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

What does it take to become a physician in the military, and how does it differ from the civilian path? In this episode of Backtable ENT, Dr. Matthew Brigger and Dr. Philip Gaudreau, discuss their unique career paths in the Navy and how military service shaped their medical practices.

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SYNPOSIS

Dr. Brigger, Division Chief of Pediatric Otolaryngology and professor at San Diego Children’s Hospital, and Dr. Gaudreau, pediatric otolaryngologist and associate professor of surgery at the Uniformed Services University practicing at Naval Medical Center San Diego, share their career paths from medical school to serving in the Navy. The conversation delves into the application processes for military and civilian medical schools, differences in training, and how military service instills a sense of purpose and leadership. The episode also covers the intricate balance required to practice in both civilian and military settings, emphasizing the importance of flexibility, resourcefulness, and teamwork.

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TIMESTAMPS

00:00 - Introduction

02:57 - Military Medical Education Pathways

09:29 - Differences in Military and Civilian Medical Training

17:23 - Applying for ENT Residency in the Military

22:04 - Advice for Medical Students

23:16 - Military Medical Career Insights

28:36 - Military and Civilian Practices

31:19 - Leadership and Mentorship in Medicine

34:07 - Transitioning to Civilian Practice

42:44 - Final Thoughts and Reflections

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RESOURCES

Dr. Philip Gaudreau

https://health.usnews.com/doctors/philip-gaudreau-807965

Dr. Matthew Brigger

https://www.rchsd.org/doctors/matthew-brigger-md-mph/

BackTable+ for ENT

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

What if the most common symptoms of obstructive sleep apnea in women aren’t the ones doctors are trained to recognize? In this episode, Dr. Megan Durr, an otolaryngologist from the University of California San Francisco, discusses obstructive sleep apnea in women with host Dr. Gopi Shah. 

The doctors explore how symptoms in women differ from men, leading to missed diagnoses. They delve into the lack of literature on the topic and the potential for underrepresented groups to be overlooked. The conversation highlights the need for more inclusive screening tools and the long-term cardiovascular risks women face due to untreated sleep apnea. Dr. Durr emphasizes the importance of better diagnosing and treating sleep apnea in women. 

TIMESTAMPS

00:00 - Introduction 

00:18 - Recognizing Obstructive Sleep Apnea in Women 

00:36 - Pregnancy and Obstructive Sleep Apnea 

01:13 - Menopause and Sleep Disorders 

01:59 - Underrepresented Groups and OSA

02:47 - Symptoms and Misdiagnosis in Women 

04:40 - Screening Questionnaires and Gender Bias 

05:59 - Clinical Observations and Gender Disparities 

09:39 - Long-term Effects of OSA in Women 

CHECK OUT THE FULL EPISODE

BackTable ENT Podcast Episode #182

Understanding OSA in Women with Dr. Megan Durr

https://www.backtable.com/shows/ent/podcasts/182/understanding-osa-in-women

What should parents and pediatricians know about early ear molding interventions? In this episode of the BackTable ENT podcast, pediatric otolaryngologist Dr. Jason Qian discusses the practice of ear molding in infants and new advancements in the field with host Dr. Gopi Shah.

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SYNPOSIS

Dr. Qian, a surgeon scientist at the University of California, San Diego, shares his journey in integrating ear molding into his clinical practice, explaining the importance of early intervention and the process involved in molding infant ears. They delve into the challenges of billing, different molding techniques, and the growing demand for non-invasive ear correction methods. Dr. Qian also highlights the potential future developments in the field, including enhanced education and simulation models.

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TIMESTAMPS

00:00 - Introduction

01:13 - Understanding Ear Molding in Infants

03:49 - Training and Incorporating Ear Molding

06:06 - Challenges and Success Stories

10:13 - Clinical Workflow and Procedures

30:08 - Billing and Insurance Issues

32:13 - Collaborations and Advanced Techniques

37:42 - Future of Ear Molding and Final Thoughts

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RESOURCES

Dr. Jason Qian

https://health.usnews.com/doctors/zhen-jason-qian-1078594

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

Could the key to more effective allergy therapies lie in the nasal microbiome? In this episode of BackTable ENT, Dr. Jennifer Villwock from Kansas University Medical Center discusses the intricacies of treating allergies and sinus issues with hosts Dr. Ashley Agan and Dr. Gopi Shah.

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SYNPOSIS

Dr. Villwock begins by highlighting the importance of personalized medicine and the role of the microbiome in immunotherapy. Topics include topical and oral probiotics, the nasal microbiome, intralymphatic immunotherapy, and the significance of accurate allergy testing. Dr. Villwock also shares insights on sublingual and subcutaneous immunotherapy, the future of allergy treatments, and the impact of environmental factors on sinus health.

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TIMESTAMPS

00:00 - Introduction

01:53 - Understanding the Sinus Microbiome

04:34 - The Role of the Microbiome in Health

09:31 - Challenges in Microbiome Research

23:21 - Clinical Decision-Making in Antibiotic Use

25:07 - Exploring Probiotics & Dietary Factors for Sinus Health

30:12 - Immunotherapy and Microbiome

35:47 - Allergy Testing Methods

41:40 - Future Directions in Immunotherapy

44:18 - Conclusion and Final Thoughts

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RESOURCES

Jennifer Villwock Profile

https://www.kumc.edu/jvillwock.html

AAOA 2025 Explorers Course in Allergy and Immunology, Vail, CO. March 27-29, 2025

https://www.aaoallergy.org/education/aaoa-explorers-course-2025/

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