BackTable ENT & Allergy

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• Ep. 280 Leadership Through Resiliency & Mentorship with Dr. Troy Woodard 30.06.2026 1時間 4分

  Every leader has a story. The experiences, mentors, and moments along the way shape not only who we become, but how we lead. In this episode of BackTable ENT and Allergy, Drs. Ashley Agan and Gopi Shah interview internationally renowned rhinologist Dr. Troy Woodard about his leadership journey and the lessons learned along the way. Together, they explore how leadership is about actions rather than titles, the value of national involvement, and the importance of embracing change and personal growth throughout a career. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:20 - From Fan Moment to Bio04:15 - Early Leadership Roots06:40 - Lead Without a Title08:43 - Finding Leadership Itch14:56 - Burnout and the Pivot19:16 - Coaching and Victim Mindset22:31 - FMLA Reset and Purpose Shift27:11 - Letting Go to Grow30:14 - Listening Tour at Buffalo33:59 - DEI and Minority Leadership35:47 - Mentorship and Leaky Pipeline39:48 - Purpose Through Outreach44:28 - Respectful Change Leadership47:25 - Emotional Intelligence Growth50:27 - Advice for New Leaders52:53 - Handling Dream Crushers56:50 - Imposter Syndrome Breakthrough01:01:01 - Leadership Impact and Closing Remarks --- More about this episode Dr. Woodard describes early leadership roles, being raised by a single mother, the mentors who impacted his career, and how responsibility and service shaped his work ethic. He explains that leadership doesn’t require a title and recounts pivoting from limited departmental opportunities to national involvement through the Academy and ARS, including advocacy work. Woodard discusses burnout, executive coaching, emotional intelligence, delegation, mentorship and ultimately, how recognizing and embracing a changing purpose mid-career is a normal part of professional growth. Now Chair of Otolaryngology-Head and Neck Surgery at the University at Buffalo, he practices “listening tours,” mentors faculty, and emphasizes how diversity drives excellence while highlighting mentorship and pipeline development. --- Resources Dr. Troy Woodard’s Public Emailtwoodard@buffalo.edu --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 279 Collaborative Care in Chronic Sinusitis & Allergies with Dr. Karen Kaufman 23.06.2026 58分

  When should recurrent sinus infections trigger an allergy or immune workup? In this episode of the BackTable ENT and Allergy podcast, Dr. Karen Kaufman of Kaufman Allergy, Asthma, & Immunology in Vienna, Virginia, sits down with Dr. Ashley Agan to discuss chronic sinusitis evaluation, allergy testing, immunotherapy, immune deficiency screening, and building a private practice. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:53 - Chronic Sinusitis Basics06:44 - Sinusitis Types and Polyps10:18 - Testing and Treatment Plan18:40 - When to Suspect Immunodeficiency25:44 - Allergy Testing Methods38:39 - Why Go Solo43:10 - Practice Growth, Visibility, Team Building, and Systems51:55 - ENT and Allergy Collaboration55:50 - Closing Remarks --- More about this episode Dr. Kaufman explains how to distinguish chronic sinusitis from other causes of nasal and facial symptoms, when to evaluate for allergy and immune dysfunction, and how sinusitis phenotypes influence treatment decisions. She also shares her experience launching a private practice during the pandemic and discusses strategies for practice growth through community engagement, increased visibility, and social media. --- Resources Dr. Karen Kaufman - https://kaufmanallergy.com/ Jeffery Modell Foundation 10 Warning Signs of Primary Immunodeficiency - https://www.uhhospitals.org/-/media/files/rainbow/services/allergy-and-immunology/10warningsigns.pdf --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 278 Comprehensive Evaluation and Surgical Management of Nasal Septal Perforations with Dr. Oswaldo Henriquez 16.06.2026 1時間 28分

  Septal perforations can be deceptively challenging, with a wide range of etiologies, symptoms, and treatment options to consider. In this episode of BackTable ENT and Allergy podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah interview Dr. Oswaldo Henriquez, a board-certified otolaryngologist and rhinologist at WellStar Health System in Atlanta, to explore the complexities of evaluating and managing nasal septal perforations. The conversation covers how perforation size and location shape symptoms, the most common causes including iatrogenic trauma and chronic nose picking, and a thorough, stepwise approach to diagnosis and treatment. ---Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction03:01 - Septal Perforations Overview07:58 - Causes and Risk Factors13:26 - History Red Flags and Differential Diagnosis16:28 - Exam and Documentation Tips21:22 - Labs Biopsy and Imaging Workup31:19 - Conservative Care and Septal Buttons34:20 - Surgery Candidacy and Counseling41:35 - Surgical Techniques Landscape47:38 - Scaffolds and Grafts49:07 - Septal Blood Supply Map53:00 - CAT Scan Planning Tips55:15 - AEA Flap Technique01:05:22 - Real Case Walkthrough01:10:41 - Postop Care and Swelling01:20:44 - Pitfalls and Success Rates01:24:09 - Wrap Up --- More about this episodeDr. Henriquez outlines the key components of a comprehensive workup, including endoscopic exam, measurement, biopsy, and CT imaging for surgical planning. He discusses management options from conservative care and septal buttons to advanced endoscopic pedicled flap repairs, sharing insight on surgical techniques, success rates, splinting, and post-op care. The episode provides practical tips for physicians at any career stage looking to refine their approach to septal perforations, from diagnosis through recovery. --- ResourcesENT Animationshttps://www.youtube.com/@Dr.IsamAlobid --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty.► https://www.backtable.com/app
• Ep. 277 Molecular Diagnostics for Thyroid Nodules with Dr. Erik Alexander 09.06.2026 45分

