BackTable ENT

Can one surgical approach reduce postoperative bleeding, shorten recovery, and save hundreds of dollars per case? In this episode of the BackTable ENT Podcast, Dr. Stephen Chorney, pediatric otolaryngologist at the University of Texas Southwestern Medical Center, joins hosts Dr. Ashley Agan and Dr. Gopi Shah to discuss the benefits and techniques of coblation intracapsular tonsillectomy. Drawing from his extensive clinical experience and findings from his recent Triological thesis, Dr. Chorney reviews the cost effectiveness of coblation intracapsular tonsillectomy compared to traditional extracapsular approaches. --- This podcast is supported by: Smith+Nephew https://www.smith-nephew.com/en-us/health-care-professionals/products/ear-nose-and-throat/coblation-technology-for-adenotonsillectomy#overview --- SYNPOSIS The conversation highlights key advantages of coblation intracapsular tonsillectomy, including lower postoperative bleeding rates, reduced pain, faster recovery, and meaningful economic benefits. Dr. Chorney also shares practical pearls on surgical technique with coblation, equipment settings, and postoperative care, making this episode a valuable resource for surgeons considering or already performing intracapsular tonsillectomy. --- TIMESTAMPS 00:00 - Introduction03:34 - Intracapsular Tonsillectomy: Training and Adoption08:46 - Patient Selection and Surgical Techniques15:50 - Postoperative Care and Pain Management37:26 - Understanding Post-Workout Pain and Recovery38:13 - Comparing Surgical Tools: Microdebrider vs. Coblator38:54 - Visual Cues and Techniques in Tonsillectomy39:22 - Challenges and Solutions in Tonsillectomy Procedures46:37 - Case Studies and Video Demonstrations56:12 - Cost-Effectiveness of Intracapsular Tonsillectomy01:07:19 - Conclusion and Final Thoughts --- RESOURCES Dr. Stephen Chorney https://utswmed.org/doctors/stephen-chorney/ Trio Thesis https://onlinelibrary.wiley.com/doi/full/10.1002/lary.32448

When allergy meds aren't enough, how do you choose the form of immunotherapy that will work best for your patient? Board-certified allergist-immunologist Dr. Nikhila Schroeder and host Dr. Basil Kahwash answer that question and more in this episode of the BackTable ENT Podcast. --- SYNPOSIS Dr. Schroeder shares her path from an engineering background to becoming a board-certified pediatric and adult allergist-immunologist, offering insight into how that perspective shapes her approach to patient care. The discussion focuses on the nuances of sublingual immunotherapy (SLIT) versus subcutaneous immunotherapy (SCIT), including administration, efficacy, safety, and patient adherence challenges. They also explore how immunotherapy can modulate the immune system and provide long-term symptom relief. Dr. Schroeder concludes by sharing her vision for the future of allergy immunotherapy, highlighting the accessibility and growing potential of SLIT. This episode offers ENT specialists a practical overview of why understanding and integrating allergy-immunotherapy can benefit both their practice and their patients. --- TIMESTAMPS 00:00 - Introduction05:01 - History and Evolution of Immunotherapy10:36 - Mechanisms of Immunotherapy14:59 - Subcutaneous Immunotherapy: Process and Benefits19:52 - Sublingual Immunotherapy: Process and Benefits27:56 - Comparing Subcutaneous and Sublingual Immunotherapy34:14 - Efficacy Comparison: Allergy Shots vs. SLIT39:51 - Patient Adherence and Treatment Choices41:58 - Contraindications for Allergy Immunotherapy48:58 - Long-term Benefits of Immunotherapy59:26 - Key Takeaways for ENT Professionals --- RESOURCES Dr. Nikhila Schroeder https://allergenuityhealth.com/about-us/

Think beyond the esophagus. Up to 75% of eosinophilic esophagitis (EoE) patients have ENT-relevant atopic disease that is often best managed with a multidisciplinary approach. Get caught up on best practices in EoE diagnosis and treatment with this episode of the BackTable ENT Podcast, featuring dual board-certified gastroenterologist and allergist-immunologist Dr. John Leung and host Dr. Basil Kahwash. --- SYNPOSIS The discussion covers the definition, symptoms, and diagnosis of EoE, highlighting the role of food and environmental allergies. Dr. Leung and Dr. Kahwash cover diagnostic techniques like endoscopy and emerging non-invasive methods, as well as various treatment options including dietary modifications, pharmacology, and biologics. The doctors also emphasize the importance of multidisciplinary collaboration between gastroenterologists, allergists, and otolaryngologists to provide optimal care for patients with EoE. --- TIMESTAMPS 00:00 - Introduction 03:13 - Understanding Eosinophilic Esophagitis (EoE)05:45 - EoE Symptoms and Diagnosis08:41 - Role of ENT in EoE Diagnosis11:32 - Diagnostic Criteria for EoE16:34 - Treatment Options for EoE20:55 - Role of Allergists and Environmental Allergies23:24 - Pharmacological Management of EoE29:38 - Complications and Risks of EoE36:21 - Follow-Up Endoscopies and Surveillance40:34 - Future Directions in EoE Management45:21 - Conclusion and Final Thoughts --- RESOURCES Dr. John Leunghttps://www.bostonspecialists.org/dr-leung-full-profile

The best approach to sinus surgery is the one tailored to the patient in front of you. In this episode of the BackTable ENT podcast, guest host Dr. Satyan Sreenath, rhinologist and Assistant Professor at Indiana University, and Dr. Dennis Tang, rhinologist and Assistant Professor at Cedars-Sinai, discuss advanced surgical techniques and post-operative management strategies in Functional Endoscopic Sinus Surgery (FESS). --- SYNPOSIS The conversation covers the latest practices in intraoperative maneuvers, the use of bioabsorbable materials, and the contentious topic of middle turbinate resections. They review patient cases, surgical approaches, and provide insights into optimizing patient outcomes. Additionally, they emphasize the importance of individualized care tailored to specific chronic sinusitis phenotypes and patient-specific factors. --- TIMESTAMPS 00:00 - Introduction 03:28 - Case Study #1: CRSsNP with Nasal Congestion 04:59 - Factors Influencing Minimal vs. Maximal Surgery 14:23 - Case Study #2: Severe Nasal Polyposis27:56 - Debating the Use of Packing in Sinus Surgery40:24 - Scrutinizing Overhead Costs in Patient Care42:45 - FESS Postoperative Care 43:54 - Evolving Biomaterials in Sinus Surgery49:46 - The Debate on Middle Turbinectomy50:46 - Middle Turbinate Management Strategies01:13:17 - Concluding Thoughts on Surgical Practices --- RESOURCES Dr. Satyan Sreenath https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999 Dr. Dennis Tanghttps://www.cedars-sinai.org/provider/dennis-tang-3316614.html

When should an antibiotic allergy actually be tested? In this episode of the BackTable ENT Podcast, guest host Dr. Basil Kahwash, an allergist and immunologist at Ohio ENT & Allergy, sits down with Dr. Cosby Stone, an allergist and immunologist at Vanderbilt University Medical Center, to discuss antibiotic allergies and how to distinguish true allergies from intolerances. --- SYNPOSIS Dr. Stone breaks down common misconceptions around antibiotic allergies, with a focus on penicillin and cephalosporins. The conversation explores how these allergies are evaluated, including when skin testing is appropriate, why inaccurate allergy labels matter, and how confirmed allergies should be managed long term. They also dive into more advanced topics such as drug desensitization, current research in the field, and where the future of drug allergy evaluation is headed. --- TIMESTAMPS 00:00 - Introduction 01:03 - Understanding Antibiotic Allergies07:28 - The Importance of Accurate Allergy Diagnosis10:55 - Key Questions for Diagnosing Allergies17:10 - Implementing Allergy Testing in Healthcare Settings19:06 - Identifying Severe Allergic Reactions26:31 - Interpreting Allergy Skin Testing Procedures33:17 - Penicillin and Cephalosporin Cross-Reactivity37:15 - Drug Desensitization: Indications and Process40:30 - Prognosis and Long-Term Outcomes of Drug Allergies47:22 - Conclusion and Final Thoughts --- RESOURCES Dr. Basil Kahwash https://www.ohioentandallergy.com/physicians/basil-kahwash-md/ Dr. Cosby Stonehttps://www.vanderbilthealth.com/doctors/stone-cosby

