BackTable ENT & Allergy

BackTable ENT & Allergy

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BackTable ENT & Allergy episodes

  • Ep. 286 What's The Big Deal With This BackTable App? with Dr. Aaron Fritts

    BackTable is moving beyond the traditional podcast experience and into a platform built specifically for clinicians. On this episode of the BackTable ENT & Allergy Podcast, hosts Drs. Gopi Shah and Ashley Agan welcome Dr. Aaron Fritts, interventional radiologist and BackTable CEO and Co-Founder, to discuss the history and future of BackTable, and what listeners can look forward to on the new BackTable App.


    ---

    Get the BackTable app
    https://www.backtable.com/app

    ---

    Timestamps
    00:00 - Introduction
    00:51 - Meet the CEO and Co-Founder
    02:32 - How Backtable Got Its Name
    04:32 - Why Move to the App
    07:31 - Community and Learning Features
    12:36 - Playlists and Transcripts
    15:42 - Beyond Backtable Content
    18:07 - Searchability and Other Platform Limits
    19:35 - Privacy and NPI Verification
    21:31 - Download the App and Give Feedback
    22:53 - October Timeline and Academy Party
    24:26 - Closing Thoughts

    ---

    More about this episode

    Dr. Fritts shares how BackTable started as an app concept for medical devices in 2016, evolved into the IR podcast in 2017, and expanded to the ENT show in 2020. He explains how Gopi coined the name “BackTable” as an homage to the informal, behind-the-scenes conversations that fuel clinical learning. With eight shows now producing 30 to 40 episodes each month, BackTable will begin releasing most new podcast episodes exclusively on the BackTable app starting in October.

    The conversation highlights the app’s robust features designed for busy clinicians, including physician-only NPI-verified guest Q&As, quick-study cases, searchable and organized playlists, episode transcripts, offline listening, upcoming CarPlay integration, and access to resources like the Curbsiders internal medicine podcast. The BackTable app is free to download and free to use, providing easy access to a growing library of high-yield medical education content.

    ---

    Resources

    Download the BackTable App on Google Play
    https://play.google.com/store/apps/details?id=com.backtable.app&hl=en_GB

    Download the BackTable App on the Apple App Store
    https://apps.apple.com/us/app/backtable/id6751363383

    ---

    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.

    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.
    ► https://www.backtable.com/app

    28 min
  • Ep. 285 Post-Operative Care & Complications in Coblation Intracapsular Tonsillectomy in Children with Dr. Kevin Huoh and Dr. Stephen Chorney

    Most surgeons trained learning extracapsular tonsillectomies. What does the evidence say about intracapsular tonsillectomies? Two pediatric otolaryngologists explain why they made the switch and never looked back. On this episode of the BackTable ENT Podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah sit down with pediatric otolaryngologists Dr. Stephen Chorney from UT Southwestern and Children's Health Dallas and Dr. Kevin Huoh from Children's of Orange County to examine post-operative complications after tonsillectomy and adenoidectomy, with a focus on coblation intracapsular tonsillectomy.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    This podcast is supported by


    Smith + Nephew
    https://www.smith-nephew.com/en/


    ---


    Timestamps


    00:00 - Introduction
    02:53 - Why Switch Techniques?
    07:58 - Risk Stratification and Patient Selection
    11:04 - Respiratory Complications and Management
    15:57 - Preop Screening
    21:35 - Risks for Post-op Bleeding and Counseling
    26:16 - Managing Post-op Bleeding
    31:56 - Surgical Tips to Prevent Bleeds and Management
    39:30 - Intracapsular Tonsillectomy in Older Kids
    43:44 - Post Op Pain Plan and Return To School
    48:33 - Use of Toradol & Readmission for Pain and Dehydration
    53:16 - Caution of Burn and Stenosis Injuries
    61:01 - Final Takeaways


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    More about this episode


    Dr. Chorney and Dr. Huoh share why they each committed fully to the intracapsular technique and what that shift has meant in practice, from secondary hemorrhage rates hovering around 0.5–0.6% to fewer nursing line calls, readmissions for pain and dehydration, and faster returns to school and normal activity. They walk through their approach to patient risk stratification and admission criteria (age <3, severe OSA/comorbidities, AHI >30/ICU consideration) as well as how to manage the most common post-operative respiratory complications. The conversation also covers practical guidance for handling outside-ER bleed calls, the role of nebulized TXA, toradol considerations, and managing dehydration. They also share for navigating intracapsular coblation in older children, strategies to reduce burn injuries, and a closer look at the rare but serious risk of pharyngeal stenosis.


