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. 5 小時前

    Ep. 288 AERD: Diagnosis & Treatment Strategies with Dr. Andrew White

    Aspirin or biologics? How do you choose the right treatment for AERD? On this episode of the BackTable ENT & Allergy Podcast, Dr. Basil Kahwash interviews Dr. Andrew White, Director of the AERD Clinic at Scripps Clinic, to discuss the diagnosis and management of this often underrecognized condition. They cover practical strategies for identifying AERD, the importance of a detailed NSAID history, and how treatment decisions are shaped by patient goals and disease severity. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:08 - What Is AERD and Prevalence 06:32 - History Taking and Mechanism 11:10 - Typical Symptom Progression and Alcohol Intolerance 16:41 - When to Do Aspirin Challenge 19:00 - Challenge Protocol And Upper Airway Reactions24:53 - Aspirin Desensitization vs Challenge27:58 - Aspirin therapy after desensitization and Risk of GI Bleeds31:17 - Biologics Change AERD33:42 - Choosing Aspirin Desensitization vs Biologics 35:52 - Patient Counseling and Motivational Interviewing 41:26 - Convenience and Cost of Therapy 44:10 - ENT Allergy Collaboration47:22 - Rapid Fire Pearls51:13 - Future Research & Management Direction54:05 - Final Takeaways --- More about this episode Dr. White explains that AERD affects about 8 to 10 percent of asthmatics, with even higher rates in those with severe asthma or nasal polyps. He reviews typical adult-onset progression, alcohol-related respiratory symptoms, and the underlying pathophysiology, including imbalances in arachidonic acid mediators and leukotriene surges after NSAID exposure.The conversation includes practical questions to ask when taking an NSAID history, such as reactions to common pain relievers or alcohol, and when to consider aspirin challenge. Dr. White also details long-term treatment strategies, including the role of biologics like dupilumab and aspirin therapy after desensitization, with considerations for dosing and gastrointestinal risk. He explains how factors like asthma severity, recurrent polyp disease, sense of smell, cost, and convenience all influence therapy choice. The episode concludes with a discussion of multidisciplinary collaboration, patient counseling, and Dr. White’s insights on future research directions in AERD management. --- Resources Aspirin sensitivity and severity of asthma: evidence for irreversible airway obstruction in patients with severe or difficult-to-treat asthmahttps://pubmed.ncbi.nlm.nih.gov/16275362/ Polyphenolic Activation of Basophils Explains Alcohol Hypersensitivity in AERDhttps://pubmed.ncbi.nlm.nih.gov/41065188/ New insights into the mechanisms of aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/39641750/ The role of aspirin desensitization followed by oral aspirin therapy in managing patients with aspirin-exacerbated respiratory disease: A Work Group Report from the Rhinitis, Rhinosinusitis and Ocular Allergy Committee of the American Academy of Allergy, Asthma & Immunologyhttps://pmc.ncbi.nlm.nih.gov/articles/PMC7980229/ Safety and outcomes of aspirin desensitization for aspirin-exacerbated respiratory disease: A single-center studyhttps://pubmed.ncbi.nlm.nih.gov/28550988/ Selection of aspirin dosages for aspirin desensitization treatment in patients with aspirin-exacerbated respiratory diseasehttps://pubmed.ncbi.nlm.nih.gov/17208597/ Factors influencing aspirin therapy after desensitization (ATAD) tolerance in aspirin-exacerbated respiratory disease (AERD) patientshttps://pubmed.ncbi.nlm.nih.gov/41022281/ Feed the Good Wolf: Motivational Interviewing, Cognitive Behavioral Therapy, and Mindsethttps://pubmed.ncbi.nlm.nih.gov/42103433/ --- 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

  2. 8月11日

    Ep. 287 Unified Airway: Unified Biology, Unified Inflammation with Dr. Cedric "Jamie" Rutland

