BackTable ENT & Allergy

En este episodio de Backable ENT, El Dr. Carlos Torre entrevista al Dr. Luisam Tarrats, un otorrinolaringólogo de Puerto Rico, sobre su práctica médica y su viaje empresarial para construir Burble, una empresa de enjuagues nasales.

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SYNPOSIS

Primero, el episodio explora la trayectoria del Dr. Luisam Tarrats, quien decidió regresar a Puerto Rico para mejorar la oferta quirúrgica y enfrentar los desafíos tras el huracán María. Se destaca su innovación empresarial con Burble Inc., una empresa que desarrolló un sistema de irrigación nasal salina aprobado por la FDA. La conversación incluye temas como la importancia de la higiene nasal para la salud y el bienestar, estrategias para emprender en el campo médico, y el balance entre la vida profesional y personal. Se subraya la importancia de educar a médicos y pacientes sobre el uso adecuado de productos de higiene nasal y el papel proactivo de la medicina preventiva.

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TIMESTAMPS

00:00 - Trayectoria profesional del Dr. Luisam Tarrats

03:45 - Fundación y desarrollo de Burble

16:51 - Innovaciones y beneficios del producto Burble

37:40 - Educación y concienciación sobre la higiene nasal

48:03 - Equilibrio entre la vida profesional y personal

58:39 - Consideraciones legales y estructurales

01:16:54 - Consejos para emprendedores aspirantes

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RESOURCES

Burble

https://letsburble.com/

Surgeons are fortunate that their work is both fulfilling and well compensated. When this earning potential meets solid financial planning, personal and material satisfaction results. In this episode of BackTable ENT, Dr. Robert Puchalski (South Carolina ENT) discusses financial wellness with guest host Dr. Ayesha Khalid (Cambridge Health Alliance).

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SYNPOSIS

First, Dr. Puchalski describes the benefits and challenges of different private practice models, emphasizing the importance of market share. Then, he explores income generation beyond clinical work, including ancillary services and investment. Transitioning to personal finance, he shares financial planning strategies so that practicing medicine is a choice rather than a necessity. The episode wraps with Dr. Puchalski’s thoughts on practicing medicine.

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TIMESTAMPS

00:00 - Introduction

06:56 - Market Share: Why it Matters

10:16 - The Importance of Passive Income & Ancillaries

21:47 - Personal Finance for Physicians

28:13 - Supporting Wellness Through Financial Planning

43:11 - Final Thoughts

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RESOURCES

Dr. Robert Puchalski’s SC ENT Profile: https://www.southcarolinaent.com/providers/robert-puchalski

Dr. Ayesha Khalid’s Cambridge Health Alliance Profile: https://www.challiance.org/doctors/profile?n=899

Tinnitus remains one of otology’s greatest, most challenging, and unsolved clinical problems. In this episode of the BackTable ENT Podcast, Dr. Hamid Djalilian, chair of otolaryngology at University of California Irvine (UCI), joins guest host and fellow otologist Dr. Walter Kutz (UT Southwestern) to discuss contemporary tinnitus therapy.

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This podcast is supported by:

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

First, Dr. Djalilian shares how he got interested in tinnitus. After observing how migraines and tinnitus share many similar triggers, he hypothesized that increased central sensitivity underlies both diseases. He successfully adopted migraine management strategies for his tinnitus patients and found great clinical success. After sharing pathophysiologic similarities between the two diseases, Dr. Djalilian expounds on how he evaluates and treats tinnitus. His discussion includes lifestyle modifications, medication, and emerging surgical therapies. Finally, he advises listeners to think of tinnitus as a manageable condition, rather than a poorly-understood phenomenon.

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TIMESTAMPS

00:00 - Introduction

02:34 - The Challenge of Treating Tinnitus

07:19 - Connecting Tinnitus & Migraine

15:59 - Atypical (Otologic) Migraine & Diagnostic Challenges

19:59 - Managing Tinnitus Triggers

26:27 - Dietary Triggers of Tinnitus

28:44 - The Role of Sleep Quality in Tinnitus

33:04 - Caring for Older Patients with Tinnitus

37:59 - New Therapies for Tinnitus: Sound & Cognitive Behavioral Therapy

44:08 - Neuromodulation: The Future of Tinnitus Therapy?