    Check out this episode to hear Dr. Chorney and Dr. Huoh discuss how intracapsular tonsillectomy doesn't just improve outcomes but can transform the recovery experience for patients and their families.


    ---


    Resources


    Extracapsular vs Intracapsular Tonsillectomy: Outcomes in Children with a Focus on Developmental Delay
    https://pubmed.ncbi.nlm.nih.gov/34839135/


    Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United States
    https://pubmed.ncbi.nlm.nih.gov/32969500/


    Dr. Chorney Episode 259 - Understanding Coblation Tonsillectomy https://www.backtable.com/shows/ent/podcasts/259/understanding-coblation-tonsillectomy-benefits-outcomes-techniques


    Dr. Huoh Episode 110 - Intracapsular Tonsillectomy in Children
    https://www.backtable.com/shows/ent/podcasts/110/intracapsular-tonsillectomy-in-children


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    1 hr 4 min
  • Ep. 284 Optimizing Nasal Airway for CPAP Compliance with Dr. Michael Hutz and Dr. Atul Malhotra

    Is nasal obstruction the overlooked culprit behind CPAP intolerance? On this episode of BackTable ENT & Allergy, Dr. Gopi Shah interviews Dr. Atul Malhotra and Dr. Michael Hutz to examine the critical but often underappreciated role of the nose in obstructive sleep apnea management. They discuss how nasal obstruction can undermine CPAP adherence, why relying solely on AHI may miss key issues, and how identifying the true cause of intolerance can lead to more personalized and effective therapy.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    This podcast is supported by


    Aerin Medical
    https://vivaer.com/


    ---


    Timestamps


    00:00 - Introduction
    04:05 - OSA Presentation and AHI Limitations
    08:13 - Understanding CPAP Intolerance and Nasal Obstruction
    15:24 - Evaluating Nasal Obstruction
    20:32 - Nasal Anatomy and Workup
    27:47 - DICE Technique and Assessing Dynamic Nasal Collapse
    32:51 - Medical and Non-Surgical Management
    37:29 - Surgical Options and VivAer
    43:39 - Nasal Procedures and CPAP Success
    51:57 - Nasal Surgery and Heart Outcomes
    55:23 - Beyond CPAP: Nasal Breathing, Myofunctional Therapy, and Collaborative Care
    01:04:51 - Wrap Up


    ---


    More about this episode


    The physicians review practical strategies for evaluating nasal obstruction, from targeted patient questionnaires, physical exams, nasal endoscopy, and selective imaging. The doctors also detail medical and surgical treatment options, from allergy management and nasal sprays to septoplasty, turbinate reduction, functional rhinoplasty, and temperature-controlled radiofrequency (VivAer). Throughout the episode, they highlight how comprehensive nasal evaluation and intervention can significantly improve CPAP comfort and adherence.


    ---


    Resources


    Dr. Atul Malhotra - https://providers.ucsd.edu/details/22362/sleep-medicine-pulmonology-(lung)


    Dr. Michael Hutz- https://doctors.rush.edu/details/19100


    CPAP treatment persistence following nasal procedures in obstructive sleep apnea - https://www.tandfonline.com/doi/pdf/10.1080/13696998.2026.2671550


    Design and rationale for treating Obstructive Sleep Apnea using Targeted Hypoglossal Nerve Stimulation trial - https://www.sciencedirect.com/science/article/pii/S1551714422001306


    The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea - https://pmc.ncbi.nlm.nih.gov/articles/PMC9498537/


    VATRAC Trial of VivAer - https://aerinmedical.com/company/news-and-media/aerin-medical-announces-positive-two-year-outcomes-from-the-vatrac-trial-of-vivaer/


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    1 hr 8 min
  • Ep. 283 Streamlining Surgery: The Future of the OR with Dr. Raj Sindwani

    What if the next major advance in ENT surgery isn’t a new instrument, but a better-integrated operating room? In this episode of the BackTable ENT & Allergy Podcast, Cleveland Clinic rhinologist and skull base surgeon Dr. Raj Sindwani joins Dr. Gopi Shah and Dr. Ashley Agan to discuss how reducing cognitive load, improving workflows, and creating a more efficient OR environment can enhance the surgical experience.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    This podcast is supported by


    Stryker
    https://www.stryker.com/us/en/ent.html


    ---


    Timestamps


    00:00 - Introduction
    03:50 - Where Surgery Happens: Choosing the Right Site for Service
    06:27 - Quality Safety And Throughput
    09:48 - Reducing Cognitive Load In Surgery
    15:34 - Building an Efficient OR Ecosystem And Culture
    23:06 - Tech Adoption and Team Training
    26:19 - Smarter Surgical Navigation and Augmented Reality
    37:02 - Navigation Accuracy, Registration, and Smart Coaching
    40:29 - Inside the Stryker RISE Platform
    49:55 - Integration Challenges and Voice-Control Safety
    56:36 - Surgical Ergonomics and Injury Prevention
    01:09:14 - The Future of Surgical Innovation and AI in the OR


    ---


    More about this episode


    Dr. Sindwani explores how minimizing unnecessary friction, improving team dynamics, and thoughtfully integrating technology can help surgical teams focus on what matters most: patient care. The conversation examines the operating room as an ecosystem where people, processes, and technology all contribute to patient outcomes. Dr. Sindwani shares strategies for reducing extrinsic cognitive load, including standardizing room setup, minimizing interruptions, and optimizing the surgical environment.
    He also discusses advances in sinus and skull base navigation, augmented reality guidance, and Stryker’s RISE platform, highlighting how integrated technology can simplify workflow, improve ergonomics, and reduce distractions in the OR. Throughout the episode, Dr. Sindwani emphasizes the importance of thoughtful technology adoption, team collaboration, and designing the operating room of the future around safety, efficiency, and the needs of both patients and surgeons.


    ---


    Resources


    Dr. Raj Sindwani
    https://providers.clevelandclinic.org/provider/raj-sindwani/4268990


    Stryker ENT
    https://www.stryker.com/us/en/ent.html


    Stryker RISE Platform
    https://www.stryker.com/us/en/portfolios/medical-surgical-equipment/integration-and-connectivity/or-integration/rise.html


    Technological Advances in Sinus and Skull Base Surgery by Dr. Raj Sindwani
    https://www.oto.theclinics.com/article/S0030-6665(17)30050-6/fulltext


    Ergonomics in ENT Practice NIH Article
    https://pmc.ncbi.nlm.nih.gov/articles/PMC11455805/


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    1 hr 15 min
  • Ep. 282 Awake Cochlear Implantation: An Expert Guide with Dr. Sarah Mowry

    Have you considered performing a cochlear implant while your patient is awake? In this episode of the Backtable ENT & Allergy Podcast, Dr. Walter Kutz and Dr. Brandon Isaacson sit down with Dr. Sarah Mowry to explore her protocol for cochlear implants under local anesthesia, an approach especially relevant for older adults concerned about the cognitive risks of general anesthesia. Dr. Mowry shares her criteria for patient selection, preoperative counseling strategies, and how she adapts the OR setup to maximize comfort and communication during awake surgery.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    Timestamps


    00:00 - Introduction
    02:06 - Why to Consider Awake Cochlear Implants
    05:32 - Indications for Awake CI
    08:50 - Local Blocks and Pain Control
    10:58 - Counseling and Expectations
    14:40 - Preventing Intraoperative Vertigo and Converting to General Anesthesia
    17:17 - Set Up and Communication with Patient
    19:14 - Lesser Occipital Nerve Block and Potential Role of Processed EEG
    26:32 - Pitch Matching for Single-Sided Deafness, CI, and Anxiety Considerations
    29:00 - Feedback from Patients and Electrode Choice
    31:30 - Advice to Surgeons and Closing Remarks


    ---


    More about this episode


    The conversation covers her anesthesia protocol, including lesser occipital and postauricular nerve blocks, minimizing propofol, and using topical 2% lidocaine in sensate areas like the facial recess and epitympanum. Dr. Mowry discusses practical strategies of using warmed irrigation to reduce intraoperative vertigo and contingency plans for conversion to general anesthesia. She discusses electrode considerations and the potential role of processed EEG to titrate anesthesia depth and practical tips for surgeons interested in adopting awake cochlear implantation. Throughout, they highlight the importance of individualized patient care, multidisciplinary teamwork, and the growing role of local anesthesia in otologic surgery.



    ---


    Resources


    Cochlear Implantation Under Local Anesthesia With Conscious Sedation in the Elderly: First 100 Cases
    https://pubmed.ncbi.nlm.nih.gov/32663339/


    Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomes
    https://pubmed.ncbi.nlm.nih.gov/34487218/


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    37 min
  • Ep. 281 Expert Insight on Congenital CMV & Pediatric Hearing Loss with Dr. Albert Park

    Did you know that congenital CMV-related hearing loss can develop several years after birth? On the BackTable ENT & Allergy Podcast, hosts Dr. Gopi Shah and Dr. Jeff Hyzer interview pediatric otolaryngologist Dr. Albert Park about the latest evidence on congenital CMV and its role in pediatric sensorineural hearing loss. The discussion covers diagnosis, risk factors, screening protocols, testing strategies, antiviral treatment, genetic workup, long-term surveillance, and future directions for early detection and prevention.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    Timestamps


    00:00 - Introduction
    02:47 - Basics of CMV Infections and Hearing Loss Presentation
    07:57 - CMV Screening Workflow
    11:33 - Saliva vs. Urine Based Screening
    14:00 - Early Workup and Communication
    19:37 - Late Onset Workup and Use of Antivirals
    24:39 - Treatment with Antiviral Medications
    27:22 - Head Ultrasound vs. MRI
    30:06 - Role of Genetic Testing
    32:47 - Surveillance and Progression Risk
    37:29 - CI Outcomes and Predictors
    42:18 - BAHA and Older Candidates
    45:44 - Awareness, Prevention Efforts, and Education
    54:25 - Vaccines and Universal Screening Pitfalls
    57:40 - Advocacy and Closing Thoughts


    ---


    More about this episode


    Dr. Park explains the differences between congenital and acquired CMV, reviews epidemiology and, and highlights that hearing loss may be present at birth or develop later in childhood. He discusses Utah’s evolution from hearing-targeted CMV testing to universal NICU screening, emphasizing the importance of diagnosis within the first 21 days of life. The conversation covers saliva versus urine testing, dried blood spot testing, and the role of a multidisciplinary team in evaluation and management. Dr. Park also reviews antiviral treatment strategies, imaging and genetic testing considerations, audiologic surveillance, and cochlear implantation outcomes. Finally, he discusses ongoing advocacy efforts, emerging prenatal screening technologies, and future directions and challenges for CMV prevention and early detection.


    ---


    Resources


    Nance & Morton NEJM Paper Cited - 20% of Congenital SNHL linked to Congenital CMV
    https://www.nejm.org/doi/full/10.1056/NEJMra050700


    Dr.Kimberlin’s work supporting antiviral treatment for 6 months
    https://www.nejm.org/doi/full/10.1056/NEJMoa1404599?utm_source=openevidence


    Dr.Vossen’s antiviral therapy research
    https://pubmed.ncbi.nlm.nih.gov/38336204/


    AAP Red Book
    https://publications.aap.org/redbook


    Dr. Smith’s Research - Genetic Testing for Congenital Bilateral Hearing Loss in the Context of Targeted Cytomegalovirus Screening
    https://pubmed.ncbi.nlm.nih.gov/31985074/


    Dr.Park’s Research Congenital Cytomegalovirus Testing Outcomes From the ValEAR Trial
    https://pubmed.ncbi.nlm.nih.gov/38415855/


    Dr.Park’s Research - Analysis of an Expanded Targeted Early Cytomegalovirus Testing Program
    https://pubmed.ncbi.nlm.nih.gov/36884018/


    Dr.Foulon - Hearing Loss With Congenital Cytomegalovirus Infection
    https://pubmed.ncbi.nlm.nih.gov/31266824/


    Research about the use of Vaclovir to reduce vertical transmission
    https://pubmed.ncbi.nlm.nih.gov/32919517/


    Dr.Gantt’s research on the Ping-Pong Effect
    https://pubmed.ncbi.nlm.nih.gov/29889809/


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    1 hr 2 min
  • Ep. 280 Leadership Through Resiliency & Mentorship with Dr. Troy Woodard

    Every leader has a story. The experiences, mentors, and moments along the way shape not only who we become, but how we lead. In this episode of BackTable ENT and Allergy, Drs. Ashley Agan and Gopi Shah interview internationally renowned rhinologist Dr. Troy Woodard about his leadership journey and the lessons learned along the way. Together, they explore how leadership is about actions rather than titles, the value of national involvement, and the importance of embracing change and personal growth throughout a career.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    Timestamps


    00:00 - Introduction
    02:20 - From Fan Moment to Bio
    04:15 - Early Leadership Roots
    06:40 - Lead Without a Title
    08:43 - Finding Leadership Itch
    14:56 - Burnout and the Pivot
    19:16 - Coaching and Victim Mindset
    22:31 - FMLA Reset and Purpose Shift
    27:11 - Letting Go to Grow
    30:14 - Listening Tour at Buffalo
    33:59 - DEI and Minority Leadership
    35:47 - Mentorship and Leaky Pipeline
    39:48 - Purpose Through Outreach
    44:28 - Respectful Change Leadership
    47:25 - Emotional Intelligence Growth
    50:27 - Advice for New Leaders
    52:53 - Handling Dream Crushers
    56:50 - Imposter Syndrome Breakthrough
    01:01:01 - Leadership Impact and Closing Remarks


    ---


    More about this episode


    Dr. Woodard describes early leadership roles, being raised by a single mother, the mentors who impacted his career, and how responsibility and service shaped his work ethic. He explains that leadership doesn’t require a title and recounts pivoting from limited departmental opportunities to national involvement through the Academy and ARS, including advocacy work. Woodard discusses burnout, executive coaching, emotional intelligence, delegation, mentorship and ultimately, how recognizing and embracing a changing purpose mid-career is a normal part of professional growth. Now Chair of Otolaryngology-Head and Neck Surgery at the University at Buffalo, he practices “listening tours,” mentors faculty, and emphasizes how diversity drives excellence while highlighting mentorship and pipeline development.


    ---


    Resources


    Dr. Troy Woodard’s Public Email
    [email protected]


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    1 hr 5 min
  • Ep. 279 Collaborative Care in Chronic Sinusitis & Allergies with Dr. Karen Kaufman

    When should recurrent sinus infections trigger an allergy or immune workup? In this episode of the BackTable ENT and Allergy podcast, Dr. Karen Kaufman of Kaufman Allergy, Asthma, & Immunology in Vienna, Virginia, sits down with Dr. Ashley Agan to discuss chronic sinusitis evaluation, allergy testing, immunotherapy, immune deficiency screening, and building a private practice.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    Timestamps


    00:00 - Introduction
    02:53 - Chronic Sinusitis Basics
    06:44 - Sinusitis Types and Polyps
    10:18 - Testing and Treatment Plan
    18:40 - When to Suspect Immunodeficiency
    25:44 - Allergy Testing Methods
    38:39 - Why Go Solo
    43:10 - Practice Growth, Visibility, Team Building, and Systems
    51:55 - ENT and Allergy Collaboration
    55:50 - Closing Remarks


    ---


    More about this episode


    Dr. Kaufman explains how to distinguish chronic sinusitis from other causes of nasal and facial symptoms, when to evaluate for allergy and immune dysfunction, and how sinusitis phenotypes influence treatment decisions. She also shares her experience launching a private practice during the pandemic and discusses strategies for practice growth through community engagement, increased visibility, and social media.


    ---


    Resources


    Dr. Karen Kaufman - https://kaufmanallergy.com/


    Jeffery Modell Foundation 10 Warning Signs of Primary Immunodeficiency - https://www.uhhospitals.org/-/media/files/rainbow/services/allergy-and-immunology/10warningsigns.pdf


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    59 min
  • Ep. 278 Comprehensive Evaluation and Surgical Management of Nasal Septal Perforations with Dr. Oswaldo Henriquez

    Septal perforations can be deceptively challenging, with a wide range of etiologies, symptoms, and treatment options to consider. In this episode of BackTable ENT and Allergy podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah interview Dr. Oswaldo Henriquez, a board-certified otolaryngologist and rhinologist at WellStar Health System in Atlanta, to explore the complexities of evaluating and managing nasal septal perforations. The conversation covers how perforation size and location shape symptoms, the most common causes including iatrogenic trauma and chronic nose picking, and a thorough, stepwise approach to diagnosis and treatment.