  For years, an indeterminate thyroid biopsy meant diagnostic surgery but molecular testing is now changing that reality entirely. On this episode of the BackTable ENT podcast, Dr. Ashley Agan interviews endocrinologist Dr. Erik Alexander about how molecular testing and a systematic, layered approach to thyroid nodule evaluation are reducing diagnostic surgeries and enabling more individualized patient care. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Veracytehttps://www.veracyte.com/ --- Timestamps 00:00 - Introduction02:48 - Incidence, Presentation, and Workup of Thyroid Nodules 06:26 - Hormonal Impact and Indications for FNA 10:49 - FNA workflow and Bethesda Categories 16:10 - Role of Molecular Testing for Indeterminate Nodules19:59 - Evolution of Molecular Testing and Afirma 23:51 - Basics of DNA based Testing and RNA based Testing 28:34 - Comparing DNA based and RNA Based Testing 32:10 - Utility of Molecular Testing and Sampling Techniques 35:55 - Cost Coverage and Practical Limits39:20 - Clinical Implications and Future Impact42:00 - Final Takeaways --- More about this episode Together they walk through the full evaluation pathway, including ultrasound risk stratification using the TI-RADS criteria, the role of TSH testing, and how FNA indications have shifted from biopsying every solid nodule to a more selective, risk-adapted approach. The discussion covers the Bethesda classification system and addresses why the one-third of patients landing in indeterminate categories (Bethesda III, IV, and V) have historically been the most challenging and most overtreated group. The conversation then explores molecular diagnostics as an additional layer of risk assessment, highlighting key differences between DNA-based mutation panels and RNA-based expression classifiers. Dr. Alexander also discusses practical considerations like insurance coverage, sampling technique, turnaround time, and the future potential of molecular testing to move beyond diagnosis toward individualized prognosis. --- Resources American College of Radiology: TI-Rads Guidelines https://edge.sitecorecloud.io/americancoldf5f-acrorgf92a-productioncb02-3650/media/ACR/Files/RADS/TI-RADS/TI-RADS-Assessment-Categories.pdf American Thyroid Association - Nodule Guidelineshttps://pmc.ncbi.nlm.nih.gov/articles/PMC4739132/ Bethesda System for Reporting Thyroid Ctyopathology https://www.ncbi.nlm.nih.gov/books/NBK278969/table/thyroid-nod-canc-eld.T.bethesda_system_f/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 276 LPR vs. LPS: Key Differences & Diagnostic Techniques with Dr. Inna Husain 02.06.2026 1時間 3分

  Not all chronic cough, globus, or voice changes are due to reflux, so how do you distinguish laryngopharyngeal symptoms (LPS) from true laryngopharyngeal reflux disease (LPRD)? In this episode of the BackTable ENT & Allergy podcast, Dr. Ashley Agan interviews laryngologist Dr. Inna Husain about how nuanced diagnostic definitions and a careful clinical approach can improve patient outcomes and avoid both under- and overdiagnosis. Together, they discuss the differences between GERD and LPRD, review the importance of detailed patient histories, endoscopic findings, and the evolving role of biomarkers like pepsin. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:14 - LPS Versus LPR Basics06:34 - GERD Versus LPRD11:28 - Clinic Workup and Scoping18:02 - San Diego Consensus Debate24:14 - Testing Over Empiric PPIs31:45 - Managing Proven Reflux34:59 - Stroboscopy Before Surgery36:10 - Pepsin Therapies and Tests39:54 - What Counts as Abnormal Reflux44:24 - Tapering Off PPIs Safely50:12 - Long Term Plan and Dietitians55:39 - GLP One Drugs and Reflux57:34 - Menopause Rhinitis and Hormones01:00:09 - Final Pearl For ENTs --- More about this episode They outline contemporary workup strategies, including the San Diego Consensus on Bravo testing, 24-hour pH impedance, and alternatives for negative reflux testing. The conversation covers management strategies, from selective PPIs and lifestyle tailoring to emerging therapies and the impact of GLP-1 drugs, helping ENT specialists refine their approach to complex laryngopharyngeal complaints. --- Resources San Diego Consensus for LPS and LPRD:https://doi.org/10.14309/ajg.0000000000003482 Dr. Inna Husainhttps://innahusainmd.com/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 275 Evaluation & Management of Unilateral Vocal Fold Paralysis in Adults with 26.05.2026 53分