    Can viewing the airway as one connected system change the future of respiratory care and improve patient outcomes? On this episode of the BackTable ENT & Allergy Podcast, Dr. Cedric Jamie Rutland, pulmonary and critical care medicine physician, joins Dr. Basil Kahwash to discuss the unified airway hypothesis and its implications for clinical care. They explore how upper and lower airway inflammation are closely linked, and why multidisciplinary collaboration is essential for treating the whole patient. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction05:06 - Understanding the Unified Airway14:27 - Decoding Asthma Biomarkers20:34 - Endotyping in Clinical Practice26:36 - Addressing Asthma Symptom and “Outgrowing” Asthma32:13 - Strategies for Precision Biologics34:23 - Navigating Insurance and Treatment Indications35:36 - Treating the Whole Patient and Breaking Down Specialty Silos46:07 - Effective Patient Communication51:36 - Asthma Lightning Round57:33 - Biologics and Airway Remodeling1:00:00 - Closing Thoughts --- More about this episode The conversation covers the biology of type II inflammation, the use of biomarkers and biologics for more personalized treatment, and practical strategies for overcoming insurance barriers and specialty silos. Dr. Rutland shares insights on patient communication, the limitations of current diagnostics, and the impact of chronic inflammation on systemic disease. The episode highlights the need for ENT, allergy, and pulmonology teams to work together and embrace a connected view of airway disease to achieve better patient outcomes. --- Resources Dr. Jamie Rutland - https://www.lung.org/media/meet-our-experts/cedric-jamie-rutland-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

  3. 8月4日

    Ep. 286 What's The Big Deal With This BackTable App? with Dr. Aaron Fritts

    BackTable is moving beyond the traditional podcast experience and into a platform built specifically for clinicians. On this episode of the BackTable ENT & Allergy Podcast, hosts Drs. Gopi Shah and Ashley Agan welcome Dr. Aaron Fritts, interventional radiologist and BackTable CEO and Co-Founder, to discuss the history and future of BackTable, and what listeners can look forward to on the new BackTable App. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps00:00 - Introduction00:51 - Meet the CEO and Co-Founder02:32 - How Backtable Got Its Name04:32 - Why Move to the App07:31 - Community and Learning Features12:36 - Playlists and Transcripts15:42 - Beyond Backtable Content18:07 - Searchability and Other Platform Limits19:35 - Privacy and NPI Verification21:31 - Download the App and Give Feedback22:53 - October Timeline and Academy Party24:26 - Closing Thoughts --- More about this episode Dr. Fritts shares how BackTable started as an app concept for medical devices in 2016, evolved into the IR podcast in 2017, and expanded to the ENT show in 2020. He explains how Gopi coined the name “BackTable” as an homage to the informal, behind-the-scenes conversations that fuel clinical learning. With eight shows now producing 30 to 40 episodes each month, BackTable will begin releasing most new podcast episodes exclusively on the BackTable app starting in October. The conversation highlights the app’s robust features designed for busy clinicians, including physician-only NPI-verified guest Q&As, quick-study cases, searchable and organized playlists, episode transcripts, offline listening, upcoming CarPlay integration, and access to resources like the Curbsiders internal medicine podcast. The BackTable app is free to download and free to use, providing easy access to a growing library of high-yield medical education content. --- Resources Download the BackTable App on Google Playhttps://play.google.com/store/apps/details?id=com.backtable.app&hl=en_GB Download the BackTable App on the Apple App Store https://apps.apple.com/us/app/backtable/id6751363383 --- 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

  4. 7月28日

    Ep. 285 Post-Operative Care & Complications in Coblation Intracapsular Tonsillectomy in Children with Dr. Kevin Huoh and Dr. Stephen Chorney

    Most surgeons trained learning extracapsular tonsillectomies. What does the evidence say about intracapsular tonsillectomies? Two pediatric otolaryngologists explain why they made the switch and never looked back. On this episode of the BackTable ENT Podcast, hosts Dr. Ashley Agan and Dr. Gopi Shah sit down with pediatric otolaryngologists Dr. Stephen Chorney from UT Southwestern and Children's Health Dallas and Dr. Kevin Huoh from Children's of Orange County to examine post-operative complications after tonsillectomy and adenoidectomy, with a focus on coblation intracapsular tonsillectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Smith + Nephewhttps://www.smith-nephew.com/en/ --- Timestamps 00:00 - Introduction02:53 - Why Switch Techniques?07:58 - Risk Stratification and Patient Selection11:04 - Respiratory Complications and Management15:57 - Preop Screening21:35 - Risks for Post-op Bleeding and Counseling26:16 - Managing Post-op Bleeding31:56 - Surgical Tips to Prevent Bleeds and Management39:30 - Intracapsular Tonsillectomy in Older Kids43:44 - Post Op Pain Plan and Return To School48:33 - Use of Toradol & Readmission for Pain and Dehydration53:16 - Caution of Burn and Stenosis Injuries61:01 - Final Takeaways --- More about this episode Dr. Chorney and Dr. Huoh share why they each committed fully to the intracapsular technique and what that shift has meant in practice, from secondary hemorrhage rates hovering around 0.5–0.6% to fewer nursing line calls, readmissions for pain and dehydration, and faster returns to school and normal activity. They walk through their approach to patient risk stratification and admission criteria (age 30/ICU consideration) as well as how to manage the most common post-operative respiratory complications. The conversation also covers practical guidance for handling outside-ER bleed calls, the role of nebulized TXA, toradol considerations, and managing dehydration. They also share for navigating intracapsular coblation in older children, strategies to reduce burn injuries, and a closer look at the rare but serious risk of pharyngeal stenosis. Check out this episode to hear Dr. Chorney and Dr. Huoh discuss how intracapsular tonsillectomy doesn't just improve outcomes but can transform the recovery experience for patients and their families. --- Resources Extracapsular vs Intracapsular Tonsillectomy: Outcomes in Children with a Focus on Developmental Delayhttps://pubmed.ncbi.nlm.nih.gov/34839135/ Current Status and Future Trends: Pediatric Intracapsular Tonsillectomy in the United Stateshttps://pubmed.ncbi.nlm.nih.gov/32969500/ Dr. Chorney Episode 259 - Understanding Coblation Tonsillectomy https://www.backtable.com/shows/ent/podcasts/259/understanding-coblation-tonsillectomy-benefits-outcomes-techniques Dr. Huoh Episode 110 - Intracapsular Tonsillectomy in Childrenhttps://www.backtable.com/shows/ent/podcasts/110/intracapsular-tonsillectomy-in-children --- 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