“This is the kind of conversation I wish I heard earlier in training.” If you're thinking about private practice at all, you'll want to hear this episode of the BackTable ENT Podcast. Private practice otolaryngologist Dr. Caleb Masterson joins host Dr. Ashley Agan for a conversation about what modern ENT private practice can look like when autonomy, leadership, and patient experience take priority. --- SYNPOSIS Dr. Masterson shares his journey from academic medicine to establishing his own private practice, highlighting his motivations for seeking autonomy and the challenges he faced. The discussion covers the importance of creating a patient-centered experience, innovating during the COVID-19 pandemic, and the significance of developing strong leadership within a practice. Dr. Masterson also shares his entrepreneurial ventures, including the creation of a coffee shop within his clinic and the development of an allergy engagement mobile app to enhance patient care. --- TIMESTAMPS 00:00 - Introduction 01:40 - Journey to Private Practice06:36 - COVID-19 Impact and Adaptation09:37 - Building a Successful Team16:37 - Financial Strategies in Private Practice27:59 - Creating an Exceptional Patient Experience30:05 - Community Involvement and Unexpected Outcomes39:53 - The Importance of Autonomy in Healthcare48:41 - Developing Resources for Healthcare Providers51:17 - Innovations in Patient Experience --- RESOURCES Dr. Caleb Mastersonhttps://www.bnbsinusandallergy.com/team-members/caleb-masterson

How can your clinical experience translate into industry leadership? In this episode of the BackTable ENT Podcast, otolaryngologist Dr. Karen Hoffmann at Piedmont ENT in Atlanta joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss the many opportunities for industry involvement within otolaryngology. --- SYNPOSIS Dr. Hoffmann shares her extensive experience in otology and rhinology, highlighting her involvement in clinical trials, public speaking, and industry collaborations. The discussion focuses on the vast opportunities available for ENTs in industry, addressing how clinical experience can translate into meaningful contributions beyond traditional practice. Dr. Hoffmann offers insights on balancing clinical practice with industry work, the importance of gender diversity in advancing medical tools and practices, and the potential for future innovations in ENT driven by women in the field. --- TIMESTAMPS 00:00 - Introduction02:31 - Opportunities for ENTs in Industry08:43 - Balancing Career and Family16:39 - Navigating Industry Partnerships21:39 - Addressing Criticism in Medicine25:09 - Getting Started with Clinical Trials in Private Practice28:57 - The Role of Mentorship and Networking36:13 - The Importance of Women in Medicine42:10 - Future Opportunities for Women in ENT --- RESOURCES Dr. Karen Hoffmannhttps://www.piedent.com/about-us/providers/karen-hoffmann

Ever wondered what a high-powered healthcare executive thinks physicians should know about money, leadership, and career longevity? This episode of BackTable ENT features an especially engaging conversation with Bob Glazer, a recently retired healthcare executive, who shares his wisdom on achieving financial and personal abundance with guest host Dr. Aleysha Khalid. --- SYNPOSIS The discussion covers Bob's extensive career in healthcare administration to key financial strategies for otolaryngologists, including tax planning and long-term financial management. Mr. Glazer emphasizes the importance of balancing career ambitions with personal life, planning for different stages of one's professional journey, and exploring entrepreneurial ventures. With practical advice on leadership, maintaining work-life balance, and continuous self-improvement, Mr. Glazer offers invaluable guidance for both young practitioners and seasoned professionals in healthcare. --- TIMESTAMPS 00:00 - Introduction02:53 - The Importance of Tax Planning for Physicians06:50 - Navigating Early Career Financial Decisions11:40 - Building a Strong Professional Reputation14:51 - The Seven-Year Itch: Seeking New Challenges23:59 - Understanding Risk Tolerance26:25 - Balancing Work and Life as an Otolaryngologist29:37 - Retirement and Rediscovering Hobbies32:36 - Leading Yourself and Crafting Your Life35:37 - Data-Driven Leadership and Career Advice38:43 - Final Takeaways --- RESOURCES Robert Glazerhttps://www.askascent.com/page/RobertGlazerbio

Does tongue tie impact pediatric sleep disordered breathing? In this episode of the Back Table ENT Podcast, otolaryngologist Dr. Brennan Dodson and speech language pathologist Allegra Bereszniewicz discuss tongue-tie and the pediatric airway with hosts Dr Ashley Agan and Dr. Gopi Shah. --- SYNPOSIS The discussion covers the anatomy and pathophysiology of tongue tie, surgical techniques for its release, and the importance of pre- and post-operative myofunctional therapy. They delve into patient selection, the impact of tongue tie on sleep-disordered breathing, and contrasting surgical methodologies, including frenuloplasty. The episode also features an insightful case study with visuals, examining Dr. Dodson's surgical approach in detail. Additionally, they touch on insurance considerations and the challenges within current medical practice regarding tongue tie diagnosis and treatment. Check out detailed surgical techniques at the end with case presentations! --- TIMESTAMPS 00:00 - Introduction01:29 - Understanding Tongue Tie and Pediatric Airway06:17 - The Role of Myofunctional Therapy10:37 - Scientific Evidence and Research on Tongue Tie15:52 - Clinical Approaches and Patient Evaluations35:00 - Pre-Op and Post-Op Procedures39:02 - Post-Surgery Recovery and Exercises40:32 - Surgical Techniques and Tools44:31 - Post-Operative Care and Pain Management48:59 - Patient Selection and Considerations01:02:41 - Sleep Studies and Outcome Measures01:12:30 - Incision Techniques and Dissection Tools01:17:24 - Closure and Post-Operative Care01:23:51 - Innovations and Techniques in Surgery01:28:09 - Final Thoughts --- RESOURCES Dr. Brennan Dodson https://www.bridgerent.com/ Allegra Bereszniewicz MS, CCC-SLPhttps://grospeech.com/about/

From asymptomatic dimples to chronic infections—here's how experts navigate the spectrum of preauricular pits. In this episode of the Back Table ENT podcast, pediatric otolaryngologists Dr. Eric Gantwerker and Dr. Eric Berg discuss the surgical management of Preauricular Pits with host Dr. Gopi Shah. --- SYNPOSIS The conversation covers the etiology of preauricular pits, their presentations, decision-making for excision, surgical techniques, post-operative management, recurrence, and valuable tips in preauricular pit management. The doctors also touch upon collaboration with facial plastics and the importance of communication with families. --- TIMESTAMPS 00:00 - Introduction 03:11 - Common Presentations & Management of Preauricular Pits06:17 - Differential Diagnoses and Imaging13:56 - Surgical Considerations and Techniques18:51 - Managing Recurrent Infections19:07 - Skin Flap Techniques19:55 - Excising Chronic Wounds23:07 - Post-Op Management24:46 - Revision Surgery Insights29:08 - Final Tips and Pearls --- RESOURCES Dr. Eric Gantwerker https://www.northwell.edu/find-care/find-a-doctor/dr-eric-alan-gantwerker-md-ms-1144482662 Dr. Eric Berg https://www.wellstar.org/physicians/eric-berg-md

Are you a med student with an upcoming away rotation? Get a head start with this episode of the BackTable ENT Podcast. Dr. Viraj Shah, a PGY-4 ENT resident at UT Southwestern and guest host Dr. Quynh-Chi Dang, PGY-1 at UC Davis Medical Center, discuss how to succeed on away rotations. --- SYNPOSIS They cover the basics of away rotations, factors to consider when applying, and effective strategies for excelling both in the operating room and within the residency team. Additionally, they delve into the importance of networking, securing recommendation letters, and making a positive impression through situational awareness and preparation. Personal anecdotes and practical tips make this a valuable listen for medical students gearing up for their rotations. --- TIMESTAMPS 00:00 Introduction 02:33 Diving into Away Rotations05:20 Factors to Consider for Away Rotations22:54 Handling Away Rotation Offers28:33 Succeeding in the OR34:30 Navigating OR Dynamics40:49 Securing Recommendation Letters46:11 Onsite Interviews: Preparation and Presentation50:48 Housing for Away Rotations56:03 Final Tips: Observing Team Dynamics and Being Proactive --- RESOURCES Chi Danghttps://health.ucdavis.edu/otolaryngology/our-team/residents.html Viraj Shah https://www.utsouthwestern.edu/departments/otolaryngology/education-training/residency-program/residents/

From misdiagnosed asthma to anxiety-related breathing issues, inducible laryngeal obstruction is often hiding in plain sight. In this episode of the BackTable ENT Podcast, Dr. Steven Sims from Rush University Medical Center discusses contemporary care for inducible laryngeal obstruction (ILO) with guest host Dr. Stephen Schoeff. --- SYNPOSIS The discussion elaborates on the evolution of the nomenclature surrounding vocal cord dysfunction and the clinical challenges in diagnosing and managing ILO. Dr. Sims shares his approach to patient evaluation, various presentations, and targeted treatment strategies, including the use of neuromodulators, speech pathology, and nerve blocks. He also delves into trauma-informed care, particularly focusing on patients with adverse childhood events and their impact on laryngeal function. The episode highlights the importance of an interdisciplinary approach, especially the role of speech pathologists in treating this complex condition. --- TIMESTAMPS 00:00 - Introduction 01:39 - Understanding Inducible Laryngeal Obstruction04:53 - Patient Presentation and Evaluation07:51 - Management Strategies and Patient Care09:06 - Trauma and Mental Health Considerations19:27 - Interdisciplinary Approach and Additional Testing23:52 - Understanding Subglottic Stenosis and Asthma27:08 - The Role of Botox in Treatment31:49 - Biofeedback and Patient Empowerment34:25 - Exercise-Induced Laryngeal Obstruction39:05 - Advanced Treatment Approaches and Challenges41:06 - Conclusion and Final Thoughts --- RESOURCES Dr. Stephen Schoeff https://www.enthealth.org/find-ent/stephen-s-schoeff/ Dr. H, Steven Sims https://doctors.rush.edu/details/22035