  With such a wide range of presentations and severity, how do laryngologists approach the diagnosis and treatment of unilateral vocal fold paralysis? In this episode of the BackTable ENT and Allergy Podcast, Dr. Rebecca Howell, Laryngologist at the University of Cincinnati, joins Dr. Stephen Schoeff to discuss the evaluation and management of unilateral vocal fold paralysis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:18 - Classic Symptoms of Vocal Fold Paralysis 04:15 - Etiology and Imaging Workup08:40 - Injection Timing and Materials23:20 - Permanent Options and Framework Surgery28:41 - Arytenoid Adduction Risks and When to Add Adduction30:56 - Awake Thyroplasty Technique compared to Sedation and OR Setup35:48 - Reinnervation and Bilateral Medialization Choices42:10 - Vocal Fold Long-term Injectables51:54 - Closing Remarks --- More about this episode Dr. Howell reviews the spectrum of patient presentations and common causes, including thoracic surgery, ACDF, thyroid surgery, intubation injuries, and idiopathic cases. She explains when to pursue imaging from brainstem to chest, how to set realistic recovery expectations, and the benefits of early intervention. The episode covers office-based injection augmentation, the pros and cons of injectable materials, and treatment durability, as well as risks like calcium hydroxylapatite. Long-term care options are discussed, including framework surgery, arytenoid adduction, bilateral approaches for vocal fold atrophy, reinnervation, and patient selection considerations. --- Resources Pathophysiology of Iatrogenic and idiopathic vocal fold paralysis may be distinct - Ted Mau: https://pubmed.ncbi.nlm.nih.gov/31498451/ Vocal Fold augmentation with injectable calcium hydroxylapatite - Clark Rosen: https://pubmed.ncbi.nlm.nih.gov/15331112/ Using High-Speed Videoendoscopy to Analyze Laryngeal closure parameters during normal swallow - Rebecca Howell: https://pubmed.ncbi.nlm.nih.gov/39659169/ Arytenoid abduction for bilateral vocal fold immobility - Gayle Woodson: https://pubmed.ncbi.nlm.nih.gov/22001662/ Laryngeal Reinnervation for Unilateral Vocal Fold Paralysis - Randal Paniello : https://profiles.wustl.edu/en/publications/laryngeal-reinnervation-for-unilateral-vocal-fold-paralysis/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 274 Pediatric Thyroid Nodules: Clinical Insights & Approaches with Dr. Wen Jiang 19.05.2026 1時間

  Pediatric thyroid nodules are rare, but their risk of malignancy is significantly higher than in adults, raising the stakes for accurate diagnosis and multidisciplinary management. In this episode of the BackTable ENT Podcast Dr. Gopi Shah and co-host Dr. Jeff Hyzer interview Dr. Wen Jiang, pediatric otolaryngologist at Rady Children’s Hospital in San Diego, for an in-depth discussion on the evaluation and management of thyroid nodules in children. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:27 - Thyroid Nodule Risks and Care Team 06:47 - Age-related Differences in Nodule Presentation and Outcomes08:50 - Initial workup 13:42 - Ultrasound Interpretation16:07 - Lymph Node Mapping and CT19:58 - Incidental Findings24:14 - Role of FNA, Molecular Testing, and Radiofrequency Ablation32:40 - Molecular Testing Results and Counseling 38:04 - Neck Dissection Strategy40:44 - Hypocalcemia Protocol Considerations44:01 - Parathyroid and Recurrent Laryngeal Nerve Dissection Tips 47:33 - Postop Care and Follow-up 51:25 - Using Radioactive Iodine and Targeted Therapy 54:55 - AI’s and Ultrasound and Final Thoughts --- More about this episode Dr. Jiang highlights the key differences between pediatric and adult thyroid nodules. She describes her multidisciplinary approach including collaboration with radiology, pathology, endocrinology and nuclear medicine. The discussion reviews the initial workup for pediatric thyroid nodules and why ultrasound remains the primary diagnostic tool. She also discusses situations where CT with contrast can be helpful for surgical planning. This episode explores the growing role of reflex molecular testing in guiding management decisions and outlines the impacts of molecular testing results. Dr. Jiang shares her approach to patient counseling along with management of calcium and PTH after surgery. The conversation concludes with emerging applications of molecular diagnostics and AI models for improving thyroid ultrasound interpretation. --- Resources Dr. Jiang's Research on Pediatric Thyroid Nodule Management - https://pubmed.ncbi.nlm.nih.gov/26770219/ Bethesda System for Thyroid Cytopathology - https://pmc.ncbi.nlm.nih.gov/articles/PMC7182964/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 273 Integrating Narrative Medicine into Patient Care with Dr. Alessandra Colaianni 12.05.2026 36分

