BackTable ENT

BackTable

The BackTable ENT Podcast is a resource for otolaryngologists to learn tips, techniques, and practical advice on all things ear, nose, and throat. Tune in to the BackTable ENT Podcast every week for candid conversations about rhinology, laryngology, otology, and head and neck surgery.

  1. HACE 2 DÍAS

    Ep. 263 Immunotherapy for Adults with RRP with Dr. Aaron Friedman

    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

    42 min
  2. 24 FEB

    Ep. 262 Systematic Approach to Pediatric OSA Management with Dr. Tali Lando

    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

    1 h y 14 min
  3. 17 FEB

    Ep. 261 Cochlear Implants in the Elderly - Challenges & Solutions with Dr. Cameron Wick

    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

    44 min
  4. 10 FEB

    Ep. 260 Clinical Insights on Immunodeficiency & ENT Infections with Dr. Lauren Gunderman

    At what point does a “routine” sinus or ear infection become a warning sign of immunodeficiency? In this episode of the BackTable ENT Podcast, board-certified allergist-immunologist Dr. Basil Kahwash explores the intersection of immunodeficiency and otolaryngology with Dr. Lauren Gunderman, a pediatric immunologist at Seattle Children’s Hospital. Learn why ENTs should remain vigilant for underlying immune disorders, and how to manage suspected immunodeficiency. --- SYNPOSIS The conversation reviews common signs and symptoms of immunodeficiency, key elements of the diagnostic workup, and when ENT physicians should consider referral to immunology. Dr. Kahwash and Dr. Gunderman discuss the role of family history and genetics, as well as current management strategies, including antibiotic use, immunoglobulin replacement therapy, and lifestyle modifications. Throughout the episode, Dr. Gunderman emphasizes the importance of multidisciplinary collaboration between otolaryngologists and immunologists to improve outcomes for patients with recurrent or severe infections. --- TIMESTAMPS 00:00 - Introduction 02:45 - Understanding Immunodeficiency in ENT08:20 - Common Immunodeficiencies and Indicators11:02 - Basic Immunology Refresher22:13 - Initial Diagnostic Workup25:05 - Challenges in Allergy and Immunology Testing27:57 - When to Refer to an Immunologist34:01 - Antibiotic Stewardship in Immunodeficient Patients46:07 - Advances in Diagnosing Immunodeficiency50:31 - Final Thoughts and Takeaways --- RESOURCES Lauren Michelle Gunderman, MDhttps://www.seattlechildrens.org/directory/lauren-michelle-gunderman/

    54 min
  5. 3 FEB

    Ep. 259 Understanding Coblation Tonsillectomy: Benefits, Outcomes & Techniques with Dr. Stephen Chorney

    Can one surgical approach reduce postoperative bleeding, shorten recovery, and save hundreds of dollars per case? In this episode of the BackTable ENT Podcast, Dr. Stephen Chorney, pediatric otolaryngologist at the University of Texas Southwestern Medical Center, joins hosts Dr. Ashley Agan and Dr. Gopi Shah to discuss the benefits and techniques of coblation intracapsular tonsillectomy. Drawing from his extensive clinical experience and findings from his recent Triological thesis, Dr. Chorney reviews the cost effectiveness of coblation intracapsular tonsillectomy compared to traditional extracapsular approaches. --- This podcast is supported by: Smith+Nephew https://www.smith-nephew.com/en-us/health-care-professionals/products/ear-nose-and-throat/coblation-technology-for-adenotonsillectomy#overview --- SYNPOSIS The conversation highlights key advantages of coblation intracapsular tonsillectomy, including lower postoperative bleeding rates, reduced pain, faster recovery, and meaningful economic benefits. Dr. Chorney also shares practical pearls on surgical technique with coblation, equipment settings, and postoperative care, making this episode a valuable resource for surgeons considering or already performing intracapsular tonsillectomy. --- TIMESTAMPS 00:00 - Introduction03:34 - Intracapsular Tonsillectomy: Training and Adoption08:46 - Patient Selection and Surgical Techniques15:50 - Postoperative Care and Pain Management37:26 - Understanding Post-Workout Pain and Recovery38:13 - Comparing Surgical Tools: Microdebrider vs. Coblator38:54 - Visual Cues and Techniques in Tonsillectomy39:22 - Challenges and Solutions in Tonsillectomy Procedures46:37 - Case Studies and Video Demonstrations56:12 - Cost-Effectiveness of Intracapsular Tonsillectomy01:07:19 - Conclusion and Final Thoughts --- RESOURCES Dr. Stephen Chorney https://utswmed.org/doctors/stephen-chorney/ Trio Thesis https://onlinelibrary.wiley.com/doi/full/10.1002/lary.32448

    1 h y 11 min
  6. 27 ENE

    Ep. 258 Understanding Sublingual vs. Subcutaneous Immunotherapy with Dr. Nikhila Schroeder