  5. 7月23日

    Ep. 284 Optimizing Nasal Airway for CPAP Compliance with Dr. Michael Hutz and Dr. Atul Malhotra

    Is nasal obstruction the overlooked culprit behind CPAP intolerance? On this episode of BackTable ENT & Allergy, Dr. Gopi Shah interviews Dr. Atul Malhotra and Dr. Michael Hutz to examine the critical but often underappreciated role of the nose in obstructive sleep apnea management. They discuss how nasal obstruction can undermine CPAP adherence, why relying solely on AHI may miss key issues, and how identifying the true cause of intolerance can lead to more personalized and effective therapy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Aerin Medicalhttps://vivaer.com/ --- Timestamps 00:00 - Introduction04:05 - OSA Presentation and AHI Limitations08:13 - Understanding CPAP Intolerance and Nasal Obstruction15:24 - Evaluating Nasal Obstruction20:32 - Nasal Anatomy and Workup27:47 - DICE Technique and Assessing Dynamic Nasal Collapse32:51 - Medical and Non-Surgical Management37:29 - Surgical Options and VivAer43:39 - Nasal Procedures and CPAP Success51:57 - Nasal Surgery and Heart Outcomes55:23 - Beyond CPAP: Nasal Breathing, Myofunctional Therapy, and Collaborative Care01:04:51 - Wrap Up --- More about this episode The physicians review practical strategies for evaluating nasal obstruction, from targeted patient questionnaires, physical exams, nasal endoscopy, and selective imaging. The doctors also detail medical and surgical treatment options, from allergy management and nasal sprays to septoplasty, turbinate reduction, functional rhinoplasty, and temperature-controlled radiofrequency (VivAer). Throughout the episode, they highlight how comprehensive nasal evaluation and intervention can significantly improve CPAP comfort and adherence. --- Resources Dr. Atul Malhotra - https://providers.ucsd.edu/details/22362/sleep-medicine-pulmonology-(lung) Dr. Michael Hutz- https://doctors.rush.edu/details/19100 CPAP treatment persistence following nasal procedures in obstructive sleep apnea - https://www.tandfonline.com/doi/pdf/10.1080/13696998.2026.2671550 Design and rationale for treating Obstructive Sleep Apnea using Targeted Hypoglossal Nerve Stimulation trial - https://www.sciencedirect.com/science/article/pii/S1551714422001306 The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea - https://pmc.ncbi.nlm.nih.gov/articles/PMC9498537/ VATRAC Trial of VivAer - https://aerinmedical.com/company/news-and-media/aerin-medical-announces-positive-two-year-outcomes-from-the-vatrac-trial-of-vivaer/ --- 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