  From clinic to the OR, storytelling quietly shapes every decision in clinical care. This episode of BackTable ENT & Allergy examines how narrative medicine and the stories at the heart of each patient encounter can elevate your clinical practice, enhance empathy, and deepen the doctor-patient relationship. Pediatric ENT Dr. Gopi Shah interviews Dr. Alessandra (Alessa) Colaianni, a head and neck surgical oncologist at the University of North Carolina, about the power and relevance of narrative medicine in modern surgical care. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:53 - What is Narrative Medicine? 11:36 - Narrative Medicine in Clinic 17:28 - Narrative Medicine in the OR21:09 - Patient Case Presentation and Boundaries 25:05 - Writing For Reflection and the impact of AI 29:35 - Resources And Podcasts33:19 - Final Takeaways --- More about this episode Dr. Colaianni is a published writer whose work has been featured in the New York Times, New Yorker, and the New England Journal of Medicine. She describes her lifelong interest in writing and shares how earning a master’s degree in the history and philosophy of science at the University of Cambridge during medical school helped her reconnect with the humanistic side of medicine. She reframes narrative medicine not as an extra task, but as an approach already woven into daily clinical work through history-taking, listening, and documentation. The conversation explores the influence of patient identity, socioeconomic context, and the “characters” in each patient’s story on clinical decisions and care. Dr. Colaianni reflects on the role of storytelling in surgical training, the apprenticeship model, and how thoughtful boundaries can foster meaningful doctor-patient relationships. The episode concludes with a discussion of AI’s potential impact on empathy and recommended reading for further exploration of narrative medicine. --- Resources Dr.Colaianni’s published work https://www.alessandracolaianni.com Columbia University Division of Narrative Medicine https://www.mhe.cuimc.columbia.edu/division-narrative-medicine Columbia University Narrative Medicine Youtube channel https://www.youtube.com/@columbiauniversitynarrativ8472 The Nocturnists podcast https://thenocturnists.org/podcast Autobiography of a Face by Lucy Grealey https://www.amazon.com/Autobiography-Face-Lucy-Grealy The Empathy Exams by Leslie Jameson https://www.graywolfpress.org/books/empathy-exams The Collected Schizophrenias Essays by Esmé Weijun Wanghttps://www.graywolfpress.org/books/collected-schizophrenias My Own Country: A Doctor’s Story by Abraham Verghese https://www.amazon.com/My-Own-Country-Doctors-Story --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 272 Allergy Education on Social Media and Beyond: Challenges and Strategies with Dr. Zachary Rubin 05.05.2026 56分

  From the clinic to the camera, discover how an allergist turned social media into a patient education powerhouse. On this week’s episode of the BackTable ENT & Allergy Podcast, allergist Dr. Zachary Rubin of Oak Brook Allergists joins host Dr. Basil Kahwash to discuss his path from fellowship training to becoming a widely followed social media educator and author of the New York Times bestselling book “All About Allergies”. He explains how the COVID-19 pandemic and the rapid spread of online medical misinformation inspired him to educate the public through social media, developing an authentic on-camera style and consistent brand that has expanded his reach far beyond the clinic. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:21 - Learning the Creator Playbook10:10 - Authenticity and Creating a Personal Brand16:51 - Writing for Patients and Clinicians20:41 - Balancing Clinic and Content Creation26:15 - How to Start Your Public Voice29:11 - Professional Boundaries and Handling Criticism Online36:34 - How Patients Following Your Content Impacts the Clinic43:08 - The Unexpected Doors Content Creation Can Open48:44 - Future of Public Health53:09 - Final Advice --- More about this episode The conversation explores strategies for communicating complex medical topics, such as using metaphors to improve public understanding, and the importance of professionalism, boundaries, and safety in the online space. Dr. Rubin offers advice on avoiding individualized medical advice, managing online harassment, and navigating the nonfiction publishing world. He also discusses the impact of advocacy and media engagement for both patients and healthcare professionals, showing how physicians can leverage media to make a difference well beyond their practice. --- Resources Dr. Zachary Rubinhttps://www.oakbrookallergists.com/our-team/zachary-e-rubin-md/ --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 271 The OR Surgical Tech in Pediatric ENT with Jose Flores 28.04.2026 32分