51:34 - Final Thoughts on Tinnitus Treatment

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RESOURCES

BackTable ENT Episode 60 Otologic Manifestations of Migraine with Dr. Hamid Djalilian

https://www.backtable.com/shows/ent/podcasts/60/otologic-manifestations-of-migraine

Dr. Hamid Djalilian University of California, Irvine Profile: https://www.ent.uci.edu/faculty/hamid-djalilian-md.asp

Dr. Hamid Djalilian’s Website:

https://hamiddjalilianmd.com/

Fan-Gang Zeng (Hearing and Speech) Lab at UCI:

https://faculty.sites.uci.edu/hesplab/

PearsonRavitz:

https://pearsonravitz.com/

Many of us continue to associate “Artificial Intelligence” (AI) with the worst moments in The Terminator, Ex Machina, or The Matrix. Others think first of the known ethical challenges of AI and the potential workforce disruption of widespread AI implementation in healthcare and beyond. Dr. Mas Takashima, AI expert and chair of Houston Methodist’s Otolaryngology Department, wants to change our lingering apprehensions around AI. In this episode, Dr. Takashima interviews his Houston Methodist colleague and guest host Dr. Omar Ahmed.

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SYNPOSIS

First, Dr. Takashima shares his journey from video gamer to sinus surgeon and advocate for AI in medicine. He explains relevant concepts such as Generative Preformed Transformer (GPT) and neural network. Then, he and Dr. Ahmed dive into applications of AI to ENT, which include (but aren’t limited to) analysis of CT images, prediction of surgical success, and screening of residency applications. They review the unique challenges of applying this powerful technology to healthcare and emphasize the importance of safeguarding patient privacy in the era of Big Data. Finally, Dr. Takashima challenges his fellow otolaryngologists and researchers to embrace this transformative technology.

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TIMESTAMPS

00:00 - Introduction

11:43 - AI 101

23:26 - Applications of AI in Medicine

31:21 - Current & Emerging Applications of AI in ENT

33:44 - Using AI to Improve Surgical Robotics

39:09 - AI in Personalized Medicine

46:41 - AI in Medical Education

57:23 - Ethics & AI: The Need for an Updated HIPAA

01:02:20 - The Future of AI in ENT

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RESOURCES

Dr. Mas Takashima’s Houston Methodist profile: https://www.houstonmethodist.org/doctor/masayoshi-takashima/

Dr. Omar Ahmed’s Houston Methodist profile: https://www.houstonmethodist.org/doctor/omar-g-ahmed/

Many doctors enjoy writing, but how does a meaningful idea become a published book? Just ask Dr. Julie Wei, director of pediatric otolaryngology at Akron Children’s Hospital and author of two books. In this episode of the BackTable ENT podcast, Dr. Wei discusses her third book “Safeguarding Physician Wellbeing” with podcast host Dr. Gopi Shah.

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CHECK OUT OUR SPONSOR

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

First, Dr. Wei shares her journey to authorship, which grew out of her efforts as an advocate for physician wellness. Then, she delves into topics covered in her book, including personal relationships, finances, fertility, and career growth. Much like operating room time-outs, “Safeguarding Physician Wellbeing” uses checklists at the end of each chapter to provide action items for readers. Drawing from her own experience as a surgeon and writer, Dr. Wei offers practical advice for prospective authors. The podcast wraps with thoughts on the need to prioritize physician wellness in an increasingly productivity-focused healthcare system.

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TIMESTAMPS

00:00 - Introduction

02:28 - Dr. Julie Wei’s Journey to Authorship

08:17 - The Concept of Well-being

16:10 - Checklists: A Tool for Patient Safety & Surgeon Well-Being

30:59 - Empowering Trainees to Speak Up

33:41 - The Importance of Taking Time Off

39:54 - Physician Well-being in the U.S. Healthcare System

44:06 - The Process of Writing A Book

52:45 - Final Thoughts & Encouragement for Aspiring Authors

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RESOURCES

Dr. Julie Wei’s Akron Children’s Hospital Profile: https://www.akronchildrens.org/people/Julie-Wei.html

“Safeguarding Physician Wellbeing,” Dr. Julie Wei: https://www.amazon.com/Safeguarding-Physician-Wellbeing-Julie-Wei/dp/1032589892

Artificial Intelligence (AI) already powers search results and chat bots, but what if it could help physicians diagnose cancer? In this episode of the BackTable ENT podcast, laryngologist Dr. Anthony Law of Emory University discusses applications of AI to laryngology with host Dr. Ashley Agan and guest host Dr. Mihir Patel, also of Emory.