When treating head and neck cancer, how can you tell the difference between true disease progression and pseudoprogression? In this episode of the BackTable Podcast, we discuss the practical implementation of the KEYNOTE-689 trial published in the New England Journal of Medicine, which demonstrated the benefit of adding neoadjuvant and adjuvant immunotherapy to standard head and neck cancer care. Our tumor board panel includes Dr. Mihir Patel, a head and neck surgeon from UNC Chapel Hill, Dr. Siddharth Sheth, a head and neck medical oncologist from UNC, Dr. Jennifer Johnson, a professor of medical oncology and otolaryngology at Sidney Kimmel Comprehensive Cancer Center, and Dr. Adam Luginbuhl, a head and neck surgical oncologist at Thomas Jefferson University. --- SYNPOSIS The doctors address the trial's practical implications, patient selection, case management, dealing with tumor progression, and the integration of multidisciplinary care. They also emphasize the importance of communication, real-world application of trial protocols, and the potential benefits and challenges of such therapies. --- TIMESTAMPS 00:00 - Introduction03:18 - Discussing the New Indication for Immunotherapy11:42 - Challenges and Practical Implementation22:48 - Managing Tumor Progression: A Case Study28:07 - Exploring Treatment Options: Surgery vs. Chemotherapy36:46 - Operational Challenges and Future Directions43:58 - Concluding Thoughts and Future Directions --- RESOURCES Keynote 689https://www.nejm.org/doi/full/10.1056/NEJMoa2415434

If your patients still struggle with sleep apnea after other treatments, it might be time to look at the nose. In this episode of the BackTable ENT Podcast, otolaryngologist and facial plastic surgeon Dr. Scott McCusker joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss the impact of nasal airway obstruction on obstructive sleep apnea (OSA).---This podcast is supported by:Aerin Medicalhttps://aerinmedical.com/---SYNPOSISDr. McCusker shares insights on his practice, evaluation techniques for nasal obstruction, and the use of minimally invasive procedures like VivAer. The conversation covers the importance of the septal swell bodies, the effectiveness of nasal treatments on OSA outcomes, and patient management strategies, including when to combine different surgical interventions. The episode also touches on post-operative care and the potential role of new technologies and treatments in enhancing patient outcomes.---RESOURCESDr. Scott McCusker https://ambrdfcs.org/doctors/scott-mccusker-md/

While the standard for adjuvant head and neck cancer treatment hasn't changed since 2004, a new trial using perioperative pembrolizumab is forcing clinicians to rethink their entire workflow, starting with diagnosis. In this episode of the BackTable Podcast, head and neck surgical oncologist Dr. Adam Luginbuhl is joined by colleagues Dr. Dylan Roden and Dr. Ravindra Uppaluri to discuss the implementation and implications of the Keynote-689 trial, which introduced neoadjuvant and adjuvant immunotherapy for locally advanced head and neck cancer.---SYNPOSISThe doctors discuss the trial details, FDA approval, and practical challenges of integrating this new paradigm into clinical practice. The conversation covers critical points such as the necessity of CPS score testing, timely drug administration, patient monitoring, and the importance of collaboration among multidisciplinary teams.---TIMESTAMPS00:00 - Introduction02:18 - Keynote-689 Trial Explained04:42 - Implementation Challenges and Strategies06:40 - Practical Considerations for CPS Testing13:59 - Case Studies and Real-World Applications30:48 - Future Directions and Final Thoughts---RESOURCESKeynote-689https://www.nejm.org/doi/full/10.1056/NEJMoa24154342004 Cisplatin Phase III Trialhttps://www.nejm.org/doi/full/10.1056/NEJMoa032646

Endoscopes, AI, and the future of ENT care—otolaryngologist and Presidio CEO Dr. Jonathan Simmonds shares why the tech game is just getting started in this episode of the BackTable ENT Podcast.---SYNPOSISDr. Simmonds shares his journey from the UK to becoming a sinus surgeon in New York, and the founding of Presidio to create affordable endoscopic equipment. They discuss how AI can transform ENT practice, emphasizing the unique position ENTs hold due to their routine use of camera systems in exams. The conversation also tackles the economic aspects of implementing new technology, the importance of capturing clinical data, and the necessity of ENT specialists to advocate for their role in the evolving landscape. Dr. Simmonds offers insights into the various AI tools and the significance of contributing to the development and implementation of AI models in ENT.---TIMESTAMPS00:00 - Introduction03:38 - AI in ENT: Opportunities and Challenges12:46 - Protecting the Role of ENTs17:26 - The Future of ENT Exams24:41 - Ownership of Medical Data: The Ethical Dilemma 30:09 - Human-Like Behavior in AI Models31:18 - The Role of AI in ENT Practice34:30 - Challenges and Opportunities in AI Implementation42:12 - Economic Considerations for AI in Private Practice45:03 - Final Thoughts and Future Directions---RESOURCESDr. Jonathan Simmondshttps://www.summithealth.com/doctors/provider/1538549936

When should a parotid mass raise red flags? In this episode of the BackTable ENT podcast, Dr. Mirabelle Sajisevi, head and neck surgeon at the University of Vermont Medical Center, joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss her approach to diagnosing and managing parotid malignancies. ---SYNPOSISDr. Sajisevi shares insights from her practice, including the importance of thorough physical exams, the utility of ultrasound and biopsy, and the intricacies of surgical planning. They also cover post-operative care, the role of radiation and chemotherapy, surveillance strategies, and the potential of emerging treatments and technologies.---RESOURCESDr. Mirabelle Sajisevi https://www.uvmhealth.org/providers/mirabelle-sajisevi-md

We're keeping the chronic rhinitis conversation going in this week's episode of BackTable ENT. Otolaryngologist Dr. Greg Davis joins Dr. Ashley Agan and Dr. Gopi Shah to break down his approach to posterior nasal nerve (PNN) ablation with the NeuroMark Gen 3, including patient prep, anesthesia, technique, and postoperative care.---This podcast is supported by:Neurent Medical http://neuromark.com/---SYNPOSISBeyond his posterior nasal nerve ablation technique, Dr. Davis shares his experiences with the various generations of the NeuroMark device, and also discusses the insurance and billing side of its use. The conversation also touches on topics like eustachian tube dysfunction, chronic cough, and the future of chronic rhinitis treatment.---TIMESTAMPS00:00 - Introduction03:04 - NeuroMark Device Trials04:15 - Patient Presentation and Diagnosis11:50 - Medical Management and Treatment Options21:44 - Procedure Setup and Anesthesia Protocol30:49 - Understanding RF Devices and Their Usage31:13 - Deploying the Device for Turbinate Treatment31:52 - Tips and Tricks for Difficult Anatomy33:58 - Posterior Nasal Nerve Ablation in the OR34:40 - Addressing Posterior Nasal Drainage and Chronic Cough36:51 - Impedance Control vs. Temperature Control RF38:02 - Choosing the Right Device for Patients40:52 - Managing Post-Procedure Care and Risks53:18 - Insurance and Billing56:13 - Final Thoughts and Future Directions---RESOURCESDr. Greg Davis https://www.gregdavismd.com/ 10th International Otolaryngology Underwater Update Coursehttps://ssf.cloud-cme.com/course/courseoverview?P=0&EID=1254

So many patients deal with a runny, stuffy nose every day, and sprays only go so far. Let's talk about what's new for chronic rhinitis. In this episode of the BackTable ENT podcast, Dr. Dennis Tang, a Rhinologist at Cedars-Sinai Medical Center discusses chronic rhinitis and the latest treatment advancements with hosts Dr. Gopi Shah and Dr. Ashley Agan. ---This podcast is supported by:Aerin Medicalhttps://aerinmedical.com/---SYNPOSISDr. Tang discusses the benefits of posterior nasal nerve (PNN) ablation and the recent approval of the procedure by Cigna Insurance, which expands accessibility for patients. The conversation covers the typical presentation of chronic rhinitis, the procedural details, patient selection, preoperative and postoperative care, and billing considerations. Dr. Tang also touches on the anatomy involved and the technological innovations that are enabling contemporary rhinitis treatment.---TIMESTAMPS00:00 - Introduction03:01 - Insurance Coverage for Posterior Nasal Nerve Ablation04:23 - Patient Presentation, Diagnostic & Treatment Approaches11:07 - Posterior Nasal Nerve (PNN) Ablation Explained17:57 - Physical Examination and In-Office Procedure20:47 - Allergy Patients and Immunotherapy22:21 - Chronic Rhinosinusitis vs. Chronic Rhinitis32:33 - Radiofrequency Ablation Technology39:49 - Procedure Techniques and Anatomical Considerations46:42 - In-Office Procedure Logistics01:06:10 - Final Thoughts ---RESOURCESDr. Dennis Tanghttps://www.cedars-sinai.org/provider/dennis-tang-3316614.html