  Behind every smooth surgery is a team member you may not see in the spotlight—but without them, the operation doesn’t run. In this episode of the BackTable ENT podcast, Jose Flores, a surgical technologist at Rady Children’s Hospital in San Diego and ENT service coordinator, joins host Dr. Gopi Shah to discuss the importance of the surgical technologist’s role in the OR and how it directly impacts patient care. --- SYNPOSIS Jose discusses his journey from being a medical assistant to finding his calling in the operating room, specifically in ENT. They explore the critical yet often overlooked role of OR scrub techs, the necessity of proper preparation and organization, and the importance of good communication and teamwork within the surgical team. Jose also shares personal experiences and advice for both new surgical techs and medical students, emphasizing the rewarding nature of working in pediatric ENT. --- TIMESTAMPS 00:00 - Introduction 01:29 - Jose Flores’s Journey to Becoming a Surgical Tech05:41 - Daily Responsibilities and Preparation10:11 - Communication and Teamwork in the OR15:30 - Building Strong Surgical Tech Relationships18:51 - Advice for New Surgical Techs21:25 - The Role of Techs in Quality and Safety23:15 - Giving and Receiving Feedback27:02 - Fostering Respect and Recognition30:40 - Final Thoughts and Contact Information --- RESOURCES Jose Flores’s Story:https://vimeo.com/1096085041
• Ep. 270 Management of Sinonasal Tumors with Skull Base Involvement: Part 2 with Dr. Zara Patel, Dr. JP Almeida and Dr. Garret Choby 21.04.2026 45分

  Could that routine epistaxis actually be the first sign of a challenging skull base tumor? This week’s episode of the BackTable ENT Podcast is part two of the sinonasal tumor and skull base involvement discussion. Host Dr. Satyan Sreenath is joined again by Dr. Joao Paulo Almeida, Dr. Zara Patel, and Dr. Garret Choby for a case-based deep dive into the multidisciplinary management of complex sinonasal tumors. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 01:20 - Case 1: Juvenile Nasopharyngeal Angiofibroma05:03 - Considerations for Pre-Operative Embolization 08:10 - Disaster Scenario: High Volume Loss09:21 - Operative Approach18:10 - Post-Op Imaging Considerations21:00 - Case 2: Invasive Keratinizing Squamous Cell Carcinoma24:40 - Operative Approach vs. Neoadjuvant Treatment Strategies28:30 - Importance of Diagnostic Nasal Endoscopy30:15 - Operative Approach32:37 - Lumbar Drain Considerations 40:35 - Closing Thoughts --- More about this episode The panel works through advanced cases presenting with epistaxis, using them to highlight key principles in evaluation, imaging, staging, and operative planning. They first discuss a 16-year-old male with a large juvenile nasopharyngeal angiofibroma extending to the skull base and middle cranial fossa, focusing on vascular supply, preoperative embolization, surgical strategy near the carotid, and planning for intraoperative hemorrhage and postoperative surveillance. They also emphasize the importance of thorough endoscopic evaluation and early referral to experienced centers. They then review a 72-year-old female with invasive, HPV-negative keratinizing squamous cell carcinoma involving the anterior cranial fossa and dura. The conversation addresses tumor board decision-making, neoadjuvant considerations, endoscopic craniofacial resection, reconstruction strategies, and management of delayed positive margins. It highlights how accurate histopathology and coordinated multidisciplinary care guide outcomes in these complex cases. --- Resources Joao Paulo Almeida, MD, PhDhttps://medicine.iu.edu/faculty/68351/almeida-joao-paulo Satyan B. Sreenath, MDhttps://medicine.iu.edu/faculty/60724/sreenath-satyan Zara M. Patel, MD https://med.stanford.edu/profiles/zara-patel Garret W. Choby, MDhttps://providers.upmc.com/provider/garret-w-choby/2592344 --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 269 Management of Sinonasal Tumors with Skull Base Involvement: Part 1 with Dr. Zara Patel, Dr. JP Almeida, & Dr. Garret Choby 14.04.2026 43分

