BackTable ENT & Allergy

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 Airway
03:09 - Patient Concerns and Environmental Factors
10:24 - Impact of Temperature and CO2 on Allergies
14:57 - Barometric Pressure and Migraines
21:03 - Pollution, Particulate Matter, and Solutions
24:49 - Urban Planning
29:32 - Epigenetics and Environmental Impact
34:15 - Indoor Air Quality and Mold Issues
41:01 - Advocacy and Environmental Health
45:46 - Final Thoughts and Hope for the Future

---

RESOURCES

Dr. Jennifer Villwock
https://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.
---
TIMESTAMPS
00:00 - Introduction
06:18 - The Impact of CRS on Quality of Life
14:02 - Understanding Brain Fog and Cognitive Dysfunction
24:29 - Pathophysiology and Theories of Cognitive Dysfunction
27:44 - Chronic Inflammation and Cognitive Effects
28:59 - Impact of Biologics on Cognitive Function
31:28 - Risk Factors for Cognitive Dysfunction
35:02 - Olfactory Symptoms
37:13 - Future Research and Treatment Approaches
45:31 - 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 Procedures
07:47 - Safety Protocols and Equipment
19:11 - Anesthesia and Sedation Protocols
27:29 - Handling Emergencies and Reversal Agents
30:00 - Local Anesthesia and Toxicity
38:29 - Effective Anesthesia Techniques for Office Procedures
41:25 - Bleeding Control in Office Procedures
53:36 - Handling Office Procedure Complications
01:00:19 - 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 Procedures
https://www.oto.theclinics.com/article/S0030-6665(25)00020-9/abstract

AAOA anaphylaxis guidelines
https://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.
---
SYNPOSIS
The 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.
---
TIMESTAMPS
00:00 - Introduction
02:05 - Understanding and Diagnosing Bilateral Vocal Fold Paralysis
09:19 - Management and Treatment Options
25:40 - Tracheotomy Techniques and Considerations
31:31 - Exploring Surgical Options for Patients
34:22 - Addressing Dysphagia in Airway Surgeries
35:50 - Innovative Techniques in Laryngeal Reinnervation
39:34 - Patient Selection for Advanced Surgeries
47:11 - Laryngeal Pacing: A Future Option
54:50 - Final Thoughts and Recommendations
---
RESOURCES
Dr. James Daniero
https://uvahealth.com/findadoctor/James-Daniero-1386817484
Dr. 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.
---
SYNPOSIS
The 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.
---
TIMESTAMPS
00:00 - Introduction
03:23 - Understanding Survivorship & Challenges in Head and Neck Cancer
14:06 - Managing Mobility and Lymphedema
18:47 - Addressing Chronic Pain and Mental Health
21:37 - Dental Care and Trismus Therapy
25:58 - Long-Term Survivorship and Quality of Life
31:36 - Survivorship Clinics and Multidisciplinary Care
34:39 - Resources for Patients and Providers
38:49 - Future Research and Educational Gaps
---
RESOURCES
Dr. Heather Starmer
https://med.stanford.edu/profiles/heather-starmer
Dr. Michael Moore
https://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.
---
SYNPOSIS
Dr. 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.
---
TIMESTAMPS
00:00 - Introduction
03:20 - Defining Chronic Cough
06:47 - Patient Evaluation and Key Questions
11:10 - Asthma vs. Allergic Rhinitis Cough
18:31 - Red Flags in Chronic Cough
30:20 - Diagnostic Testing for Chronic Cough
34:46 - ENT Collaboration in Allergy
36:08 - Skin Testing vs. Blood Testing for Allergies
44:30 - Eosinophilic Esophagitis (EOE) & Upper Airway Cough Syndrome
50:28 - Allergy Treatment Pathways
01:03:05 - Conclusion and Contact Information
---
RESOURCES
Dr. 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

https://www.medtronic.com/en-us/healthcare-professionals/specialties/ear-nose-throat.html

---

SYNPOSIS

Dr. 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.

---

TIMESTAMPS

00:00 - Introduction
04:39 - Nasal Polyps: Patient Presentation and Initial Examination
10:25 - Detailed Examination and Endoscopy Techniques
17:26 - Imaging and Lab Workup
20:11 - Treatment Strategies and Patient Management
31:08 - Managing Patients with Allergies, AERD, and Asthma
34:09 - Biologics vs. Surgery: A Comparative Discussion
42:50 - Steroid Delivery Methods and Their Effectiveness
52:24 - Follow-Up, Long-Term Management and Future Research
57:01 - Conclusion and Final Thoughts

---

RESOURCES

Dr. 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/