Is there a different way to do an Intracapsular tonsillectomy without using a microdebrider or a Coblator? In this episode of the BackTable ENT Podcast, otolaryngologist Dr. Evan Tobin from Ohio ENT and Allergy Physicians sits down to discuss the intracapsular technique for tonsillectomy with hosts Dr. Gopi Shah and Dr. Ashley Agan. ---SYNPOSISDr. Tobin shares his journey and practice in Ohio, emphasizing his transition to using intracapsular tonsillectomy with monopolar electrocautery. The discussion covers the historical evolution of tonsillectomy techniques, the benefits of intracapsular tonsillectomy (such as reduced bleed rates and postoperative pain), as well as the practical aspects and indications for different methods. Dr. Tobin presents his technique in detail, supported by video demonstrations and highlights the significance of patient counseling in making surgical decisions.---TIMESTAMPS00:00 - Introduction 04:38 - Tonsillectomy Techniques07:20 - Evolution and Debate of Tonsillectomy Practices11:09 - Personal Experiences and Techniques in Tonsillectomy21:42 - Pain Management and Post-Operative Care29:51 - Shared Decision Making and Future of Tonsillectomy34:53 - Managing Bleeds: A Practical Approach37:51 - Cost Analysis of Tonsillectomy Techniques41:46 - Surgical Techniques and Settings53:06 - Post-Operative Considerations and Outcomes57:33 - Final Thoughts and Recommendations---RESOURCESDr. Evan Tobinhttps://www.ohioentandallergy.com/physicians/evan-tobin-md/

What every ENT needs to know about the resurgence of measles—and how to talk to patients about vaccines. In this episode of the Back Table ENT podcast, Dr. Romaine Johnson and Dr. Daniel Chelius, both pediatric otolaryngologists, talk about the resurgence of measles and vaccine hesitancy with host Dr. Gopi Shah. ---SYNPOSISThey delve into their professional backgrounds, the importance of recognizing symptoms early, and the risks associated with measles, such as otitis media and sensorineural hearing loss. The conversation highlights the role of ENT specialists in identifying and managing the disease, strategies for addressing vaccine hesitancy, and the broader public health implications. They also touch on ways the medical community can tackle misinformation and advocate for vaccinations through collective efforts and patient education.---TIMESTAMPS0:00 Introduction 07:07 Measles Contagion and Symptoms23:23 Complications and Long-term Effects28:37 Assessing Respiratory Status and Complications29:44 Addressing Common Vaccine Myths31:18 Challenges in Vaccination Conversations32:38 Personal Stories and Impact of Vaccination Choices35:00 Building Trust and Addressing Concerns38:15 Approaching Non-Vaccination in Clinical Practice53:12 Global Perspective on Vaccination54:17 Final Thoughts and Contact Information

How to help children with ear deformities look and feel their best. In this episode of the BackTable ENT Podcast, Dr. Jason Qian from Rady Children's in San Diego and special guest Dr. Charlotte Célérier, a pediatric otolaryngologist at Neckar-Enfants Malades Hospital in Paris, France discuss the technical aspects of pediatric otoplasty with Dr. Gopi Shah. ---SYNPOSISThe conversation covers surgical techniques, patient selection, procedural nuances, and post-operative care for various ear deformities including prominent ears, Stahl's ear, cauliflower ear, and cryptotia. Both experts share their insights on different methodologies, handling complications, and the importance of ensuring the child is motivated for surgery. Learn practical tips and evolving practices in the field of pediatric otoplasty.---TIMESTAMPS00:00 - Introduction 02:22 - Otoplasty Techniques and Patient Referrals05:35 - Terminology and Ear Abnormalities13:16 - Surgical Considerations20:04 - Prepping and Draping for Surgery30:22 - Suturing Techniques33:38 - Instrument Preferences35:12 - Repairing Stahls Ear Deformity37:16 - Cauliflower Ear Challenges38:46 - Cryptotia Repair Techniques40:59 - Post-Operative Care and Managing Complications52:30 - Final Thoughts and Innovations---RESOURCESJason Qian:https://www.rchsd.org/doctors/zhen-jason-qian-md/Charlotte Célérier:https://www.researchgate.net/profile/Charlotte-Celerier

Is the advice you're getting from your mentor really what you need, or is the real breakthrough hidden in your own answers? In this episode of the BackTable ENT podcast, Dr. Gopi Shah welcomes Dr. Stacey Ishman, a chief medical officer, pediatric ENT, real estate investor, syndicator, and career coach for physicians, to discuss transitioning from academic medicine to utilization management. ---SYNPOSISDr. Ishman emphasizes the significance of mentorship and coaching in academic medicine, the difference between the two, and how understanding one's values is crucial for career fulfillment. The conversation addresses common challenges faced by physicians such as setting boundaries, managing time effectively, and achieving work-life balance. Dr. Ishman also shares practical tips for personal and professional growth, encourages networking, and highlights how coaching can help physicians realign their careers with their values. The episode concludes with resources and strategies for physicians feeling burnt out and advice on navigating career transitions.---TIMESTAMPS00:00 - Introduction 03:56 - Mentoring vs. Coaching11:10 - Time Management and Setting Boundaries17:38 - Gender and Equity in Academic Medicine22:18 - Exploring Personal Values23:41 - Time Management Tips for Physicians26:17 - Mid-Career Physician Challenges28:28 - Networking and Self-Promotion30:12 - Translational Skills in Medicine32:04 - Knowing When to Make a Change39:02 - Coaching Programs and Resources---RESOURCESDr. Stacey Ishmanhttps://www.childrensdayton.org/doctors/stacey-ishman-md-mphhttps://www.medicalmentorcoaching.com/

How do we integrate biologics into the existing stepwise treatment model for chronic rhinosinusitis with nasal polyps (CRSwNP)? In this episode, Dr. Reena Mehta, an allergist from Uptown Allergy and Asthma in New Orleans, discusses the use of biologics for treating chronic rhinosinusitis with nasal polyps. ---SYNPOSISDr. Mehta elaborates on the common presentations of patients, the role of biologics such as dupilumab and tezepelumab, and the nuances of patient management post-sinus surgery. Dr. Mehta also covers the workup process, the significance of patient comorbidities like asthma and allergies, and the future perspectives on biologic treatments. Practical aspects of biologic therapy, including insurance hurdles, patient compliance, and the effectiveness of various biologics are thoroughly examined.---TIMESTAMPS00:00 - Introduction 02:27 - Understanding Chronic Rhinosinusitis with Nasal Polyps & Presentation05:22 - Workup and Management of Nasal Polyps07:31 - Treatment Options: Steroids and Biologics15:28 - Tezepelumab: A New Tool in the Toolkit25:03 - Side Effects and Safety of Biologics28:59 - Insurance and Approval Challenges36:14 - Long-Term Safety and Efficacy38:47 - Pediatric Considerations and Future Directions41:37 - Collaboration Between ENT and Allergy Specialists45:07 - Conclusion and Final Thoughts---RESOURCESDr. Reena Mehtahttps://uptownallergyasthma.com/allergist-dr-reena-mehta/

What happens when a high-achieving physician trades perfectionism for purpose? In this episode of the BackTable ENT podcast, Dr. Tiffany Moon, an anesthesiologist, mom, entrepreneur, former Real Housewives of Dallas cast member, and author of the book 'Joy Prescriptions' joins host Dr. Ashley Agan. --- SYNPOSIS Tiffany shares her journey from a driven, high-achieving academic physician to exploring new passions outside of medicine. She discusses her midlife crisis, the inspiration behind her book, and the importance of finding joy through gratitude and letting go of perfectionism. They delve into the challenges of balancing a medical career with motherhood, the decision to go part-time, and the impact of her social media presence. Also, Tiffany introduces her upcoming Lead Her Summit, aimed at empowering female entrepreneurs. The episode wraps up with practical insights on maintaining joy and navigating career transitions. --- TIMESTAMPS 00:00 - Introduction01:37 - Tiffany's Journey in Medicine03:15 - Writing Joy Prescriptions05:32 - Balancing Medicine and Personal Life12:21 - The Decision to Go Part-Time17:34 - Navigating Career and Personal Goals20:42 - Understanding Joy Interrupted23:05 - Practicing Gratitude in Daily Life25:14 - The Struggle with Control29:57 - Navigating Social Media Fame34:57 - Upcoming Lead Her Summit37:48 - Final Thoughts and Farewell --- RESOURCES Tiffany Moonhttps://www.tiffanymoonmd.com/ LeadHer Summit 2025 (use code BACKTABLE300 for $300 off):https://www.leadhersummit.com/

