BackTable ENT BackTable
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- Health & Fitness
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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Ep. 175 Understanding Atypical LPR: Beyond the Larynx with Dr. Inna Husain
In this episode, laryngologist Dr. Inna Husain joins host Dr. Ashley Agan for a deep dive into laryngopharyngeal reflux (LPR) to illuminate patient presentation, diagnostic tests, and future directions in LPR research.
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SYNPOSIS
The episode begins with a recap of Episode 83, in which Dr. Husain explained LPR fundamentals. Continuing from where they left off, the surgeons discuss various presentations of LPR, emphasizing the distinctions between acidic/non-acidic and direct/indirect reflux. Then, they review tests used to diagnose LPR and role of collaboration with gastroenterology colleagues. Dr. Husain shares her therapeutic approach to LPR, which includes lifestyle modifications for all patients, alginates for those with mechanical reflux, and nerve blocks for those with neurally mediated symptoms. The podcast wraps with a discussion of hot topics in LPR research.
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TIMESTAMPS
00:00 - Introduction
01:01 - Sponsor Spotlight: Medtronic ENT Innovations
04:37 - Summary of BackTable Episode 83 on Laryngopharyngeal Reflux (LPR)
08:34 - Typical vs. Atypical Presentations of LPR
23:36 - Dr. Husain’s Personal Experience with LPR
38:27 - Diagnosing LPR
46:43 - Lifestyle & Dietary Changes for LPR
50:53 - Hot Topics in Contemporary LPR Research
53:17 - The Brain-Gut Connection & LPR
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RESOURCES
BackTable ENT Episode 83: “Laryngopharyngeal Reflux with Dr. Inna Hussain:” https://www.backtable.com/shows/ent/podcasts/83/laryngopharyngeal-reflux
Medtronic ENT
www.medtronicent.com
Dr. Inna Husain’s Community Healthcare System profile: https://www.comhs.org/find-a-doctor/h/husain-inna
Dr. Inna Husain’s X:
https://x.com/drinnahusain
Dr. Inna Husain’s Instagram:
https://www.instagram.com/innahusainmd/
Dr. Inna Husain’s TikTok:
https://www.tiktok.com/@throatdoc -
Ep. 174 Advanced Navigation Systems for FESS: Enhancing Safety with Dr. Raj Sindwani
In this episode, Dr. Raj Sindwani, rhinologist at the Cleveland Clinic, joins host Dr. Gopi Shah to discuss advanced navigation systems, such as virtual reality (VR), to improve functional endoscopic sinus surgery (FESS).
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CHECK OUT OUR SPONSOR
Stryker ENT
https://ent.stryker.com
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SYNPOSIS
First, Dr. Sindwani shares how he combines pre-operative imaging data and navigation to plan successful surgeries. Then, he delves into features available in newer navigation systems, including target/anti-target technology, which notifies surgeons as their instruments approach critical structures. He covers topics relevant to navigation in clinical practice, including reimbursement, patient counseling, and troubleshooting in the OR. The episode concludes with a short conversation on the future of navigation-assisted FESS.
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TIMESTAMPS
00:00 - When to Use Navigation
10:42 - Harnessing Augmented Reality for Better Surgical Planning
20:43 - Registering Landmarks with Navigation
22:27 - How Navigation Systems Enhance Surgical Education
27:53 - Navigation in Office-Based Procedures
35:05 - Troubleshooting Problems with Navigation Systems
42:25 - The Future of Navigation-Assisted FESS
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RESOURCES
Stryker ENT Products:
https://www.stryker.com/us/en/ent.html
Dr. Sindwani’s Cleveland Clinic Profile:
https://my.clevelandclinic.org/staff/14102-raj-sindwani -
Ep. 173 Hypothyroidism Unmasked: The ENT’s Diagnostic Journey with Dr. Dana Gibbs
In this episode of the BackTable ENT Podcast, thyroid expert Dr. Dana Gibbs speaks with host Dr. Ashley Agan about Hashimoto’s Thyroiditis and hypothyroidism. Despite the high prevalence of Hashimoto’s Thyroiditis (1-2%), the condition is often misunderstood. Otolaryngologists and internists alike will benefit from Dr. Gibbs’ insight into Hashimoto’s presentation, diagnosis, and treatment.
