Bastian Voice Institute

Damaged nerve endings in the throat can become "jittery" and "tickle" or "zing" to initiate coughing. Such a cough syndrome may persist for months, years, and even decades before the patient finally finds the correct diagnosis: sensory neuropathic cough. There are many treatment approaches, usually beginning with neuralgia medications. Although there is a list of such medications, a prominent one is gabapentin (and its cousin, pregabalin). The concept of their mechanism: they raise the threshold of aberrant firing of the damaged nerve endings, thereby diminishing the patient's coughing: https://lnkd.in/gUsZWPC2

For those suffering from Sensory Neuropathic Cough (SNC), Dr. Bastian gives a brief overview of the disorder and the current treatments available; including the use of several medications that calm down damaged, jittery nerve endings. https://lnkd.in/gPQ83rHd The attempt is to touch upon the major points: ? Explanation of "damaged nerve endings" as the cause; ? The futility of allergy, acid reflux, and asthma treatments; ? The unfrutiful "chasing of mucus;" ? The use of medications that calm down damaged, jittery nerve endings; ? And a brief description of the many current treatment options.

Last month, we were pleased to host Dr. Rodel Velasquez from the Philippines for another visitorship at our practice! Dr. Velasquez has applied many of our concepts and techniques in Laryngology (sensory neuropathic cough [SNC], spasmodic dysphonia [SD], and retrograde cricopharyngeus dysfunction [R-CPD, aka no-burp], etc.) to his country to better serve his patients. Especially notably, he has introduced the diagnosis and treatment of R-CPD to the Philippines and has built a significant caseload in Manila. He has been invited to present on the no-burp disorder to a conference of Laryngologists in New Cairo, Egypt later this month. We wish him all the best!

How does one distinguish between a mucus retention cyst and a polyp? Dr. Bastian published a new photo essay guiding the viewer through the sometimes-subtle differences: https://lnkd.in/gY5gU577

Here are true stories illustrating the "vocal vincibility syndrome." That term describes people who have self-sabotaged socially for years due to (inappropriate) lack of confidence in their voices. In both cases, they possessed normal voices but believed profoundly that they were fragile...weak...incapable...defective. You can't simply talk such individuals into believing in their voices; they must experience them as normal via "vocal boot camp."

Dr. Bastian presented a webinar on retrograde cricopharyngeus dysfunction (R-CPD) to laryngologists and speech pathologists of the University of Toronto. Thank you to Dr. R. Jun Lin, Canadian laryngology colleague, for the invitation!

A lovely story of a 4-year-old treated for R-CPD from the 2019 paper in which Dr. Bastian and PA Wingo first described the condition! BVI clinicians will soon reach 2000 patients treated! Listen for the celebration!

Dr. Luciana Fernandes Costa from Sao Paulo, Brazil spent a week at Bastian Voice Institute after attending the annual meeting (OTO EXPO) of the American Academy of Otolaryngology-Head and Neck Surgery in Miami. She observed each of our physicians work with patients with retrograde cricopharyngeus dysfunction (R-CPD), sensory neuropathic cough (SNC), singing voice disorders, spasmodic dysphonia, laryngeal cancer, and more… She also saw how we use the Integrative Diagnostic Model for diagnosing voice disorders. The entire staff of BVI enjoyed her visit!

Post-radiation telangiectasia is atypical dilation or formation of capillaries as a mid- or long-term response to radiation. These are a benign but sometimes impressive-looking tissue change: https://lnkd.in/gGAGiqb7

A 20-year-old man complains that his neck expands and that he has pain while playing the trumpet. The cause is a dilated outpouching (Pharyngocele) from the normal contour of the pharynx, which can be seen with both radiographic and endoscopic images: https://lnkd.in/gxj__ZtP