RRP is a devastating chronic infection of the larynx and sometimes trachea caused by the human papilloma virus (HPV). Until recently, RRP was thought to “always” be caused by “low risk” subtypes 6 and 11. More than 25 years ago, Dr. Bastian disputed this truism, and he and Dr. Richardson have been routinely HPV-subtyping each new patient. They learned that other subtypes could cause the same clinical scenario as types 6 and 11. And it appeared that persons with low-risk subtypes could be followed on an “as needed” basis according to voice needs, while higher-risk subtype patients should be followed on a strict schedule. Recently, their new colleague, Dr. Rebecca Hoesli, with logistical help from physician assistant Melissa Wingo, created a study from their large database of subtypes. One result is to formally dispel the common notion that RRP is “always” caused by HPV subtypes 6 or 11. (They found 11 different subtypes.) Another is to propose to colleagues who manage this disease that knowledge of specific HPV subtypes can inform clinical management of this disease. To read the entire article, See also https://journals.sagepub.com/doi/abs/10.1177/0194599820931817
Initially described by Dr. Bastian (and his first R-CPD patient, on Reddit: no-burp https://www.reddit.com/r/noburp/), inability to belch can cause the severe symptoms of socially-awkward gurgling noises, bloating, and excessive flatulence, etc. BVI clinicians Bastian and Smithson (Wingo) published a report of the first 51 such patients, all treated successfully with Botox injection into the upper esophageal sphincter. (See https://journals.sagepub.com/doi/10.1177/2473974X19834553) Drs. Bastian and Hoesli have now published the first known report of a surgical solution to this problem: cricopharyngeus myotomy. For more information, see https://journals.sagepub.com/doi/full/10.1177/2473974X20917644.
The Bastian Voice Institute remains open during the shelter at home order. We are open to seeing patients with urgent need in-person here at the office. We also offer telehealth visits for those patients who would prefer to speak to a clinician remotely. Feel free to call the office 630-724-1100 to schedule an appointment.
Dr. Bastian was recently featured in an article from The Guardian for the discovery and treatment of Retrograde Cricopharyngeus Dysfunction or The Inability to Burp. This new and ongoing treatment has been growing in numbers since our first case in 2015. Read more about it below!
Take a look at our educational website to read more about the disorder:
We would like to welcome Melissa Wingo, MS, PA-C to the Bastian Voice Institute family as our new Physician’s Assistant! Melissa will be assisting both Dr. Bastian and Dr. Richardson, and we are so excited to have her as a part of our team.
In June 2017, Dr. Bastian spoke at a Chicago Master Singers event in Palatine, IL on “How To Protect Your Vocal Health.” Drawing from his experience both in music and in the otolaryngology field, he provided an overview of the anatomy of the voice and vibratory mechanics of the vocal cords and then explained what can go wrong especially in persons who are using their voices extensively, and how to detect and respond to injury when it is early and easily-reversible.
Have you checked out BVI’s Journal of Observational Laryngology? The Journal features observations and insights gleaned from the practice of laryngology. We hope you find it both educational and thought-provoking.
This coming Friday, May 22nd, Mary Spremulli will be hosting a live podcast at 12pm (EST) discussing spasmodic dysphonia. Her guests will include Kim Kuman Executive Director of National SD Association, Charlie Reavis, president NSDA, James Anderson, co-facilitator Tampa Bay support group, and Connie Pike, SLP. Come with open ears and prepared questions as you will be able to ask or email the guests questions! For more detailed information click here.
Bastian Voice Institute physician Dr. Robert Bastian co-authored a study published this month, “The use of neuralgia medications to treat sensory neuropathic cough.” The paper, which was published in the open-access journal PeerJ, reports a series of 32 consecutive patients newly diagnosed with sensory neuropathic cough who were treated with one or more of the medications amitriptyline, desipramine, and gabapentin.
To learn more about sensory neuropathic cough, see our learning website’s encyclopedia entry, complete with teaching videos.
Bastian Voice Institute physician Dr. Robert Bastian presented a lecture at a conference focused on the science and clinical aspects of neurotoxins like botulinum. The conference was held January 14–17, 2015, in Lisbon, Portugal.
Dr. Bastian presented on the subject of vocal tremor, explaining how spasmodic dysphonia often includes a component of tremor (i.e., dystonic tremor) which should not be confused with other types of tremor, like essential tremor or enhanced physiological tremor. To learn more about this topic, see our educational website’s entry on dystonic tremor of the voice or larynx.