  Pathology, anatomy, and staging: how do these three pillars come together to guide sinonasal tumor management? In this episode of the BackTable ENT Podcast, host Dr. Satyan Sreenath is joined by Dr. Joao Paulo Almeida, Dr. Zara Patel, and Dr. Garret Choby to discuss a multidisciplinary approach to sinonasal tumors, emphasizing the triad of pathology, anatomy, and staging to guide treatment. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:04 - First Principles of Workup05:23 - Case 1: Maxillary Sinus Mass 06:23 - Imaging and Biopsy Strategy08:11 - Inverted Papilloma Pathology and Surgical Planning20:28 - Case 2: Unilateral Disease Red Flags24:34 - MRI Clues for Malignancy31:47 - Video Walkthrough of Endonasal Resection38:51 - Surveillance41:41 - Key Papers---More about this episode The panel reviews key workup considerations, including in-office biopsy and the use of CT and MRI to distinguish tumor from retained secretions and guide operative planning. They walk through two illustrative cases of inverted papilloma. The first involves a left maxillary sinus mass treated with an endoscopic medial maxillectomy using a Denker-type approach, with emphasis on complete attachment-site eradication. The second case highlights an elderly patient with frontal and anterior ethmoid disease abutting the orbit and skull base, requiring meticulous endoscopic technique, careful management of the anterior ethmoid artery, and thoughtful handling of bone and periorbita. The discussion also covers imaging features suggestive of malignant transformation, as well as emerging AI-based CT and MRI tools that show high accuracy in distinguishing benign inverted papillomas from those associated with squamous cell carcinoma. The episode concludes with postoperative surveillance strategies and key consensus and review publications. --- ResourcesJoao Paulo Almeida, MD, PhDhttps://medicine.iu.edu/faculty/68351/almeida-joao-paulo Satyan B. Sreenath, MDhttps://medicine.iu.edu/faculty/60724/sreenath-satyan Zara M. Patel, MD https://med.stanford.edu/profiles/zara-patel Garret W. Choby, MDhttps://providers.upmc.com/provider/garret-w-choby/2592344 --- BackTable ENT & Allergy is the go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app
• Ep. 268 Building a Skull Base Program in Private Practice with Dr. Kibwei McKinney 07.04.2026 53分

  What if you could build a skull base practice outside academia, without sacrificing complexity, income, or fulfillment? On this episode of the BackTable ENT Podcast, Dr. Kibwei McKinney from SSM Health St. Anthony Hospital in Oklahoma City joins guest host Dr. Dennis Tang to discuss building a rhinology and skull base surgery practice outside academia. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 01:30 - Introduction and Career04:55 - Private Practice vs. Academics10:38 - Defining Skull Based Surgery15:10 - Patient Pool and Logistics in Academics vs Private Practice19:03 - Marketing and Referral Sources24:58 - Case Management and the O.R. in Private Practice29:30 - Balanced Workload and Intentional Care32:10 - Billing and Coding38:55 - Lifestyle Benefits of Private Practice44:21 - Strategic Advice and Advantages or Disadvantages of Private Practice.47:38 - Common Misconceptions50:00 - Advice and Closing Thoughts --- More about this episode Dr. McKinney walks through his training journey, from dedicated research years to time in private-practice rhinology and a skull base fellowship, before ultimately starting his academic career in Oklahoma. He shares how shifting family priorities and the growing push for clinical productivity led him to step away from academia and into an employed private-practice model focused exclusively on rhinology and skull base surgery, without ER call. Along the way, he dives into what that transition really looks like, including the autonomy he’s gained, the role of marketing support, how he builds referrals through direct communication, and the operational differences of working without residents. He also touches on postoperative care structure, billing and coding, insurance challenges, and the impact on his overall lifestyle. Check out this episode to hear Dr. McKinney’s perspective on why skull base surgery in private practice can be not only technically feasible and financially viable, but also emotionally sustainable, creating space for truly patient-centered care and the ability to pursue the work with genuine passion. --- Resources Dr. Kibwei McKinney https://www.getcare.ssmhealth.com/find-a-doctor/doctor-details/kibwei-mckinney-md
• Ep. 267 Clinical Hypnotherapy Applications in ENT Medicine with Dr. Sonia Gupte 31.03.2026 52分

  Why do some patients recover faster, cope better, and experience less pain despite similar diagnoses? The answer may lie not in the pathology, but in perception. In this episode of the BackTable ENT & Allergy Podcast, Dr. Sonia Gupte, a former family physician and board-certified clinical hypnotherapist, joins host Dr. Gopi Shah to explore how hypnotherapy works and where it fits in modern medical care. --- Get the BackTable app https://www.backtable.com/app --- Timestamps 00:00 - Introduction05:13 - Understanding the Subconscious Mind09:29 - The Hypnotherapy Process15:43 - Patient Selection18:58 - Anxiety, Stress, and Pain Perception23:54 - Use in General ENT Population28:14 - When to Refer31:51 - History of Hypnotherapy in Cancer Care32:56 - Awareness, Access, and Billing Insurance38:59 - Setting Expectations, Visits Required, and Smoking Cessation43:42 - Virtual Visits and Possible Limitations46:57 - Techniques for ENTs49:14 - Closing Thoughts --- More about this episode Dr. Gupte shares how her mother’s cancer journey led her to recognize gaps in addressing the mind-body connection and ultimately transition into hypnotherapy. She clarifies the difference between hypnosis and clinical hypnotherapy, emphasizing the latter as a collaborative, goal-oriented process aimed at uncovering the “why” behind patient patterns and reshaping perceptions. The conversation covers the structure of a hypnotherapy session, relevant brainwave states, patient selection and contraindications, and clinical applications ranging from oncology support to ENT-related quality-of-life concerns. They also discuss use in pediatric patients, expected timelines for improvement, virtual care delivery, and practical communication strategies clinicians can use to reduce patient anxiety in everyday practice. --- Resources Dr. Sonia Gupte https://enso-nia.com/about-sonia/
• Ep. 266 Clinical Steps for Efficient Anaphylaxis Diagnosis & Treatment with Dr. Payel Gupta 24.03.2026 1時間 4分

