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The BackTable ENT Podcast is a resource for otolaryngologists to learn tips, techniques, and practical advice on all things ear, nose, and throat. Tune in to the BackTable ENT Podcast every week for candid conversations about rhinology, laryngology, otology, and head and neck surgery.
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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.
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SYNPOSIS
They 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.
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TIMESTAMPS
00:00 - Introduction
07:07 - Measles Contagion and Symptoms
23:23 - Complications and Long-term Effects
28:37 - Assessing Respiratory Status and Complications
29:44 - Addressing Common Vaccine Myths
31:18 - Challenges in Vaccination Conversations
32:38 - Personal Stories and Impact of Vaccination Choices
35:00 - Building Trust and Addressing Concerns
38:15 - Approaching Non-Vaccination in Clinical Practice
53:12 - Global Perspective on Vaccination
54:17 - 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
Hyperbaric oxygen is out and surgical innovation is in—here’s how the rescue flap is reshaping ORN care. Facial plastic and microvascular surgeons Dr. Ariel Frost and Dr. Eli Gordin join host Dr. Ashley Agan to discuss osteoradionecrosis (ORN) of the mandible.---SYNPOSISThe discussion begins with a detailed overview of the condition and patient presentation, and the impact of radiation therapy. The conversation then delves into historical and contemporary staging systems, highlighting the innovative 'rescue flap' technique developed by Cleveland Clinic. The episode emphasizes the ineffectiveness of hyperbaric oxygen therapy and showcases the superior outcomes and cost-effectiveness of the rescue flap procedure. Practical insights on surgical techniques, patient management, and future directions in treating ORN are also discussed.---TIMESTAMPS00:00 - Introduction 01:26 - Understanding Osteoradionecrosis (ORN)08:49 - Clinical Presentation of ORN13:56 - Diagnosis and Imaging16:58 - Staging and Treatment Options27:39 - Conservative Therapy for ORN37:19 - Understanding Disease Progression and Imaging39:46 - Exploring the Rescue Flap Technique52:46 - Post-Operative Care and Recovery59:20 - Advanced Stages and Bone Grafting01:13:38 - Cost Effectiveness and Referral Guidelines---RESOURCESDr. Ariel Frosthttps://utswmed.org/doctors/ariel-frost/Dr. Eli Gordin https://utswmed.org/doctors/eli-gordin/
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.
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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.
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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
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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.
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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!
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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
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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.
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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.
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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
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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.
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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.
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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.
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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.
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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
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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.
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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.
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TIMESTAMPS
00:00 - Introduction02:40 - History and Evolution of Office-Based Endoscopy05:32 - Understanding Obstructive Salivary Gland Disease09:36 - Patient Selection and Office-Based Procedures14:45 -Imaging and Diagnostic Approaches20:50 - Office Setup and Procedure Details30:38 - Injecting Mucosa for Better Access31:10 - Using Sour Candy to Stimulate Saliva32:29 - Dilation and Anesthesia Techniques37:05 - Handling Stones and Stents40:44 - Treating Stenosis in the Office47:16 - Post-Procedure Care and Instructions49:42 - Billing and Reimbursement Challenges54:43 - Future of Salivary Gland Endoscopy
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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.
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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.
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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
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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.
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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.
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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
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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.
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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.
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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
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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.
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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
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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.
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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.
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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
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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/
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