A 47 year old male presents with intermittent, unilateral nasal drainage and headache. What do you do? In this episode of the BackTable Podcast, Dr. Satyan Sreenath, a rhinologist at Indiana University, and Dr. Sanjeet Rangarajan, a rhinologist at Case Reserve University, examine complex cases involving CSF leaks and encephaloceles. --- SYNPOSIS The doctors discuss diagnostic approaches, imaging techniques, and innovative surgical methods, using endoscopic and minimally invasive strategies. The conversation highlights the difficulties of diagnosing and surgically repairing these leaks, focusing on their personal experiences and preferred techniques. Through detailed case studies with imaging and surgical videos, they explore the importance of meticulous planning, interdisciplinary collaboration, and adaptive strategies to manage these challenging conditions effectively. A must watch on Youtube! --- TIMESTAMPS 00:00 - Introduction02:17 - Patient Case 1: “Headache and Drippy Nose..”02:58 - Diagnostic Imaging and Findings07:55 - Surgical Approach and Postoperative Care16:52 - Patient Case 2: “Drippy nose and nasal congestion… just allergies right?”17:32 - Diagnostic Imaging and Findings20:21 - Surgical Approach and Postoperative Care29:03 - Patient Case 3: “Runny nose after my MVC 3 years ago…”29:21 - Imaging and Surgical Approach Discussion31:46 - Post-Operative Challenges and Patient Follow-Up42:46 - Patient Case 4: “Continuous nasal drainage BOTH sides”43:31 - Imaging and Findings 44:43 - Surgical Approach for Bilateral Defects56:39 - Final Thoughts --- RESOURCES Dr. Satyan Sreenath profile:https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999 Dr. Sanjeet Rangarajan's profile:https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-164956839

A patient walks in with a persistent runny nose. Is it allergies, or something more dangerous? In this episode of the BackTable ENT Podcast, two renowned rhinologists, Dr. Satyan Sreenath and Dr. Sanjeet Rangarajan, delve into the evaluation and management of cerebrospinal fluid (CSF) leaks at the anterior skull base with host Dr. Gopi Shah. --- SYNPOSIS The discussion encompasses patient presentations, differential diagnosis, physical examination, and imaging techniques for localization. They also explore the impact of underlying conditions such as idiopathic intracranial hypertension (IIH) and obstructive sleep apnea (OSA) on CSF leaks. Dr. Sreenath and Dr. Rangarjan offer insight into diagnostic strategies, patient management, and surgical planning, providing a comprehensive overview of best practices in managing this complex condition. --- TIMESTAMPS 00:00 - Introduction 02:48 - Patient Presentation and Initial Evaluation04:45 - Common Symptoms and Diagnostic Challenges06:02 - Risk Factors and Etiologies of CSF Leaks10:59 - Management and Treatment Approaches16:55 - Physical Examination and Diagnostic Techniques22:35 - Patient Instructions for Sample Collection24:29 - Differentiating CSF Leaks from Other Conditions26:12 - Endoscopic Examination Techniques30:21 - Imaging and Diagnostic Approaches33:14 - Surgical Planning and Considerations45:23 - Concluding Thoughts --- RESOURCES Satyan Sreenath https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999 Sanjeet Rangarajan https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-1649568395

Let's talk about what it really means to show up for your patients—and yourself—as a surgeon. In this episode of Backtable ENT, Dr. Mel Thacker, an otolaryngologist and founder of The Empowered Surgeon and the Surgeons with a Purpose Podcast, joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss humanity in surgery, and how to stay grounded in a profession that demands so much of us. --- SYNPOSIS Dr. Thacker shares her journey from experiencing anxiety and panic attacks in the operating room to becoming a coach who helps surgeons discover their purpose and practice medicine with greater humanity. They discuss the significance of self-awareness, the importance of protecting oneself as a valuable asset, and how to serve patients with compassion and empathy. Practical advice is offered on shifting mindset, engaging in meaningful connections with patients, and fostering a collaborative, rather than hierarchical, approach in medical practice. --- TIMESTAMPS 00:00 - Introduction03:04 - Discovering Coaching10:52 - Residency Reflections23:06 - Improving Patient Relationships29:48 - Coaching Surgeons and Addressing Emotional Growth37:49 - Serving vs. Fixing: A New Perspective on Patient Care44:09 - Daily Practices for Empathy and Self-Awareness44:40 - Three Essentials for Success in Medicine46:31 - Conclusion and Final Thoughts

How hard is it to move your medical practice across the globe? In this episode of BackTable ENT, otolaryngologist Dr. Ananya Majumder discusses her transition from practicing in Fort Worth, Texas to becoming a consultant otolaryngologist at North Shore Hospital in Auckland, New Zealand with host Dr. Gopi Shah. --- SYNPOSIS They explore Dr. Majumder's career journey, the factors that led her to move abroad, the process of obtaining medical licensing and a visa in New Zealand, and the differences in medical practice and work culture between the U.S. and New Zealand. Dr. Majumder also shares insights into her daily routine, the challenges she faced during the transition, and the benefits of international experience in the medical field. --- TIMESTAMPS 00:00 Introduction 01:40 Journey to New Zealand & Navigating Medical Licensing08:26 Understanding the Healthcare System15:24 Residency and Training Differences21:37 Visa Process and Moving28:49 Daily Practice in New Zealand29:44 Clinic Workflow Differences & Operating Room Culture37:14 Patient Relationships and Challenges42:42 Professional and Personal Growth48:02 Final Thoughts and Advice --- RESOURCES Dr. Ananya Majumder https://www.enthealth.org/find-ent/ananya-majumder/

The sour candy myth: why it's not always the right Rx for salivary gland obstruction. In this episode, Dr. Wais Rahmati, a board-certified otolaryngologist at Mass Eye and Ear and Harvard Medical School, discusses the development of a comprehensive salivary gland center and the focus on office-based sialendoscopy with host Dr. Ashley Agan. --- SYNPOSIS The doctors explore the benefits of incorporating salivary endoscopy in the office setting, including minimally invasive and gland-sparing approaches to treat obstructive salivary gland diseases. Dr. Rahmati shares the criteria for patient selection, techniques in the procedure, and post-operative care. They also touch upon the challenges and strategies for reimbursement and the significance of tracking codes to eventually establish dedicated CPT codes for sialendoscopy. --- RESOURCES Wais Rahmati MD:https://doctors.masseyeandear.org/details/447/rahmatullah-wais_rahmati-rahmati-otolaryngology-head_and_neck_surgery-boston

Sinusitis or migraine? Understanding the difference between rhinogenic and primary headaches could change your treatment algorithm. In this episode of Backtable ENT, Dr. Jessica Lee, an otolaryngologist from Charleston ENT and Allergy, discusses the prevalence and treatment of sinus headaches with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS The doctors discuss how half of sinus infection diagnoses are often misdiagnosed, with many patients having normal CT scans and nasal endoscopies. Dr. Lee emphasizes the importance of distinguishing between sinus-related headaches and migraines, noting that 80% of sinus headache complaints meet migraine criteria. The conversation covers the use of lifestyle medicine, supplements, medications, and the role of neurologists in managing chronic headaches. Dr. Lee also touches on the role of mycotoxins, drawing from evidence-based practices while stressing patient education and collaboration in treatment. --- TIMESTAMPS 00:00 - Introduction 04:10 - Differentiating Sinus Headaches from Other Conditions10:07 - Lifestyle Factors and Migraine Management25:45 - Supplements and Treatments for Migraine30:01 - Iron Supplementation and Dietary Adjustments31:42 - Medication Management for Migraines34:52 - Botox as a Treatment Option44:50 - Mycotoxins and Mold Illness50:11 - Non-Pharmacologic Options for Headaches54:00 - Final Thoughts and Recommendations --- RESOURCES Dr. Jessica Leehttps://charlestonent.com/bio/jessica-lee/

Leadership isn't just about saying yes—it's about knowing when to say no too. In this episode of Backtable ENT, Dr. Carol Bradford, Dean of the Ohio State University College of Medicine and Vice President for Health Sciences at the Ohio State University Wexner Medical Center, shares her leadership journey with hosts Dr. Gopi Shah and Dr. Sunil Verma. --- SYNPOSIS Dr. Bradford shares insights into her journey in otolaryngology, emphasizing the importance of feedback, emotional intelligence, and leadership development. She discusses her experiences in various leadership roles, the significance of maintaining clinical practice, and strategies for fostering future leaders. The conversation touches on the challenges and rewards of leadership in academic medicine, the impact of change, and the enduring mission to improve patient care and education. --- TIMESTAMPS 00:00 - Introduction 04:32 - Role and Responsibilities of a Dean & Balancing Clinical Practice 10:25 - Leadership Development & Mentorship21:41 - Building and Leading Effective Teams28:23 - Challenges in Leadership Roles30:40 - Balancing Academic and Clinical Missions33:41 - Leadership Style and Meeting Management39:07 - Emotional Intelligence in Medicine47:12 - Navigating Change and Future Goals51:45 - Final Advice for Aspiring Leaders --- RESOURCES Dr. Carol Bradford:https://wexnermedical.osu.edu/about-us/our-people/carol-bradford Dr. Sunil Verma:https://www.ucihealth.org/clinicians/sunil-verma-1124279344