  Anaphylaxis doesn’t always look like hives and swelling. In up to 20% of cases, the skin is completely clear, making the diagnosis easy to miss. On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash speaks with Dr. Payel Gupta, allergist and immunologist at Mount Sinai in New York City, about how to recognize and manage anaphylaxis. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:02 - Defining Anaphylaxis and Key Signs04:09 - Anaphylaxis Versus Shock05:54 - Diagnostic Pitfalls12:43 - Epi First Epi Fast32:33 - ER Or Observe42:31 - Allergy Testing Limits47:16 - New Anaphylaxis Therapies51:34 - Public Awareness and Advocacy01:02:55 - Final Pearls and Wrap up --- More about this episode Dr. Gupta and Dr. Kahwash first define anaphylaxis and review common diagnostic pitfalls, including absent skin findings, overlap with asthma, atypical presentations, delayed reactions, and the effects of beta-blockers. Dr. Gupta emphasizes the importance of early treatment with intramuscular epinephrine. Antihistamines and steroids are discussed as adjunctive therapies and the episode reviews the risk and management of biphasic reactions. The conversation also covers optimal timing for tryptase testing, post-reaction counseling, evolving guidance on emergency department referral, and appropriate timing for allergy testing after a reaction. Dr. Gupta discusses emerging options such as intranasal epinephrine and the use of omalizumab to increase reaction thresholds in food allergy. The episode concludes with a discussion of public misconceptions around the term “allergy,” barriers to appropriate care, and Dr. Gupta’s advocacy and educational work. --- Resources Dr. Payel Gupta https://www.zocdoc.com/doctor/payel-gupta-md-facaai-571583
• Ep. 265 Pediatric Tympanoplasty: Butterfly Cartilage Technique with Dr. Sean Evans 17.03.2026 45分

  What makes butterfly cartilage tympanoplasty such an elegant solution for pediatric eardrum perforations? In this episode of the BackTable ENT Podcast, Dr. Sean Evans of Children’s Healthcare of Atlanta joins hosts Dr. Ashley Agan and Dr. Gopi Shah to discuss the evaluation and management of pediatric tympanic membrane perforations, with a focus on the butterfly cartilage tympanoplasty technique --- SYNPOSIS Dr. Evans describes his practice and reviews common etiologies of tympanic membrane perforations. He outlines his approach to the clinical workup and patient counseling, including the role of audiograms, careful otoscopic examination, and selective use of laboratory studies and CT imaging in patients with chronic otorrhea or suspected cholesteatoma. The discussion also addresses timing and age considerations for repair, as well as strategies for managing chronic drainage. Dr. Evans also discusses his evaluation of patient selection criteria and operative technique for butterfly cartilage tympanoplasty. He shares practical insights on surgical steps, technical pearls and pitfalls, postoperative care, recovery expectations, potential risks, coding considerations, and approaches to revision surgery. --- TIMESTAMPS 00:00 - Introduction 02:35 - When to Repair Perforations 10:36 - Physical Exam, Audiogram, & Treatment Decisions18:06 - Butterfly Graft Candidacy20:42 - Step by Step Butterfly Technique25:52 - Butterfly Technique Pearls and Pitfalls29:16 - Example Case Video and Indications35:12 - Restrictions, Pain, & Recovery37:10 - Risk Factors and Complications40:09 - Revision Timing and Failure Modes42:37 - Final Pearls and Wrap Up --- RESOURCES Dr. Sean Evans https://med.emory.edu/directory/profile/?u=SSEVAN3
• Ep. 264 Exploring Augmented Reality for Surgical Applications: Insights for Facial Plastic Surgeons with Dr. David Chou 10.03.2026 36分
• Ep. 263 Immunotherapy for Adults with RRP with Dr. Aaron Friedman 03.03.2026 42分