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CHECK OUT OUR SPONSOR

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

First, Dr. Law discusses how he connects his passions for laryngology and machine learning as a surgeon-scientist. Before opening the conversation, he defines terms needed to understand AI in medicine. Then, he discusses his work using deep learning models to identify laryngeal cancer patients based on voice recordings. Ideally, he envisions deploying his model (which is over 90% accurate) to help primary care physicians make timely ENT referrals. Mindful of the impact technology has, Dr. Law reviews technical and ethical concerns accompanying use of AI in medicine, which include underrepresented patient groups in research, patient privacy, and safe use of technology. Finally, he offers insight into the future of AI research more broadly.

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TIMESTAMPS

00:00 - Introduction

04:18 - Understanding Deep Neural Networks

07:13 - Applications of AI in Clinical Practice

15:08 - Data Security and Privacy Concerns

25:09 - Collecting Representative Data

31:13 - Biometrics: The Future of Medicine?

39:12 - Challenges & Costs of AI

42:26 - Final Thoughts & Future Directions

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RESOURCES

Pearson Ravitz

https://pearsonravitz.com/

Dr. Anthony Law’s Emory University Profile: https://winshipcancer.emory.edu/profiles/law-anthony.php

Dr. Anthony Law Lab:

https://anthonylaw2.wixsite.com/website

“What Our Voice Reveals About Our Health,” Dr. Anthony Law at TedxAtlanta: https://www.youtube.com/watch?v=-J2W5IVCECE

Nothing is more satisfying than draining an abscess, right? But when is medical management sufficient or even better? In this episode of the BackTable ENT Podcast, pediatric otolaryngologist Dr. John McClay joins host Dr. Gopi Shah to educate listeners on the diagnosis and management of pediatric retropharyngeal abscess (RPA).

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CHECK OUT OUR SPONSOR

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

First, Dr. McClay reviews the symptoms, pathophysiology, and workup of neck abscesses (including RPA) in children. When evaluating any suspected neck abscess, he uses CT results to evaluate its precise size and location. Then, he addresses the role of surgery in treatment of neck abscesses. While many patients will improve with IV antibiotics alone, he mentions that most abscesses lateral to the carotid sheath and greater than 2 cm in size require surgical drainage. Finally, the conversation shifts to cover important topics including antibiotic selection, the role of steroids, and cost-effective care.

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TIMESTAMPS

00:00 - Introduction

03:34 - Pathophysiology & Presentation of Retropharyngeal Abscess

09:54 - Physical Examination in the Child with Suspected Neck Abscess

17:43 - The Importance of CT Scans

31:40 - Treatment of Neck Abscesses: Antibiotics vs Surgery

37:56 - The Role of Steroids in Abscess Treatment

53:41 - Applying Value-Based Care as a Pediatric Otolaryngologist

55:44 - Recap & Final Pearls

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RESOURCES

Dr. McClay’s website:

https://www.johnmcclaymd.com/pediatric-sinus-center/

Pearson Ravitz

https://pearsonravitz.com/

McClay JE, Murray AD, Booth T. Intravenous antibiotic therapy for deep neck abscesses defined by computed tomography. Arch Otolaryngol Head Neck Surg. 2003 Nov;129(11):1207-12.

Johnson RF. Emergency department visits, hospitalizations, and readmissions of patients with a peritonsillar abscess. Laryngoscope. 2017 Oct;127 Suppl 5:S1-S9.

Rhinoplasty stands out as one of the most transformative yet technically challenging procedures in facial plastic surgery. In this episode of the BackTable ENT Podcast, rhinoplasty expert Dr. Patrick Cleveland of West Palm Beach shares his approach to the procedure with host Dr. Gopi Shah.

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SYNPOSIS

First, Dr. Cleveland addresses the initial rhinoplasty consultation, including patient history, physical exam, and photo documentation. Then, the surgeons delve into technical approaches to rhinoplasty. Tackling valuable topics including graft choices, cartilage sources for revision rhinoplasty, and tools used. Dr. Cleveland offers lessons to help any otolaryngologist improve their knowledge of this essential surgery. Finally, the episode concludes with a survey of contemporary trends in rhinoplasty.