Are your allergies getting worse, or is it the environment? In this episode of Backtable ENT, Dr. Jennifer Villwock, a rhinologist at the University of Kansas, and Dr. William Reisacher, an otolaryngologist at New York Presbyterian Hospital, join the podcast to discuss the impact of environmental extremes on the unified airway with hosts Dr. Ashley Agan and Dr. Gopi Shah. --- SYNPOSIS Topics include the increasing prevalence of allergies and asthma due to climate change, the effects of environmental pollutants and particulates on respiratory health, and the role of healthcare providers in educating and advocating for patients. The conversation also addresses practical strategies for managing symptoms, the importance of urban planning and sustainable practices, and the hope that collective individual efforts can lead to meaningful change. --- TIMESTAMPS 00:00 - Introduction 01:43 - Understanding the Unified Airway03:09 - Patient Concerns and Environmental Factors10:24 - Impact of Temperature and CO2 on Allergies14:57 - Barometric Pressure and Migraines21:03 - Pollution, Particulate Matter, and Solutions24:49 - Urban Planning29:32 - Epigenetics and Environmental Impact34:15 - Indoor Air Quality and Mold Issues41:01 - Advocacy and Environmental Health45:46 - Final Thoughts and Hope for the Future --- RESOURCES Dr. Jennifer Villwockhttps://www.kumc.edu/jvillwock.html Dr. William Reisacher https://weillcornell.org/wreisacher

Chronic sinusitis might be doing more than just clogging your nose–it could be clouding your brain. In this episode of Backtable ENT, Dr. Aria Jafari, an assistant professor at the University of Washington and co-director of the Neuroendocrinology Advanced Sinus and Skull-base Surgery Fellowship, discusses the connection between sinusitis and cognitive dysfunction with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Jafari shares how his interest in this field developed and details his research on the relationship between chronic rhinosinusitis (CRS) and brain function. The conversation highlights the comprehensive impact of sinus inflammation on overall health, emphasizing the importance of viewing CRS as a whole-body condition. They also discuss patient experiences, the methodologies used to assess cognitive dysfunction, potential treatments, and what's next in the research frontier.---TIMESTAMPS00:00 - Introduction 06:18 - The Impact of CRS on Quality of Life14:02 - Understanding Brain Fog and Cognitive Dysfunction24:29 - Pathophysiology and Theories of Cognitive Dysfunction27:44 - Chronic Inflammation and Cognitive Effects28:59 - Impact of Biologics on Cognitive Function31:28 - Risk Factors for Cognitive Dysfunction35:02 - Olfactory Symptoms 37:13 - Future Research and Treatment Approaches45:31 - Conclusion and Final Thoughts --- RESOURCES Dr. Aria Jafari https://www.uwmedicine.org/bios/aria-jafari

The best doctors aren't lucky—they're prepared. Discover how to keep your office safe during in-office procedures. In this episode of BackTable ENT, Dr. Scott Fortune, an otolaryngologist from Allergy and ENT Associates of Middle Tennessee, discusses office-based procedural safety with Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS The doctors delve into the importance of preparedness in handling potential complications, emphasizing the necessity of having the right equipment and protocols in place. Dr. Fortune provides detailed guidelines on managing anesthesia, preventing and handling bleeding, and addressing possible complications such as vasovagal reactions and anaphylaxis. The conversation covers practical tips, including the use of local anesthetics, sedatives, and the importance of patient history and clearance forms. This comprehensive discussion is a valuable resource for ENT professionals looking to enhance the safety and efficacy of their office-based procedures. --- TIMESTAMPS 00:00 - Introduction 01:34 - Discussing Safety in Office Procedures07:47 - Safety Protocols and Equipment19:11 - Anesthesia and Sedation Protocols27:29 - Handling Emergencies and Reversal Agents30:00 - Local Anesthesia and Toxicity38:29 - Effective Anesthesia Techniques for Office Procedures41:25 - Bleeding Control in Office Procedures53:36 - Handling Office Procedure Complications01:00:19 - Final Thoughts and Contact Information --- RESOURCES Dr. Scott Fortune https://www.enthealth.org/find-ent/d-scott-fortune/ Patient Selection, Safety, and Preparedness for Office-Based Otolaryngology Procedureshttps://www.oto.theclinics.com/article/S0030-6665(25)00020-9/abstract AAOA anaphylaxis guidelineshttps://www.aaoallergy.org/wp-content/uploads/2017/05/2015-Clinical-Care-Statements-Anaphylaxis.pdf

Never let the sun set on bilateral vocal fold paralysis–timely diagnosis and intervention are key. In this episode of Backtable ENT, Dr. James Daniero, a laryngologist from the University of Virginia, discusses the evaluation and management of bilateral vocal fold paralysis with Dr. Gopi Shah and guest host Dr. Stephen Schoeff.---SYNPOSISThe trio delves into the complexities of diagnosing and managing bilateral vocal fold paralysis in adults, examining etiologies, diagnostic procedures, and current treatment options. They specifically highlight the differences between bilateral vocal fold immobility and paralysis, discuss innovative techniques such as bilateral selective reinnervation and laryngeal pacing, and share practical tips for securing the airway in an acute setting. The episode also emphasizes the evolving nature of treatments and the importance of timely intervention.---TIMESTAMPS00:00 - Introduction 02:05 - Understanding and Diagnosing Bilateral Vocal Fold Paralysis09:19 - Management and Treatment Options25:40 - Tracheotomy Techniques and Considerations31:31 - Exploring Surgical Options for Patients34:22 - Addressing Dysphagia in Airway Surgeries35:50 - Innovative Techniques in Laryngeal Reinnervation39:34 - Patient Selection for Advanced Surgeries47:11 - Laryngeal Pacing: A Future Option54:50 - Final Thoughts and Recommendations---RESOURCESDr. James Daniero https://uvahealth.com/findadoctor/James-Daniero-1386817484Dr. Stephen Schoeff https://www.enthealth.org/find-ent/stephen-s-schoeff/

What does it take to improve quality of life after head and neck cancer? In this episode of Backtable ENT, guests Dr. Heather Starmer, a speech and language pathologist at Stanford University, and Dr. Michael Moore, a head and neck cancer surgeon at Indiana University explore the topic of head and neck cancer survivorship.---SYNPOSISThe discussion centers on the multifaceted challenges faced by survivors, including dysphagia, dry mouth, chronic pain, and mental health issues. The experts emphasize the importance of early intervention, community support, and comprehensive care to enhance the quality of life for survivors. Various resources, such as the Head and Neck Cancer Alliance, are highlighted to assist patients and providers in navigating survivorship. The conversation also outlines future directions in research and the need for more qualitative studies to better understand long-term survivorship outcomes.---TIMESTAMPS00:00 - Introduction03:23 - Understanding Survivorship & Challenges in Head and Neck Cancer14:06 - Managing Mobility and Lymphedema18:47 - Addressing Chronic Pain and Mental Health21:37 - Dental Care and Trismus Therapy25:58 - Long-Term Survivorship and Quality of Life31:36 - Survivorship Clinics and Multidisciplinary Care34:39 - Resources for Patients and Providers38:49 - Future Research and Educational Gaps---RESOURCESDr. Heather Starmerhttps://med.stanford.edu/profiles/heather-starmerDr. Michael Moorehttps://iuhealth.org/find-providers/provider/michael-g-moore-md-64028

How can you treat a chronic cough when you're not sure what's causing it? In this episode of BackTable ENT, Dr. Basil Kahwash, a board-certified allergist and immunologist from Ohio ENT and Allergy, discusses the complexities of diagnosing and treating chronic cough. ---SYNPOSISDr. Kahwash explains common causes, such as upper airway cough syndrome, allergic rhinitis, and asthma, and delves into the importance of patient history and physical exams in identifying the root cause. The conversation also covers diagnostic tools, including allergy testing, spirometry, and chest X-rays, as well as treatment options like allergy medication, immunotherapy, and cough suppressants. Dr. Kahwash also touches upon new therapies on the horizon and emphasizes the role of multidisciplinary collaboration with ENTs, pulmonologists, GI specialists, and speech therapists in managing chronic cough.---TIMESTAMPS00:00 - Introduction03:20 - Defining Chronic Cough06:47 - Patient Evaluation and Key Questions11:10 - Asthma vs. Allergic Rhinitis Cough18:31 - Red Flags in Chronic Cough30:20 - Diagnostic Testing for Chronic Cough34:46 - ENT Collaboration in Allergy36:08 - Skin Testing vs. Blood Testing for Allergies44:30 - Eosinophilic Esophagitis (EOE) & Upper Airway Cough Syndrome50:28 - Allergy Treatment Pathways01:03:05 - Conclusion and Contact Information---RESOURCESDr. Basil Kahwash https://www.ohioentandallergy.com/physicians/basil-kahwash-md/

