BackTable ENT & Allergy

BackTable

The go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Tune in every week for practical, physician-led conversations on common and complex clinical topics in allergy, immunology otolaryngology, rhinology, laryngology, otology, and head and neck surgery. Hear how experienced physicians approach real cases, and get practical advice from your peers in your field.

  1. 14時間前

    Ep. 281 Expert Insight on Congenital CMV & Pediatric Hearing Loss with Dr. Albert Park

    Did you know that congenital CMV-related hearing loss can develop several years after birth? On the BackTable ENT & Allergy Podcast, hosts Dr. Gopi Shah and Dr. Jeff Hyzer interview pediatric otolaryngologist Dr. Albert Park about the latest evidence on congenital CMV and its role in pediatric sensorineural hearing loss. The discussion covers diagnosis, risk factors, screening protocols, testing strategies, antiviral treatment, genetic workup, long-term surveillance, and future directions for early detection and prevention. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:47 - Basics of CMV Infections and Hearing Loss Presentation 07:57 - CMV Screening Workflow 11:33 - Saliva vs. Urine Based Screening 14:00 - Early Workup and Communication 19:37 - Late Onset Workup and Use of Antivirals 24:39 - Treatment with Antiviral Medications 27:22 - Head Ultrasound vs. MRI 30:06 - Role of Genetic Testing 32:47 - Surveillance and Progression Risk37:29 - CI Outcomes and Predictors42:18 - BAHA and Older Candidates45:44 - Awareness, Prevention Efforts, and Education 54:25 - Vaccines and Universal Screening Pitfalls 57:40 - Advocacy and Closing Thoughts --- More about this episode Dr. Park explains the differences between congenital and acquired CMV, reviews epidemiology and, and highlights that hearing loss may be present at birth or develop later in childhood. He discusses Utah’s evolution from hearing-targeted CMV testing to universal NICU screening, emphasizing the importance of diagnosis within the first 21 days of life. The conversation covers saliva versus urine testing, dried blood spot testing, and the role of a multidisciplinary team in evaluation and management. Dr. Park also reviews antiviral treatment strategies, imaging and genetic testing considerations, audiologic surveillance, and cochlear implantation outcomes. Finally, he discusses ongoing advocacy efforts, emerging prenatal screening technologies, and future directions and challenges for CMV prevention and early detection. --- Resources Nance & Morton NEJM Paper Cited - 20% of Congenital SNHL linked to Congenital CMV https://www.nejm.org/doi/full/10.1056/NEJMra050700 Dr.Kimberlin’s work supporting antiviral treatment for 6 months https://www.nejm.org/doi/full/10.1056/NEJMoa1404599?utm_source=openevidence Dr.Vossen’s antiviral therapy research https://pubmed.ncbi.nlm.nih.gov/38336204/ AAP Red Book https://publications.aap.org/redbook Dr. Smith’s Research - Genetic Testing for Congenital Bilateral Hearing Loss in the Context of Targeted Cytomegalovirus Screeninghttps://pubmed.ncbi.nlm.nih.gov/31985074/ Dr.Park’s Research Congenital Cytomegalovirus Testing Outcomes From the ValEAR Trialhttps://pubmed.ncbi.nlm.nih.gov/38415855/ Dr.Park’s Research - Analysis of an Expanded Targeted Early Cytomegalovirus Testing Programhttps://pubmed.ncbi.nlm.nih.gov/36884018/ Dr.Foulon - Hearing Loss With Congenital Cytomegalovirus Infectionhttps://pubmed.ncbi.nlm.nih.gov/31266824/ Research about the use of Vaclovir to reduce vertical transmissionhttps://pubmed.ncbi.nlm.nih.gov/32919517/ Dr.Gantt’s research on the Ping-Pong Effecthttps://pubmed.ncbi.nlm.nih.gov/29889809/ --- 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

    1時間2分
  2. 6月30日

    Ep. 280 Leadership Through Resiliency & Mentorship with Dr. Troy Woodard

    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

    1時間4分
  3. 6月23日

    Ep. 279 Collaborative Care in Chronic Sinusitis & Allergies with Dr. Karen Kaufman

    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

    59分
  4. Ep. 278 Comprehensive Evaluation and Surgical Management of Nasal Septal Perforations with Dr. Oswaldo Henriquez

    6月16日

    Ep. 278 Comprehensive Evaluation and Surgical Management of Nasal Septal Perforations with Dr. Oswaldo Henriquez

    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

    1時間29分
  5. 6月9日

    Ep. 277 Molecular Diagnostics for Thyroid Nodules with Dr. Erik Alexander

    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

    45分
  6. 6月2日

    Ep. 276 LPR vs. LPS: Key Differences & Diagnostic Techniques with Dr. Inna Husain

    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

    1時間4分
  7. 5月26日

    Ep. 275 Evaluation & Management of Unilateral Vocal Fold Paralysis in Adults with

    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

    54分
  8. 5月19日

    Ep. 274 Pediatric Thyroid Nodules: Clinical Insights & Approaches with Dr. Wen Jiang

    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

    1時間

番組について

The go-to podcast for otolaryngologists, allergists, and head and neck surgeons. Tune in every week for practical, physician-led conversations on common and complex clinical topics in allergy, immunology otolaryngology, rhinology, laryngology, otology, and head and neck surgery. Hear how experienced physicians approach real cases, and get practical advice from your peers in your field.

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