    When allergy meds aren’t enough, how do you choose the form of immunotherapy that will work best for your patient? Board-certified allergist-immunologist Dr. Nikhila Schroeder and host Dr. Basil Kahwash answer that question and more in this episode of the BackTable ENT Podcast. --- SYNPOSIS Dr. Schroeder shares her path from an engineering background to becoming a board-certified pediatric and adult allergist-immunologist, offering insight into how that perspective shapes her approach to patient care. The discussion focuses on the nuances of sublingual immunotherapy (SLIT) versus subcutaneous immunotherapy (SCIT), including administration, efficacy, safety, and patient adherence challenges. They also explore how immunotherapy can modulate the immune system and provide long-term symptom relief. Dr. Schroeder concludes by sharing her vision for the future of allergy immunotherapy, highlighting the accessibility and growing potential of SLIT. This episode offers ENT specialists a practical overview of why understanding and integrating allergy-immunotherapy can benefit both their practice and their patients. --- TIMESTAMPS 00:00 - Introduction05:01 - History and Evolution of Immunotherapy10:36 - Mechanisms of Immunotherapy14:59 - Subcutaneous Immunotherapy: Process and Benefits19:52 - Sublingual Immunotherapy: Process and Benefits27:56 - Comparing Subcutaneous and Sublingual Immunotherapy34:14 - Efficacy Comparison: Allergy Shots vs. SLIT39:51 - Patient Adherence and Treatment Choices41:58 - Contraindications for Allergy Immunotherapy48:58 - Long-term Benefits of Immunotherapy59:26 - Key Takeaways for ENT Professionals --- RESOURCES Dr. Nikhila Schroeder https://allergenuityhealth.com/about-us/

    1 h y 4 min
  7. 20 ENE

    Ep. 257 Understanding Eosinophilic Esophagitis: Diagnosis & Treatment Strategies with Dr. John Leung

    Think beyond the esophagus. Up to 75% of eosinophilic esophagitis (EoE) patients have ENT-relevant atopic disease that is often best managed with a multidisciplinary approach. Get caught up on best practices in EoE diagnosis and treatment with this episode of the BackTable ENT Podcast, featuring dual board-certified gastroenterologist and allergist-immunologist Dr. John Leung and host Dr. Basil Kahwash. --- SYNPOSIS The discussion covers the definition, symptoms, and diagnosis of EoE, highlighting the role of food and environmental allergies. Dr. Leung and Dr. Kahwash cover diagnostic techniques like endoscopy and emerging non-invasive methods, as well as various treatment options including dietary modifications, pharmacology, and biologics. The doctors also emphasize the importance of multidisciplinary collaboration between gastroenterologists, allergists, and otolaryngologists to provide optimal care for patients with EoE. --- TIMESTAMPS 00:00 - Introduction 03:13 - Understanding Eosinophilic Esophagitis (EoE)05:45 - EoE Symptoms and Diagnosis08:41 - Role of ENT in EoE Diagnosis11:32 - Diagnostic Criteria for EoE16:34 - Treatment Options for EoE20:55 - Role of Allergists and Environmental Allergies23:24 - Pharmacological Management of EoE29:38 - Complications and Risks of EoE36:21 - Follow-Up Endoscopies and Surveillance40:34 - Future Directions in EoE Management45:21 - Conclusion and Final Thoughts --- RESOURCES Dr. John Leunghttps://www.bostonspecialists.org/dr-leung-full-profile

    49 min
  8. 13 ENE

    Ep. 256 Keys to FESS: Intra-Op Pearls for Optimizing Outcomes in Sinus Surgery with Dr. Dennis Tang

    The best approach to sinus surgery is the one tailored to the patient in front of you. In this episode of the BackTable ENT podcast, guest host Dr. Satyan Sreenath, rhinologist and Assistant Professor at Indiana University, and Dr. Dennis Tang, rhinologist and Assistant Professor at Cedars-Sinai, discuss advanced surgical techniques and post-operative management strategies in Functional Endoscopic Sinus Surgery (FESS). --- SYNPOSIS The conversation covers the latest practices in intraoperative maneuvers, the use of bioabsorbable materials, and the contentious topic of middle turbinate resections. They review patient cases, surgical approaches, and provide insights into optimizing patient outcomes. Additionally, they emphasize the importance of individualized care tailored to specific chronic sinusitis phenotypes and patient-specific factors. --- TIMESTAMPS 00:00 - Introduction 03:28 - Case Study #1: CRSsNP with Nasal Congestion 04:59 - Factors Influencing Minimal vs. Maximal Surgery 14:23 - Case Study #2: Severe Nasal Polyposis27:56 - Debating the Use of Packing in Sinus Surgery40:24 - Scrutinizing Overhead Costs in Patient Care42:45 - FESS Postoperative Care 43:54 - Evolving Biomaterials in Sinus Surgery49:46 - The Debate on Middle Turbinectomy50:46 - Middle Turbinate Management Strategies01:13:17 - Concluding Thoughts on Surgical Practices --- RESOURCES Dr. Satyan Sreenath https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999 Dr. Dennis Tanghttps://www.cedars-sinai.org/provider/dennis-tang-3316614.html

    1 h y 19 min

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The BackTable ENT Podcast is a resource for otolaryngologists to learn tips, techniques, and practical advice on all things ear, nose, and throat. Tune in to the BackTable ENT Podcast every week for candid conversations about rhinology, laryngology, otology, and head and neck surgery.

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