Is the future of nasal polyp treatment right under our nose? In this episode of Backtable ENT, Dr. Martin Citardi, a world-renowned rhinologist and skull-based surgeon at UTHealth Houston, discusses the latest advancements in the management of nasal polyps with hosts Dr. Gopi Shah and Dr. Ashley Agan.---This podcast is supported by:Medtronic ENT---SYNPOSISDr. Citardi shares insights from his comprehensive career, spanning patient care, device, and drug development. The surgeons discuss the evolving treatment landscape, challenges in managing recurrent nasal polyps, the role of steroids and biologics, and the importance of correctly identifying the type of polyps. Additionally, Dr. Citardi emphasizes the need for a better understanding of healthcare economics, particularly concerning the high costs of new treatments. The discussion also touches on the future of research and the need for a system to deploy treatment options effectively.---TIMESTAMPS00:00 - Introduction04:39 - Nasal Polyps: Patient Presentation and Initial Examination10:25 - Detailed Examination and Endoscopy Techniques17:26 - Imaging and Lab Workup20:11 - Treatment Strategies and Patient Management31:08 - Managing Patients with Allergies, AERD, and Asthma34:09 - Biologics vs. Surgery: A Comparative Discussion42:50 - Steroid Delivery Methods and Their Effectiveness52:24 - Follow-Up, Long-Term Management and Future Research57:01 - Conclusion and Final Thoughts---RESOURCESDr. Martin Citardi's Profile:https://www.utphysicians.com/provider/martin-j-citardi/Medtronic ENT:https://www.medtronic.com/en-us/healthcare-professionals/products/ear-nose-throat

Are new solutions for pediatric hearing loss finally within earshot? In this episode of the Back Table ENT Podcast, we talk with Dr. Daniela Carvalho, pediatric otolaryngologist and director of the Cochlear Implant Program at Rady Children's Hospital in San Diego. --- SYNPOSIS Dr. Carvalho discusses the latest advancements and practices in the field of pediatric hearing loss, including newer indications for cochlear implants and innovative gene therapies. They delve into the genetic causes of congenital hearing loss, current screening practices, and various gene therapies being tested for hearing deficiencies, such as those involving the OTOF gene and its application through viral vectors. The conversation also touches on the potential for future treatments, including completely implantable cochlear devices and the role of vaccines in preventing CMV-related hearing loss. --- TIMESTAMPS 00:00 - Introduction 01:54 - Understanding Congenital Hearing Loss and Screening 05:41 - Challenges with Older Children and Hearing Loss 08:48 - Cochlear Implants: Indications and Advances 15:59 - Exploring Gene Therapy for Hearing Loss 23:54 - Challenges and Considerations in Gene Therapy 25:23 - Counseling Families on Hearing Loss 27:04 - Future of Genetic Therapy and Cochlear Implants 32:46 - Addressing Congenital CMV 40:59 - Final Thoughts and Future Research --- RESOURCES Dr. Daniela Carvalho https://www.rchsd.org/doctors/daniela-carvalho-md-mmm/

What role does craniofacial growth play in childhood sleep health? Dr. Loria Nahatis, pediatric dentist from Beyond Pediatric Dentistry in Dallas, Texas, discusses the importance of early intervention in pediatric dentistry, focusing on evaluating and treating children with sleep disordered breathing. --- SYNPOSIS Dr. Nahatis shares her personal experience with her daughter and how noticing sleep-related issues shifted her focus in dental practice. Dr. Nahatis covers various treatment methods such as habit correctors, palatal expanders, and myofunctional therapy. The podcast emphasizes the importance of interdisciplinary collaboration between dentists, ENTs, and other healthcare providers to improve patient outcomes. Key points include the significance of nasal breathing, conservative treatment options, and the impact of jaw and dental structure on overall health. --- TIMESTAMPS 00:00 - The Importance of Screening for Sleep Disorders in Children 06:26 - Treatment Options and Approaches 10:29 - Guidelines and Policies on Sleep Disorders 19:42 - Teeth Grinding and Myofunctional Therapy 27:32 - Imaging and Evaluation Techniques 29:01 - Surgical Considerations and Early Interventions 36:44 - Counseling Families on Oral Appliances 50:12 - Insurance and Cost Considerations 56:15 - Collaborative Approaches and Final Thoughts --- RESOURCES Dr. Loria Nahatis's practice profile: https://beyondpediatricdentistry.com/dr-loria-nahatis-dds/

Operating rooms generate up to 30% of a hospital's waste–what can ENT do to change that? In this episode, Dr. Julie Strychowsky, a pediatric otolaryngologist at London Health Sciences Center in Ontario, discusses environmental sustainability in ENT. --- SYNPOSIS The discussion covers the inefficiencies and environmental impacts of current practices, such as the use of nitrous oxide, disposable equipment, and OR waste. Dr. Strychowsky shares insights on transitioning to more sustainable practices, including the use of reusable and multi-use equipment, standardizing procedures, and patient education initiatives like the ‘Bring Your Own Bag' campaign. The doctors highlight the importance of climate change, the carbon footprint of healthcare, and the role of policy and innovation in reducing environmental impact. Finally, they discuss resources for further learning and potential areas for research and development in sustainable healthcare practices. --- TIMESTAMPS 00:00 - Introduction 02:51 - Climate Change and Its Impact on Health 05:07 - Surgical Sustainability: Reducing OR Waste 08:27 - Clinic Waste and Efficiency Improvements 16:12 - Anesthesia Gases and Environmental Impact 23:06 - In-Office Procedures and Telemedicine in ENT 28:58 - Global Efforts & Patient Involvement in Sustainability 37:03 - Policy Changes and Education for Sustainability 39:59 - Future Research and Innovation in ENT 42:26 - Final Thoughts and Mentorship --- RESOURCES Dr. Julie Strychowsky https://www.schulich.uwo.ca/paediatricsurgery/people/faculty/Strychowsky,%20Julie.html Kidane J, Thiel CL, Wang K, Rosen CA, Gandhi S. A Comparison of Environmental Impacts Between Reusable and Disposable Flexible Laryngoscopes. Laryngoscope. 2024 Dec 26. doi: 10.1002/lary.31927. Epub ahead of print. PMID: 39723758. https://pubmed.ncbi.nlm.nih.gov/39723758/ Anderson J, Hu H. Environmental Sustainability: Waste Audit Comparison Operating Room and In-Office Laryngeal Surgery. Laryngoscope. 2024 Feb;134(2):803-806. doi: 10.1002/lary.31005. Epub 2023 Sep 2. PMID: 37658737. https://pubmed.ncbi.nlm.nih.gov/37658737/ Cascade OR playbook https://cascadescanada.ca/

Getting lost on a road trip is one thing, but the stakes are much higher in skull base surgery. In this episode of Backtable ENT, Dr. Arif Janjua, rhinologist and fellowship director at the University of British Columbia, delves into the intricacies and advancements in navigation for sinus and skull base surgery. --- This podcast is supported by: Medtronic ENT https://www.medtronic.com/en-us/healthcare-professionals/specialties/ear-nose-throat.html --- SYNPOSIS Dr. Janjua touches on his role in the Seattle Science Foundation, emphasizing continuous education and hands-on practice for surgeons. He emphasizes the importance of accuracy in patient tracking and registration, sharing techniques for optimizing navigation system setups by using a combination of tracing and touch points for precise registration. The doctors discuss the advantages of integrating navigation systems with specific instruments like microdebriders and suctions for improved surgical outcomes. Dr. Janjua also shares his preferred navigation tech, how he utilizes specific features in his surgical practice, and what's on the horizon in sinus and skull base surgery. --- TIMESTAMPS 00:00 - Introduction 04:03 - Understanding Navigation in Sinus Surgery 07:41 - Navigating Instruments and Tools 21:58 - Challenges with Staff Training 22:43 - Choosing and Using Navigation Systems 24:25 - Advancements in Navigation Technology 32:30 - The Future of Navigation Technology 35:03 - Final Thoughts and Contact Information --- RESOURCES Medtronic ENT - Sponsor https://www.medtronic.com/en-us/healthcare-professionals/products.html Dr. Arif Janjua https://surgery.med.ubc.ca/people/ajanjua/

The road to matching in ENT looks different for every applicant. Dr. Johnathan McGinn, Vice Chair of the Department of Otolaryngology at Penn State, shares how to make yours a success in this episode of the BackTable ENT Podcast, providing an insider's look at the otolaryngology residency match process. A must listen for aspiring ENTs! --- SYNPOSIS First, Dr. McGinn discusses the impact of applicants' backgrounds and institutional resources on their evaluations, the evolution of the interview process from virtual to in-person post-COVID, and the introduction and benefits of the signaling process in residency applications. Dr. McGinn also offers valuable advice for medical students on choosing away rotations, obtaining meaningful recommendation letters, and understanding the complexities of the holistic review system. Finally, he emphasizes the importance of mentorship and the personal journey of each applicant. --- TIMESTAMPS 00:00 - Introduction 01:49 - Evolution of the Residency Match Process 07:18 - The Role of Research in Residency Applications 12:11 - Advice for Students Without Home Programs 15:19 - Navigating Away Rotations 21:24 - Geographic Preferences and Signaling 32:25 - Choosing the Right Program for You 38:17 - Virtual vs. In-Person Interviews 42:09 - Application Review Process at Penn State 48:36 - Letters of Recommendation: Tips and Insights 52:28 - Special Considerations for DO Students 58:34 - Final Thoughts and Advice for Applicants --- RESOURCES Dr. Johnathan McGinn https://www.pennstatehealth.org/doctors/johnathan-d-mcginn-md-facs BackTable+ for ENT https://plus.backtable.com/pages/ent Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent

