defects? Click here for some suggestions.

Source:
Use of Decongestants During Pregnancy and the Risk of Birth Defects. Am. J. Epidemiol. (2013) doi: 10.1093/aje/kws427

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New Movie Trailer for Fauquier ENT YouTube

It has been an amazing experience with how successful our videos have been on YouTube. We now have 60+ different videos of ENT procedures that has been viewed over 247 million times since 2007. We also now have over 12,300 subscribers to our video channel.

To celebrate, a movie trailer of sorts has been created to introduce new viewers to the sort of videos they will see and will continue to see from us.

Check it out! And... if you haven't yet subscribed to our video channel, please do so!

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Fecal Transplantation Administered Through the NOSE!

Fecal transplant is nothing new as it has been around since the 1950's... It is used to treat multi-drug resistant clostridium dificile infection by replacing the "bad" gut bacteria with normal "good" bacteria. However, what is new is the fact that such fecal transplantation is being administered through the nose using a tube threaded into the small bowel. [Thanks to @GuildfordENT who brought this to my attention!]

Historically, such fecal transplantation (aka fecal bacteriotherapy) was performed via multiple infusions via enema (uncomfortable for both the physician as well as the patient) or via colonoscope. Although first described being done in humans in 1958, it was never really seriously studied until the mid-1980's. Even before humans, it had been performed in animals by veterinarians for centuries.

In any case, there has been new literature supporting the use of nasoduodenal tubes to administer poop via the nose. With nasoduodenal tubes, a tube is threaded through the nose, past the stomach, and into the small bowel.

Now keep in mind that the stool actually NEVER comes into contact with the nose. It is contained within an impermeable tube at all times, so it is not quite as gross as you might think (though mentally, there may still be an emotional ick factor present).

Another approach being considered is encapsulating the poop inside enteric-coated capsules so a patient can theoretically swallow the pill-containing poop.

Media Mention:
Doctors save patient from deadly superbug by transplanting faeces through his NOSE. MailOnline

Reference:
Duodenal infusion of donor feces for recurrent Clostridium difficile. New England Journal of Medicine. 2013 Jan 31;368(5):407-15. doi: 10.1056/NEJMoa1205037. Epub 2013 Jan 16.

Same poop, different gut. The Scientist 11/3/105/2/13

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How the Voice Anatomically Reverberates to Produce Speech

Came across this old school animation showing how sound produced in the voicebox reverberates in the upper airway, mouth, and nasal cavity to produce speech that everybody else hears.

To watch what it looks like from the inside, check this video out.

Source:

FFFFound! 5/23/11

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The Facial Triangle of Danger (Even Death)

Image by SpooSpa from Wikipedia

If you draw a line between the eyebrow to the corners of the lip, a triangle is created which delimits a region esoterically known as the "danger triangle".

Why is this region considered dangerous?

It's because infections within this region can lead to infections of the brain (rarely). Why? The blood supply within this triangular area communicates with the cavernous sinus found at the bottom of the brain. This anatomic structure is a major source of venous drainage of the brain.

If the cavernous sinus gets inflamed/infected due to a rip-roaring pimple of the upper lip, it could lead to multiple facial abnormalities due to injury of the numerous cranial nerves that go through it including:

• Inability to move the eyeballs (CN3, 4, 6)
• Numbness, pain of the skin over the forehead and cheeks (CNV1, V2)
• Loss of pupillary constriction (CN3)
• Visual loss/changes (CN1)

The cavernous sinus could also become thrombosed.

Cavernous Sinus shown by red arrow. Taken from Sonoworld.

From there, the infection can spread to the rest of the brain and potentially can even lead to death if not treated promptly and aggressively.

Of course, tiny infections like a small pimple or a small laceration due to biting a lip is not going to cause problems.

However, rapidly progressive major infections of the skin with abscess formation do need to be treated cautiously.  Typically, such patients are hospitalized on IV antibiotics until definite and significant improvement can be seen at which time patients can be discharged home on oral antibiotics.

At which point a "minor" infection becomes "major" requiring hospitalization is a judgement call.

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Pencil Drawings of the Aging Ear, Nose, and Mouth

Came across these beautiful pencil drawings of a collection of 60 ears, noses, and mouths arranged chronologically from ages 16 to 90.

Drawn by Shawn Feeney, you can purchase your own 15" x 9" copy from his website.

Check it out!

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"Mother's Kiss" to Remove Nasal Foreign Bodies

In 1965, a general practitioner Vladimir Ctibor described the "Mother's Kiss" technique of removing nasal foreign bodies in a child.

Essentially, a trusted adult (like a mother) places her mouth over the child's mouth as if to perform mouth-to-mouth resuscitation. While pinching off the unaffected nostril, the adult than blows gently into the child's mouth until resistance is felt caused by the child closing the glottis. At that moment, the adult gives a sharp explosive exhalation to deliver a strong puff of air that passes up into the nose and out the unblocked nostril. If successful, this air puff will also blow the foreign body out the nose as well.

If the adult blow's air when the child's glottis is open, air will just go into the lungs rather than up the nose.

Prior to the procedure, the child is informed that the mom will give the child a "big kiss," hence the name of this procedure.