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TIMESTAMPS

00:00 - Introduction

03:28 - Fundamentals of Rhinoplasty

04:19 - Interviewing Patients & Identifying Red Flags

10:25 - Physical Exam for Rhinoplasty

15:14 - The Importance of Photo Documentation

30:26 - Cephalic Trim & Turnover Flap Techniques

32:52 - Tip Supporting Grafts and Cartilage Harvesting

36:46 - Instruments for Rhinoplasty

39:42 - Sourcing Cartilage in Revision Rhinoplasty

49:20 - Post-operative Care & Complications

56:07 - Future Directions in Rhinoplasty

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RESOURCES

Patrick Cleveland Facial Plastic Surgery:

https://www.drpatrickcleveland.com/

Deformity, etiology, solution, sequence (DESS): Facial analysis in rhinoplasty: https://pubmed.ncbi.nlm.nih.gov/37952257/

Facial nerve injury affects each patient in a unique way. Accordingly, surgical treatment of facial paralysis must be meticulously planned and personalized. In this episode, Dr. Shiayin Yang, Associate Professor of Otolaryngology at Vanderbilt University, addresses management of synkinesis and static procedures for flaccid facial palsy with host Dr. Ashley Agan.

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CHECK OUT OUR SPONSOR

PearsonRavitz

https://pearsonravitz.com/backtable

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SYNPOSIS

First, Dr. Yang reviews the difference between flaccid and non-flaccid (including synkinetic) facial paralysis. She describes her approach to facial paralysis, which includes clarifying the patient’s diagnosis and thoroughly examining the facial nerve function. Dr. Yang then transitions the conversation to surgical solutions, emphasizing dual goals of restoring symmetry and function. She divides her discussion to first tackle synkinesis and then static procedures for flaccid paralysis. Procedures discussed include Botox, brow lift, blepharoplasty, myectomy, and neurectomy as well as lower eyelid and midface procedures and temporalis tendon transfer. While surgical approaches to the two conditions differ, eye protection represents an important theme throughout. The episode concludes with Dr. Yang’s pearls for approaching these complex surgical problems and a reminder of how facial paralysis affects patients’ emotional health.

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TIMESTAMPS

00:00 - Introduction

02:36 - Understanding Flaccid & Non-Flaccid Facial Paralysis

07:13 - Botox for Facial Synkinesis

12:38 - History-Taking & Physical Exam in Facial Paralysis

15:07 - Surgical Management of Synkinesis

30:47 - Patient Counseling and Motivation

32:47 - Static Procedures for Flaccid Facial Palsy

37:26 - Nuances of Peri-Ocular Procedures

43:42 - Lower Eyelid & Midface Considerations

53:00 - Dynamic Surgery Options

56:56 - Final Surgical Pearls

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RESOURCES

Dr. Shiayin Yang’s Vanderbilt University Profile: https://www.vanderbilthealth.com/doctors/yang-shiayin

BackTable ENT Episode 151- Navigating Synkinesis: From Diagnosis to Comprehensive Care with Dr. Shiayin Yang

https://open.spotify.com/episode/1JucnHB8tNC5qRW6u82ie8?si=ba729d3f3e164d6f

Adding allergy services to your practice can improve your comprehensive ENT care. When otolaryngologists treat allergies, they more effectively address related conditions, such as sinusitis and otitis media. In this episode, Dr. Michelle Liu, general ENT in Fairfax, Virginia, shares her wisdom on starting an otolaryngologic allergy practice with host Dr. Ashley Agan.

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CHECK OUT OUR SPONSOR

Medtronic ENT

https://www.medtronic.com/us-en/healthcare-professionals/medical-specialties/ear-nose-throat.html?cmpid=Vanity_URL_MIX_medtronicent-com_202212_US_EN_NS_ENT_FY23

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SYNPOSIS

First, Dr. Liu summarizes her journey to treating allergy as an otolaryngologist. She finds the continuity of care and personal connections that accompany allergy care fulfilling. Then, she describes the different testing and treatment modalities used in her clinic. While subcutaneous immunotherapy is more common, sublingual immunotherapy offers an appealing needle-free alternative for some patients. Finally, she explains the logistics of starting an allergy practice, including finances, continuing education, and safety considerations for immunotherapy initiation.

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TIMESTAMPS

00:00 - Introduction

03:36 - Dr. Liu’s Medical Journey: From Military Resident to Civilian Otolaryngologist

08:46 - Adding Allergy Testing to Your Practice

28:44 - Adding Immunotherapy to Your Practice

31:22 - Patient Selection & Financial Considerations

39:39 - Pediatric Allergy

45:09 - Emergency Preparedness in Allergy Clinics

49:15 - Sublingual Immunotherapy & Tablets

53:48 - Continuing Medical Education in Allergy

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RESOURCES

Medtronic ENT

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

Dr. Michelle Liu’s Inova Profile:

https://www.inova.org/doctors/michelle-f-liu-md

Otolaryngology Associates’ Facebook Page:

https://www.facebook.com/otoassoc/

American Academy of Otolaryngologic Allergy:

https://www.aaoallergy.org/