  6. 7月21日

    Ep. 283 Streamlining Surgery: The Future of the OR with Dr. Raj Sindwani

    What if the next major advance in ENT surgery isn’t a new instrument, but a better-integrated operating room? In this episode of the BackTable ENT & Allergy Podcast, Cleveland Clinic rhinologist and skull base surgeon Dr. Raj Sindwani joins Dr. Gopi Shah and Dr. Ashley Agan to discuss how reducing cognitive load, improving workflows, and creating a more efficient OR environment can enhance the surgical experience. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by Strykerhttps://www.stryker.com/us/en/ent.html --- Timestamps 00:00 - Introduction03:50 - Where Surgery Happens: Choosing the Right Site for Service06:27 - Quality Safety And Throughput09:48 - Reducing Cognitive Load In Surgery15:34 - Building an Efficient OR Ecosystem And Culture23:06 - Tech Adoption and Team Training26:19 - Smarter Surgical Navigation and Augmented Reality37:02 - Navigation Accuracy, Registration, and Smart Coaching40:29 - Inside the Stryker RISE Platform49:55 - Integration Challenges and Voice-Control Safety56:36 - Surgical Ergonomics and Injury Prevention01:09:14 - The Future of Surgical Innovation and AI in the OR --- More about this episode Dr. Sindwani explores how minimizing unnecessary friction, improving team dynamics, and thoughtfully integrating technology can help surgical teams focus on what matters most: patient care. The conversation examines the operating room as an ecosystem where people, processes, and technology all contribute to patient outcomes. Dr. Sindwani shares strategies for reducing extrinsic cognitive load, including standardizing room setup, minimizing interruptions, and optimizing the surgical environment.He also discusses advances in sinus and skull base navigation, augmented reality guidance, and Stryker’s RISE platform, highlighting how integrated technology can simplify workflow, improve ergonomics, and reduce distractions in the OR. Throughout the episode, Dr. Sindwani emphasizes the importance of thoughtful technology adoption, team collaboration, and designing the operating room of the future around safety, efficiency, and the needs of both patients and surgeons. --- Resources Dr. Raj Sindwanihttps://providers.clevelandclinic.org/provider/raj-sindwani/4268990 Stryker ENThttps://www.stryker.com/us/en/ent.html Stryker RISE Platformhttps://www.stryker.com/us/en/portfolios/medical-surgical-equipment/integration-and-connectivity/or-integration/rise.html Technological Advances in Sinus and Skull Base Surgery by Dr. Raj Sindwanihttps://www.oto.theclinics.com/article/S0030-6665(17)30050-6/fulltext Ergonomics in ENT Practice NIH Articlehttps://pmc.ncbi.nlm.nih.gov/articles/PMC11455805/ --- 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

  7. 7月14日

    Ep. 282 Awake Cochlear Implantation: An Expert Guide with Dr. Sarah Mowry

    Have you considered performing a cochlear implant while your patient is awake? In this episode of the Backtable ENT & Allergy Podcast, Dr. Walter Kutz and Dr. Brandon Isaacson sit down with Dr. Sarah Mowry to explore her protocol for cochlear implants under local anesthesia, an approach especially relevant for older adults concerned about the cognitive risks of general anesthesia. Dr. Mowry shares her criteria for patient selection, preoperative counseling strategies, and how she adapts the OR setup to maximize comfort and communication during awake surgery. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction02:06 - Why to Consider Awake Cochlear Implants05:32 - Indications for Awake CI 08:50 - Local Blocks and Pain Control10:58 - Counseling and Expectations14:40 - Preventing Intraoperative Vertigo and Converting to General Anesthesia 17:17 - Set Up and Communication with Patient 19:14 - Lesser Occipital Nerve Block and Potential Role of Processed EEG26:32 - Pitch Matching for Single-Sided Deafness, CI, and Anxiety Considerations29:00 - Feedback from Patients and Electrode Choice 31:30 - Advice to Surgeons and Closing Remarks --- More about this episode The conversation covers her anesthesia protocol, including lesser occipital and postauricular nerve blocks, minimizing propofol, and using topical 2% lidocaine in sensate areas like the facial recess and epitympanum. Dr. Mowry discusses practical strategies of using warmed irrigation to reduce intraoperative vertigo and contingency plans for conversion to general anesthesia. She discusses electrode considerations and the potential role of processed EEG to titrate anesthesia depth and practical tips for surgeons interested in adopting awake cochlear implantation. Throughout, they highlight the importance of individualized patient care, multidisciplinary teamwork, and the growing role of local anesthesia in otologic surgery. --- Resources Cochlear Implantation Under Local Anesthesia With Conscious Sedation in the Elderly: First 100 Caseshttps://pubmed.ncbi.nlm.nih.gov/32663339/ Cochlear implantation under local anesthesia in 117 cases: patients' subjective experience and outcomeshttps://pubmed.ncbi.nlm.nih.gov/34487218/ --- 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

  8. 7月7日

    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

簡介

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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