Now... does this technique actually work?

According to one meta-analysis, it works about 59.9% of the time.

The way I consider it... it can't hurt to try before using instruments to manually remove the nasal foreign body. A "mother's kiss" is certainly a more comfortable and familiar approach for a child versus the alternative.

However, one warning point... the child should be calmly breathing during this procedure. If the child becomes hysterical during the procedure, the child might strongly inhale through the unblocked nostril and potentially suck the foreign body (if small enough) down into the lungs making an unlucky situation into a medical emergency.

Another point for those uninformed... do NOT use this procedure on ear foreign bodies. It will NOT work. The ear canal is a closed container with no inlet or outlet for any air pressure produced by a "Mother's Kiss." In fact, trying to perform this procedure on the ear may cause a ruptured eardrum and even permanent hearing loss.


Reference:
Removal of Foreign Bodies from the Nose. NEJM 1985; 312:725.

Efficacy and safety of of the "Mother's Kiss" technique: A systematic review of case reports and case series. CMAJ 2012. DOI:10.1503/cmaj.111864 (full length pdf)

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Why Does Burping after Drinking Soda Burn the Nose?

I do not believe this question has actually been scientifically studied... but I can hazard a guess.

Sodas are those flavored fizzy drinks like Coca-Cola and Pepsi.

The "fizziness" is due to carbonation or carbon dioxide dissolved within the drink. When sodas are made, carbon dioxide is forced into the liquid under pressure so that there's more gas dissolved in the liquid than at regular air pressure. The bubbles you see and feel is caused by the carbon dioxide gas being released back into the air when exposed to back into regular air pressure (a closed can or bottle keeps the carbon dioxide under pressure within the liquid).

Such machines can even be purchased to make sodas at home (see below).

A soda becomes flat when all the carbon dioxide has been released back into the air.

In any case, why the burn?

Carbon dioxide (CO2) and water (H2O) together undergo a chemical reaction to form a very weak acid  called carbonic acid (H2CO3).

CO2 + H2O <--> H2CO3

So, after drinking some soda, the CO2 that is released reacts with the water inside your mouth, throat, and belly. The resulting carbonic acid, some of which is aerosolized, can than be burped up into the nose.

The nasal lining is quite sensitive, and when in contact with carbonic acid, can cause a burning sensation.

Now... does this actually happen?

Well, sounds like a potential neat research project that can potentially even be done by a high school student.

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Spider Found Living in Woman's Ear for 5 Days

Thanks to @beubank for alerting me to this story about a spider who lived in a woman's ear for 5 days before being removed. As an aside, in typical media blunder of factual error, in the Huffington Post, a picture is shown of the spider stating an "x-ray photo"... COME ON!!! The picture is NOT an x-ray in any way shape and form!!! It's just a regular ordinary picture one takes with a camera.

On that note, August 9, 2012 must be the time for all media to report on all sorts of things found in people's ears and noses.

Fox News reported on a story about a lego being stuck inside a kid's nose for 3 years.

In the past year, I must have removed several cockroaches, ticks, rocks, pebbles, play-doe, paper, cotton, and even one moth. Never a spider however.

In perhaps one of the most impressive arrays of foreign objects removed from the ear, nose and throat (I believe in the thousands) is on display at the Mutter Museum in Philadelphia. All objects were removed by a single ENT (Dr. Chevalier Jackson). If you are ever in Philadelphia, this museum is a must see.

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Nasal Congestion or Obstruction During Pregnancy

When a woman becomes pregnant, it is not unusual for the nose to become quite congested... uncomfortably so, even to the point of being unable to breath through the nose.

This condition known as "rhinitis of pregnancy" affects as many as 30% of pregnant women and can start in the second month of pregnancy; it tends to worsen later in pregnancy. The nasal congestion should ease up soon after giving birth and be gone completely within two weeks after delivery.

The nasal congestion occurs due to elevated amounts of estrogen causing swelling of nasal mucous membranes. Furthermore, there is a marked increased in circulating blood in the body which also leads to swelling of the tiny blood vessels lining the nose. Bloodflow causing nasal obstruction (turbinate hypertrophy) is not unusual and even occurs in men (laying down on one side causes nasal obstruction that than switches when laying down on the other side; improves when sitting/standing).

On exam, a common finding are large inferior turbinates. Inferior turbinates are soft tissue outpouchings within the nose that warm and humidify the air as nasal breathing occurs. Normally, they are quite small, but with rhinitis of pregnancy, they can become enormous... even quadrupling in size.

Inferior Turbinates Seen on Exam

Generally speaking, my approach to treating this uncomfortable condition is as follows (assuming all other causes are ruled out and no medical contraindications):

1) Regular HYPER-tonic saltwater nasal irrigations to the nose 3-4x per day. I recommend HYPER-tonic saltwater rather than regular strength saltwater. Why? Salt sucks moisture out of the nose. With regular strength saltwater (aka, normal saline), the saltwater concentration is equal to that found within the body and minimal if any moisture displacement (osmosis) occurs. With HYPER-tonic saltwater, given the increased salt concentration compared to that found within the body, moisture leaves the nose allowing for decongestion to occur.