What does it take to become a physician in the military, and how does it differ from the civilian path? In this episode of Backtable ENT, Dr. Matthew Brigger and Dr. Philip Gaudreau, discuss their unique career paths in the Navy and how military service shaped their medical practices. --- SYNPOSIS Dr. Brigger, Division Chief of Pediatric Otolaryngology and professor at San Diego Children's Hospital, and Dr. Gaudreau, pediatric otolaryngologist and associate professor of surgery at the Uniformed Services University practicing at Naval Medical Center San Diego, share their career paths from medical school to serving in the Navy. The conversation delves into the application processes for military and civilian medical schools, differences in training, and how military service instills a sense of purpose and leadership. The episode also covers the intricate balance required to practice in both civilian and military settings, emphasizing the importance of flexibility, resourcefulness, and teamwork. --- TIMESTAMPS 00:00 - Introduction 02:57 - Military Medical Education Pathways 09:29 - Differences in Military and Civilian Medical Training 17:23 - Applying for ENT Residency in the Military 22:04 - Advice for Medical Students 23:16 - Military Medical Career Insights 28:36 - Military and Civilian Practices 31:19 - Leadership and Mentorship in Medicine 34:07 - Transitioning to Civilian Practice 42:44 - Final Thoughts and Reflections --- RESOURCES Dr. Philip Gaudreau https://health.usnews.com/doctors/philip-gaudreau-807965 Dr. Matthew Brigger https://www.rchsd.org/doctors/matthew-brigger-md-mph/ BackTable+ for ENT https://plus.backtable.com/pages/ent

What if the most common symptoms of obstructive sleep apnea in women aren't the ones doctors are trained to recognize? In this episode, Dr. Megan Durr, an otolaryngologist from the University of California San Francisco, discusses obstructive sleep apnea in women with host Dr. Gopi Shah.  The doctors explore how symptoms in women differ from men, leading to missed diagnoses. They delve into the lack of literature on the topic and the potential for underrepresented groups to be overlooked. The conversation highlights the need for more inclusive screening tools and the long-term cardiovascular risks women face due to untreated sleep apnea. Dr. Durr emphasizes the importance of better diagnosing and treating sleep apnea in women.  TIMESTAMPS 00:00 - Introduction  00:18 - Recognizing Obstructive Sleep Apnea in Women  00:36 - Pregnancy and Obstructive Sleep Apnea  01:13 - Menopause and Sleep Disorders  01:59 - Underrepresented Groups and OSA 02:47 - Symptoms and Misdiagnosis in Women  04:40 - Screening Questionnaires and Gender Bias  05:59 - Clinical Observations and Gender Disparities  09:39 - Long-term Effects of OSA in Women  CHECK OUT THE FULL EPISODE BackTable ENT Podcast Episode #182 Understanding OSA in Women with Dr. Megan Durr https://www.backtable.com/shows/ent/podcasts/182/understanding-osa-in-women

What should parents and pediatricians know about early ear molding interventions? In this episode of the BackTable ENT podcast, pediatric otolaryngologist Dr. Jason Qian discusses the practice of ear molding in infants and new advancements in the field with host Dr. Gopi Shah. --- SYNPOSIS Dr. Qian, a surgeon scientist at the University of California, San Diego, shares his journey in integrating ear molding into his clinical practice, explaining the importance of early intervention and the process involved in molding infant ears. They delve into the challenges of billing, different molding techniques, and the growing demand for non-invasive ear correction methods. Dr. Qian also highlights the potential future developments in the field, including enhanced education and simulation models. --- TIMESTAMPS 00:00 - Introduction 01:13 - Understanding Ear Molding in Infants 03:49 - Training and Incorporating Ear Molding 06:06 - Challenges and Success Stories 10:13 - Clinical Workflow and Procedures 30:08 - Billing and Insurance Issues 32:13 - Collaborations and Advanced Techniques 37:42 - Future of Ear Molding and Final Thoughts --- RESOURCES Dr. Jason Qian https://health.usnews.com/doctors/zhen-jason-qian-1078594 BackTable+ for ENT https://plus.backtable.com/pages/ent Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent

Could the key to more effective allergy therapies lie in the nasal microbiome? In this episode of BackTable ENT, Dr. Jennifer Villwock from Kansas University Medical Center discusses the intricacies of treating allergies and sinus issues with hosts Dr. Ashley Agan and Dr. Gopi Shah. --- SYNPOSIS Dr. Villwock begins by highlighting the importance of personalized medicine and the role of the microbiome in immunotherapy. Topics include topical and oral probiotics, the nasal microbiome, intralymphatic immunotherapy, and the significance of accurate allergy testing. Dr. Villwock also shares insights on sublingual and subcutaneous immunotherapy, the future of allergy treatments, and the impact of environmental factors on sinus health. --- TIMESTAMPS 00:00 - Introduction 01:53 - Understanding the Sinus Microbiome 04:34 - The Role of the Microbiome in Health 09:31 - Challenges in Microbiome Research 23:21 - Clinical Decision-Making in Antibiotic Use 25:07 - Exploring Probiotics & Dietary Factors for Sinus Health 30:12 - Immunotherapy and Microbiome 35:47 - Allergy Testing Methods 41:40 - Future Directions in Immunotherapy 44:18 - Conclusion and Final Thoughts --- RESOURCES Jennifer Villwock Profile https://www.kumc.edu/jvillwock.html AAOA 2025 Explorers Course in Allergy and Immunology, Vail, CO. March 27-29, 2025 https://www.aaoallergy.org/education/aaoa-explorers-course-2025/ BackTable+ for ENT https://plus.backtable.com/pages/ent Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent

We often think about exercising to stay fit as we age–but what about keeping our voices in shape? In this episode of BackTable ENT, Dr. Neel Bhatt, a laryngologist from the University of Washington in Seattle, discusses the intricacies of the aging voice with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Bhatt sheds light on the pathophysiology behind vocal fold atrophy, the role of glottic image capture, and the innovative use of the GlottIC (Glottal Image Capture) in measuring vocal fold bowing. They explore the impact of aging on the voice and swallowing, the relationship between vocal fold activity and overall health, and the benefits of voice therapy and procedural interventions in treating age-related voice changes. Overall, this episode summarizes valuable insights into maintaining vocal health as we age. --- TIMESTAMPS 00:00 - Introduction 01:33 - Understanding the Aging Voice and Clinical Presentations 10:41 - Impact of Aging Voice on Quality of Life 15:31 - Pathophysiology of Aging Voice 24:45 - Clinical Examination and Diagnosis 32:09 - Challenges in Scope Exams 39:33 - Swallow Studies: Fees vs. Video Fluoroscopy 41:16 - Management of Age-Related Voice Changes 58:27 - Maintaining Vocal Health with Age 01:01:01 - Conclusion and Contact Information --- RESOURCES Dr. Neel Bhatt https://otolaryngology.uw.edu/our-people/faculty/neel-k-bhatt-md BackTable+ for ENT https://plus.backtable.com/pages/ent Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent

Is nasal obstruction the hidden culprit behind CPAP failure in obstructive sleep apnea (OSA) patients? In this episode of BackTable ENT, host Dr. Ashley Agan discusses nasal airway obstruction's impact on OSA with guests Dr. Keith Matheny and Dr. Ashwin Ananth. --- This podcast is supported by: Aerin Medical https://aerinmedical.com/ --- SYNPOSIS The doctors emphasize the crucial role otolaryngologists play in diagnosing and treating nasal obstruction to enhance sleep quality, particularly in patients who struggle with CPAP therapy. They share their approaches to the nasal exam, treatments like VivAer and RhinAer, the importance of sleep endoscopies for CPAP-intolerant patients, and they also debunk some common misconceptions around treating OSA. This is a must-listen for ENTs and clinicians engaged in sleep medicine. --- TIMESTAMPS 00:00 - Introduction 01:57 - Discussion on Nasal Airway Obstruction 06:11 - Evolution of Sleep Disorder Treatments 12:05 - Challenges with CPAP and Alternatives 16:39 - Importance of Nasal Examination 28:44 - Nasal Medication Practices 33:20 - Sleep Endoscopy and CPAP Alternatives 35:44 - Nasal Surgery and OSA Treatment 39:57 - Posterior Nasal Nerve Ablation 46:10 - Final Thoughts and Recommendations --- RESOURCES Dr. Ashwin Ananth https://www.esentc.com/dr-ashwin-ananth Dr. Keith Matheny https://collincountyent.com/bio/keith-e-matheny/ BackTable+ for ENT https://plus.backtable.com/pages/ent Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent