BackTable ENT & Allergy

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).

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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.

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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 Polyposis
27:56 - Debating the Use of Packing in Sinus Surgery
40:24 - Scrutinizing Overhead Costs in Patient Care
42:45 - FESS Postoperative Care
43:54 - Evolving Biomaterials in Sinus Surgery
49:46 - The Debate on Middle Turbinectomy
50:46 - Middle Turbinate Management Strategies
01:13:17 - Concluding Thoughts on Surgical Practices

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RESOURCES

Dr. Satyan Sreenath
https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999

Dr. Dennis Tang
https://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.

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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.

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TIMESTAMPS

00:00 - Introduction
01:03 - Understanding Antibiotic Allergies
07:28 - The Importance of Accurate Allergy Diagnosis
10:55 - Key Questions for Diagnosing Allergies
17:10 - Implementing Allergy Testing in Healthcare Settings
19:06 - Identifying Severe Allergic Reactions
26:31 - Interpreting Allergy Skin Testing Procedures
33:17 - Penicillin and Cephalosporin Cross-Reactivity
37:15 - Drug Desensitization: Indications and Process
40:30 - Prognosis and Long-Term Outcomes of Drug Allergies
47:22 - Conclusion and Final Thoughts

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RESOURCES

Dr. Basil Kahwash
https://www.ohioentandallergy.com/physicians/basil-kahwash-md/

Dr. Cosby Stone
https://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.

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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.

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TIMESTAMPS

00:00 - Introduction
01:40 - Journey to Private Practice
06:36 - COVID-19 Impact and Adaptation
09:37 - Building a Successful Team
16:37 - Financial Strategies in Private Practice
27:59 - Creating an Exceptional Patient Experience
30:05 - Community Involvement and Unexpected Outcomes
39:53 - The Importance of Autonomy in Healthcare
48:41 - Developing Resources for Healthcare Providers
51:17 - Innovations in Patient Experience

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RESOURCES

Dr. Caleb Masterson
https://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.

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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.

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TIMESTAMPS

00:00 - Introduction
02:31 - Opportunities for ENTs in Industry
08:43 - Balancing Career and Family
16:39 - Navigating Industry Partnerships
21:39 - Addressing Criticism in Medicine
25:09 - Getting Started with Clinical Trials in Private Practice
28:57 - The Role of Mentorship and Networking
36:13 - The Importance of Women in Medicine
42:10 - Future Opportunities for Women in ENT

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RESOURCES

Dr. Karen Hoffmann
https://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. Ayesha Khalid.

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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.

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TIMESTAMPS

00:00 - Introduction
02:53 - The Importance of Tax Planning for Physicians
06:50 - Navigating Early Career Financial Decisions
11:40 - Building a Strong Professional Reputation
14:51 - The Seven-Year Itch: Seeking New Challenges
23:59 - Understanding Risk Tolerance
26:25 - Balancing Work and Life as an Otolaryngologist
29:37 - Retirement and Rediscovering Hobbies
32:36 - Leading Yourself and Crafting Your Life
35:37 - Data-Driven Leadership and Career Advice
38:43 - Final Takeaways

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RESOURCES

Robert Glazer
https://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.

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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!

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TIMESTAMPS

00:00 - Introduction
01:29 - Understanding Tongue Tie and Pediatric Airway
06:17 - The Role of Myofunctional Therapy
10:37 - Scientific Evidence and Research on Tongue Tie
15:52 - Clinical Approaches and Patient Evaluations
35:00 - Pre-Op and Post-Op Procedures
39:02 - Post-Surgery Recovery and Exercises
40:32 - Surgical Techniques and Tools
44:31 - Post-Operative Care and Pain Management
48:59 - Patient Selection and Considerations
01:02:41 - Sleep Studies and Outcome Measures
01:12:30 - Incision Techniques and Dissection Tools
01:17:24 - Closure and Post-Operative Care
01:23:51 - Innovations and Techniques in Surgery
01:28:09 - Final Thoughts

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RESOURCES

Dr. Brennan Dodson
https://www.bridgerent.com/

Allegra Bereszniewicz MS, CCC-SLP
https://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.

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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.

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TIMESTAMPS

00:00 - Introduction
03:11 - Common Presentations & Management of Preauricular Pits
06:17 - Differential Diagnoses and Imaging
13:56 - Surgical Considerations and Techniques
18:51 - Managing Recurrent Infections
19:07 - Skin Flap Techniques
19:55 - Excising Chronic Wounds
23:07 - Post-Op Management
24:46 - Revision Surgery Insights
29:08 - Final Tips and Pearls

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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.

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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.

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TIMESTAMPS

00:00 Introduction
02:33 Diving into Away Rotations
05:20 Factors to Consider for Away Rotations
22:54 Handling Away Rotation Offers
28:33 Succeeding in the OR
34:30 Navigating OR Dynamics
40:49 Securing Recommendation Letters
46:11 Onsite Interviews: Preparation and Presentation
50:48 Housing for Away Rotations
56:03 Final Tips: Observing Team Dynamics and Being Proactive

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RESOURCES

Chi Dang
https://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.

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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.

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TIMESTAMPS

00:00 - Introduction
01:39 - Understanding Inducible Laryngeal Obstruction
04:53 - Patient Presentation and Evaluation
07:51 - Management Strategies and Patient Care
09:06 - Trauma and Mental Health Considerations
19:27 - Interdisciplinary Approach and Additional Testing
23:52 - Understanding Subglottic Stenosis and Asthma
27:08 - The Role of Botox in Treatment
31:49 - Biofeedback and Patient Empowerment
34:25 - Exercise-Induced Laryngeal Obstruction
39:05 - Advanced Treatment Approaches and Challenges
41:06 - Conclusion and Final Thoughts

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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.

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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.

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TIMESTAMPS

00:00 - Introduction
03:18 - Discussing the New Indication for Immunotherapy
11:42 - Challenges and Practical Implementation
22:48 - Managing Tumor Progression: A Case Study
28:07 - Exploring Treatment Options: Surgery vs. Chemotherapy
36:46 - Operational Challenges and Future Directions
43:58 - Concluding Thoughts and Future Directions

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RESOURCES

Keynote 689
https://www.nejm.org/doi/full/10.1056/NEJMoa2415434