    ---
    Get the BackTable app
    https://www.backtable.com/app

    ---

    Timestamps
    00:00 - Introduction
    03:01 - Septal Perforations Overview
    07:58 - Causes and Risk Factors
    13:26 - History Red Flags and Differential Diagnosis
    16:28 - Exam and Documentation Tips
    21:22 - Labs Biopsy and Imaging Workup
    31:19 - Conservative Care and Septal Buttons
    34:20 - Surgery Candidacy and Counseling
    41:35 - Surgical Techniques Landscape
    47:38 - Scaffolds and Grafts
    49:07 - Septal Blood Supply Map
    53:00 - CAT Scan Planning Tips
    55:15 - AEA Flap Technique
    01:05:22 - Real Case Walkthrough
    01:10:41 - Postop Care and Swelling
    01:20:44 - Pitfalls and Success Rates
    01:24:09 - Wrap Up

    ---

    More about this episode
    Dr. Henriquez outlines the key components of a comprehensive workup, including endoscopic exam, measurement, biopsy, and CT imaging for surgical planning. He discusses management options from conservative care and septal buttons to advanced endoscopic pedicled flap repairs, sharing insight on surgical techniques, success rates, splinting, and post-op care. The episode provides practical tips for physicians at any career stage looking to refine their approach to septal perforations, from diagnosis through recovery.

    ---

    Resources
    ENT Animations
    https://www.youtube.com/@Dr.IsamAlobid

    ---

    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.

    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.
    ► https://www.backtable.com/app

    1 hr 29 min
  • Ep. 277 Molecular Diagnostics for Thyroid Nodules with Dr. Erik Alexander

    For years, an indeterminate thyroid biopsy meant diagnostic surgery but molecular testing is now changing that reality entirely. On this episode of the BackTable ENT podcast, Dr. Ashley Agan interviews endocrinologist Dr. Erik Alexander about how molecular testing and a systematic, layered approach to thyroid nodule evaluation are reducing diagnostic surgeries and enabling more individualized patient care.


    ---


    Get the BackTable app
    https://www.backtable.com/app


    ---


    This podcast is supported by


    Veracyte
    https://www.veracyte.com/


    ---


    Timestamps


    00:00 - Introduction
    02:48 - Incidence, Presentation, and Workup of Thyroid Nodules
    06:26 - Hormonal Impact and Indications for FNA
    10:49 - FNA workflow and Bethesda Categories
    16:10 - Role of Molecular Testing for Indeterminate Nodules
    19:59 - Evolution of Molecular Testing and Afirma
    23:51 - Basics of DNA based Testing and RNA based Testing
    28:34 - Comparing DNA based and RNA Based Testing
    32:10 - Utility of Molecular Testing and Sampling Techniques
    35:55 - Cost Coverage and Practical Limits
    39:20 - Clinical Implications and Future Impact
    42:00 - Final Takeaways


    ---


    More about this episode


    Together they walk through the full evaluation pathway, including ultrasound risk stratification using the TI-RADS criteria, the role of TSH testing, and how FNA indications have shifted from biopsying every solid nodule to a more selective, risk-adapted approach. The discussion covers the Bethesda classification system and addresses why the one-third of patients landing in indeterminate categories (Bethesda III, IV, and V) have historically been the most challenging and most overtreated group. The conversation then explores molecular diagnostics as an additional layer of risk assessment, highlighting key differences between DNA-based mutation panels and RNA-based expression classifiers. Dr. Alexander also discusses practical considerations like insurance coverage, sampling technique, turnaround time, and the future potential of molecular testing to move beyond diagnosis toward individualized prognosis.


    ---


    Resources


    American College of Radiology: TI-Rads Guidelines
    https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/TI-RADS/TI-RADS-Assessment-Categories.pdf


    American Thyroid Association - Nodule Guidelines
    https://pmc.ncbi.nlm.nih.gov/articles/PMC4739132/


    Bethesda System for Reporting Thyroid Ctyopathology
    https://www.ncbi.nlm.nih.gov/books/NBK278969/table/thyroid-nod-canc-eld.T.bethesda_system_f/


    ---


    BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons.


    Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.


    ► https://www.backtable.com/app

    46 min

About BackTable ENT & Allergy

From the publisher's feed

The go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Tune in every week for practical, physician-led conversations on common and complex clinical topics in allergy,…

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