  Recurrent respiratory papillomatosis (RRP) has long been managed with repeated surgical debulking, sometimes requiring dozens of procedures over a lifetime. In this episode of BackTable, Dr. Aaron Friedman and guest host Dr. Stephen Schoeff discuss a major shift in care: immune-directed therapy targeting HPV 6 and 11. --- SYNPOSIS Dr. Friedman reviews the recent FDA approval of the Precigen product PAPZIMEOS (August 2025), a therapeutic vaccine designed to stimulate HPV-specific T-cell responses. Clinical trial data show that about half of treated adults required no additional surgeries over the following year, with many responders maintaining durable benefit for years. The conversation also covers traditional management strategies, adjuvant therapies like bevacizumab, HPV vaccination, and the evolving algorithm for adult RRP care. --- TIMESTAMPS 00:00 - Introduction02:13 - RRP Patient Types and Symptoms05:06 - Adult vs Juvenile Transmission10:46 - When to Escalate Treatment15:40 - Immunotherapy 18:55 - Trial Enrollment, Results and Dosing Rules26:17 - Durable Long Term Response30:47 - Who Should Get Treated32:34 - Logistics And Public Perception37:50 - Future Research And Prevention --- Recurrent Respiratory Papillomatosis Foundation Position Statement on the Management of Adults With RRPhttps://pubmed.ncbi.nlm.nih.gov/41543033/ Dr. Stephen Schoeffhttps://healthy.kaiserpermanente.org/washington/clinicians/stephen-schoeff-6848607 Dr. Aaron Friedman https://www.uchealth.com/en/provider-profiles/friedman-aaron-d-1609057587
• Ep. 262 Systematic Approach to Pediatric OSA Management with Dr. Tali Lando 24.02.2026 1時間 14分

  Not every airway is a tonsil problem. Pediatric obstructive sleep apnea is often more nuanced than it appears, requiring thoughtful evaluation beyond routine surgery. In this episode of the BackTable ENT Podcast, pediatric otolaryngologist Dr. Tali Lando discusses managing pediatric obstructive sleep apnea (OSA) with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Lando shares insights into her clinical practice, outlining a systematic approach to diagnosing and treating pediatric OSA, and emphasizing the value of sleep endoscopy. She explores the spectrum of interventions from adenoidectomy and tonsillectomy to complex airway evaluations and surgical management, while highlighting the roles of sleep studies, obesity, and emerging therapies such as hypoglossal nerve stimulation. Dr. Lando also reflects on balancing a busy clinical career with family life and discusses her two books, Hell & Back: Wife & Mother, Doctor & Patient, Dragon Slayer and Breathless: Surgical Tales from the Brink (and Back). --- TIMESTAMPS 00:00 - Introduction06:21 - When Noisy Breathing Signals More Than Tonsils10:01 - When to Add DISE: Combining T&A with Airway Evaluation18:08 - Turbinates, Septum and Nasal Valve Matter22:03 - Red Flags in Clinic29:12 - When Surgery Helps and When It Doesn’t41:33 - Sleep Studies43:09 - Down Syndrome and OSA55:19 - Finding Hidden Sites of Airway Collapse01:06:13 - Hypoglossal Nerve Stimulation and Advanced Options --- RESOURCES Dr. Tali Lando https://www.wmchealth.org/physician-locator/tali-lando-1548383763?address_id=413 About Dr. Tali – Dr. Tali Lando
• Ep. 261 Cochlear Implants in the Elderly - Challenges & Solutions with Dr. Cameron Wick 17.02.2026 43分

  Only 7–10% of patients who qualify for cochlear implants actually receive one. Why are so many older adults missing out on life-changing hearing care? In this episode of the BackTable ENT Podcast, guest hosts Dr. Joe Walter Kutz and Dr. Brandon Isaacson are joined by Dr. Cameron Wick of University Hospitals Cleveland Medical Center to discuss cochlear implantation in the elderly population. --- SYNPOSIS The doctors explore common barriers to cochlear implantation, persistently low referral rates, and the substantial benefits these devices can offer older adults. Dr. Wick shares insights from his recent study on patients in their 80s and 90s, highlighting meaningful improvements in speech perception and overall quality of life. The conversation also addresses surgical considerations, postoperative care, the importance of timely intervention, and updated Medicare guidelines. --- TIMESTAMPS 00:00 - Introduction 02:52 - Risks and Benefits of CI in Older Adults11:57 - Handling Anticoagulation During CI Surgery13:59 - Post-Surgery Expectations and Balance Issues16:35 - Next Day Activation and Surgical Considerations19:17 - Assessing Patient Suitability for Cochlear Implants22:45 - Setting Patient Expectations for Cochlear Implants23:39 - Barriers to Cochlear Implant Access28:07 - Importance of Early Identification and Referral31:47 - Postoperative Rehabilitation and Patient Support39:30 - Concluding Thoughts and Acknowledgements --- RESOURCES J. Walter Kutz, M.D.https://utswmed.org/doctors/joe-kutz/ Brandon Isaacson, M.D.https://utswmed.org/doctors/brandon-isaacson/ Cameron Wick, MDhttps://www.uhhospitals.org/doctors/Wick-Cameron-1063737799