Nasal irrigations can be performed with Neti Potor NeilMed Sinus Rinse Bottle. Hypertonic salt packetscan be purchased and mixed with 8 ounces distilled water. Or, if you want to make it yourself, 1/2 to 3/4 teaspoon of salt and 1/4 teaspoon of baking soda in 8 ounces of distilled water.

2) Rhinocort AQ (prescription) steroid nasal spray 2 sprays on each side daily. Steroids help to decrease swelling, especially the large inferior turbinates. This steroid nasal spray is the ONLY steroid nasal spray that is Class B for pregnancy.

3) Keep the head elevated when you lie down. This reduces the blood flow to the nose which exacerbates the nasal congestion.

Of course, steps 1 and 2 assume that there is SOME room for the treatment to occur. If the nose is 100% blocked up, use over-the-counter Afrin nasal spray a few times to get things to open up (never more than 3 days). Once opened up some, immediately start #1 and 2. It is not healthy nor wise to use afrin too much. Ideally, it may need to be used for 1 day only and no more thereafter. There is also some concern that decongestant use during only the first trimester may cause some birth defects (read more). Even in non-pregnant individuals, afrin should never be used more than a few consecutive days otherwise risk addiction!

Response to treatment typically occurs within 2 weeks.

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Lithium Disc Battery Danger for Kids (and Hot Dogs)

In the last 10 years, 13 deaths related to swallowed batteries have been reported, 12 of which were due to disc batteries (20 millimeter lithium cells).

The danger is that when a disc battery is inserted into a nose (for example), a localized electric current is created between the positive and negative poles of the battery within the nose. This electric current basically "electrocutes" the lining inside the nose leading to tissue damage and ultimately necrosis (tissue death) within an hour. The same applies even if the battery is swallowed or put into the ear canal.

When swallowed, it can burn through the esophageal/intestinal lining causing a perforation which can lead to death if not promptly treated (or even in spite of it if too much time passes before treatment).

Treatment is IMMEDIATE removal... as soon as possible. Regardless of the day or time. STAT...

For illustrative purposes, lets see what happens to a hot dog when a lithium disc battery is placed inside it. This example was created by Dr. Stephen Marcus who is the director of the New Jersey Poison Information Center and published in the Pediatrics Blog here. You can also do this at home... give it a try (make a slit in the hot dog and push a lithium button battery into it... than watch).

Just 3 hours later, this is what you would see...

Keep disc batteries away from kids!!!

Please!!!

References:
A lithium battery in a hot dog is no picnic. Pediatrics Blog 7/2/2012

Pediatric Battery-Related Emergency Department Visits in the United States, 1990–2009. PEDIATRICS Vol. 129 No. 6 June 1, 2012 pp. 1111-1117

Preventing Battery Ingestions: An Analysis of 8648 Cases Published online May 24, 2010 PEDIATRICS (doi:10.1542/peds.2009-3038)

A Review of Esophageal Disc Battery Ingestions and a Protocol for Management Arch Otolaryngol Head Neck Surg. 2010;136(9):866-871. doi:10.1001/archoto.2010.146

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Bacon Can Stop Nosebleeds! No joke...

When I saw this research, I had to re-read it to believe it... Nasal packing with good-old fashioned bacon stops nosebleeds!!!

Yes... you heard me correctly... and it was actually published in a reputable ENT journal in Nov 2011. AND, it was conducted here in the USA (Detroit, Michigan).

"Cured salted pork crafted as a nasal tampon and packed within the nasal vaults successfully stopped nasal hemorrhage promptly, effectively, and without sequelae … To our knowledge, this represents the first description of nasal packing with strips of cured pork for treatment of life-threatening hemorrhage in a patient with Glanzmann thrombasthenia."

The current standard of care for nasal packing to treat nosebleeds is using synthetic hemostatic products that appear similar to tampons used for menstruation.

However, this publication in 2011 wasn't the first to document use of bacon for nosebleeds.

There have been reports on use of bacon since 1940 sporadically (see references below).

In this day and age of cost-cutting and finding cheaper alternatives, bacon is pretty much as cheap as one can go to address nosebleeds. Compare this to synthetic nasal packing which costs on upwards of $50 or more.

Read more about nosebleed management.

Another unusual nosebleed management includes the application of female hormone estrogen (vaginal premarin cream) to the nasal mucosa.

Traditional nosebleed treatment includes nasal emollient application, humidification, nasal cauterization, septoplasty, and eventually nasal packing.

References:
Nasal Packing With Strips of Cured Pork as Treatment for Uncontrollable Epistaxis in a Patient With Glanzmann Thrombasthenia. Ann Otol Rhinol Laryngol 2011;120:732-736.

Rendu-Osler-Weber Disease— Is Embolization Beneficial? Arch Otolaryngol. 1976;102(6):385.

GENERAL PRINCIPLES IN TREATMENT OF NASAL HEMORRHAGE. AMA Arch Otolaryngol. 1953;57(1):51-59.

USE OF SALT PORK IN CASES OF HEMORRHAGE. Arch Otolaryngol. 1940;32(5):941-946.

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