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 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

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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 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.
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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.
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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
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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.
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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.
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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
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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.
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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.
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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
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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.

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This podcast is supported by:
Medtronic ENT

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

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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.

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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

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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.

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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.

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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

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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.

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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.

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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

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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.

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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.

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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

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RESOURCES

Dr. Julie Strychowsky

https://www.schulich.uwo.ca/paediatricsurgery/people/faculty/Strychowsky,%20Julie.html

Kidane J, Thiel CL, Wang K, Rosen CA, Gandhi S. A Comparison of Environmental Impacts Between Reusable and Disposable Flexible Laryngoscopes. Laryngoscope. 2024 Dec 26. doi: 10.1002/lary.31927. Epub ahead of print. PMID: 39723758.

https://pubmed.ncbi.nlm.nih.gov/39723758/

Anderson J, Hu H. Environmental Sustainability: Waste Audit Comparison Operating Room and In-Office Laryngeal Surgery. Laryngoscope. 2024 Feb;134(2):803-806. doi: 10.1002/lary.31005. Epub 2023 Sep 2. PMID: 37658737.

https://pubmed.ncbi.nlm.nih.gov/37658737/

Cascade OR playbook

https://cascadescanada.ca/

Getting lost on a road trip is one thing, but the stakes are much higher in skull base surgery. In this episode of Backtable ENT, Dr. Arif Janjua, rhinologist and fellowship director at the University of British Columbia, delves into the intricacies and advancements in navigation for sinus and skull base surgery.

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This podcast is supported by:

Medtronic ENT

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

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SYNPOSIS

Dr. Janjua touches on his role in the Seattle Science Foundation, emphasizing continuous education and hands-on practice for surgeons. He emphasizes the importance of accuracy in patient tracking and registration, sharing techniques for optimizing navigation system setups by using a combination of tracing and touch points for precise registration. The doctors discuss the advantages of integrating navigation systems with specific instruments like microdebriders and suctions for improved surgical outcomes. Dr. Janjua also shares his preferred navigation tech, how he utilizes specific features in his surgical practice, and what’s on the horizon in sinus and skull base surgery.

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TIMESTAMPS

00:00 - Introduction

04:03 - Understanding Navigation in Sinus Surgery

07:41 - Navigating Instruments and Tools

21:58 - Challenges with Staff Training

22:43 - Choosing and Using Navigation Systems

24:25 - Advancements in Navigation Technology

32:30 - The Future of Navigation Technology

35:03 - Final Thoughts and Contact Information

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RESOURCES

Medtronic ENT - Sponsor

https://www.medtronic.com/en-us/healthcare-professionals/products.html

Dr. Arif Janjua

https://surgery.med.ubc.ca/people/ajanjua/

The road to matching in ENT looks different for every applicant. Dr. Johnathan McGinn, Vice Chair of the Department of Otolaryngology at Penn State, shares how to make yours a success in this episode of the BackTable ENT Podcast, providing an insider’s look at the otolaryngology residency match process. A must listen for aspiring ENTs!

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SYNPOSIS

First, Dr. McGinn discusses the impact of applicants’ backgrounds and institutional resources on their evaluations, the evolution of the interview process from virtual to in-person post-COVID, and the introduction and benefits of the signaling process in residency applications. Dr. McGinn also offers valuable advice for medical students on choosing away rotations, obtaining meaningful recommendation letters, and understanding the complexities of the holistic review system. Finally, he emphasizes the importance of mentorship and the personal journey of each applicant.

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TIMESTAMPS

00:00 - Introduction

01:49 - Evolution of the Residency Match Process

07:18 - The Role of Research in Residency Applications

12:11 - Advice for Students Without Home Programs

15:19 - Navigating Away Rotations

21:24 - Geographic Preferences and Signaling

32:25 - Choosing the Right Program for You

38:17 - Virtual vs. In-Person Interviews

42:09 - Application Review Process at Penn State

48:36 - Letters of Recommendation: Tips and Insights

52:28 - Special Considerations for DO Students

58:34 - Final Thoughts and Advice for Applicants

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RESOURCES

Dr. Johnathan McGinn

https://www.pennstatehealth.org/doctors/johnathan-d-mcginn-md-facs

BackTable+ for ENT

https://plus.backtable.com/pages/ent

Check out BackTable+ for ENT, our sponsor and new e-learning platform! https://plus.backtable.com/pages/ent