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SYNPOSIS
First, Dr. Gibbs explains how she shifted her clinical focus from comprehensive otolaryngology to thyroid disease. Recounting her decades-long, personal experience with hypothyroidism, she describes how nonspecific symptoms of fatigue, hair loss, and weight gain can lead clinicians astray. Then, she reviews the pathophysiology and diagnosis of Hashimoto’s Thyroiditis. Using labs and questionnaires, she interrogates the patient’s overall endocrine health, which she addresses using a combination of levothyroxine (T4), liothyronine (T3), and select supplements. She demonstrates how lessons learned treating Hashimoto’s extend to hypothyroidism management more broadly. Finally, the use of integrative medicine strategies to treat thyroid disorders is discussed.
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TIMESTAMPS
00:00 - Introduction
02:33 - Dr. Gibbs’ Personal Experience with Hypothyroidism
11:32 - Understanding Hashimoto’s Thyroiditis
18:26 - Hashimoto’s: A Challenging Diagnosis
33:17 - The Role of Stress in Thyroid Disease
35:04 - Thyroid Medications
51:21 - The Role of Surgery in Managing Hypothyroidism
55:01 - An Integrative Medicine Perspective on Hypothyroidism
59:27 - Final Thoughts on Hashimoto’s & Hypothyroidism
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RESOURCES
Dr. Gibbs’ Consultants in Metabolism Profile:
https://www.danagibbsmd.com/
Dr. Gibbs’ Instagram:
https://www.instagram.com/danagibbsmd/ -
Ep. 172 HPV and Oropharyngeal Cancer: Evolving Insights and Implications with Dr. Mihir Patel
In this episode, Dr. Mihir Patel, Professor of Otolaryngology at Emory University and expert in Transoral Robotic Surgery (TORS), discusses HPV-positive head and neck cancer with host Dr. Ashley Agan.
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CHECK OUT OUR SPONSOR
Medtronic ENT
https://www.medtronic.com/us-en/healthcare-professionals/medical-specialties/ear-nose-throat.html?cmpid=Vanity_URL_MIX_medtronicent-com_202212_US_EN_NS_ENT_FY23
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SYNPOSIS
Dr. Patel opens by briefly sharing his journey to head & neck surgery, and, more specifically, expertise in TORS. After, Dr. Patel explains the epidemiology and pathophysiology of HPV-caused cancers, which frequently present as painless neck masses. Then, Dr. Patel describes workup and treatment of these cancers. He shares surgical strategies, paying special attention to cases of unknown primary lesions. He underscores the importance of collaboration with medical and radiation oncologists, particularly given the rapid pace of treatment innovation. Finally, Dr. Agan and Dr. Patel examine how increased HPV vaccine uptake could drastically lower the burden of this disease in the coming decades.
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TIMESTAMPS
00:00 - Introduction
05:26 - The Evolution of HPV-Related Oropharyngeal Cancer Treatment
17:26 - Contemporary Diagnostics for Head & Neck Cancer
24:39 - Surgical Strategies for Unknown Primary Lesions
38:15 - The Role of ctDNA in Cancer Management
46:10 - Advancements in HPV-Driven Cancer Treatment
53:30 - The Future of Cancer Screening and Vaccination
01:01:54 - Vaccination: A Tool for Cancer Prevention
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RESOURCES
Medtronic ENT:
https://www.medtronic.com/us-en/healthcare-professionals/products/ear-nose-throat.html
Dr. Mihir Patel’s Emory University Profile:
https://winshipcancer.emory.edu/bios/faculty/patel-mihir-r.html
AVOID Trial:
https://pubmed.ncbi.nlm.nih.gov/31785337/ -
Ep. 171 Workforce Analysis and Why It’s Important with Dr. Andrew J. Tompkins
In this episode, hosts Dr. Ashley Agan and Dr. Gopi Shah discuss the ENT workforce with Dr. Andrew (“AJ”) Tompkins, an Ohio-based comprehensive otolaryngologist and member of the American Academy of Otolaryngology-Head and Neck Surgery’s socioeconomic task force.
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SYNPOSIS
First, Dr. Tompkins provides an overview of the ENT workforce from trainee to retiree stages. He describes his work with the Academy’s socioeconomic task force, which provides important feedback on the number, location and work environments of practicing otolaryngologists. He emphasizes participation in the Academy’s workforce survey as the source of this data. Offering a sneak preview of 2023 survey results, Dr. Tompkins underscores the need to increase resident exposure to private practice settings and to plan for how treatment breakthroughs (such as the HPV vaccine) might affect future workforce needs. The surgeons finish by discussing necessary improvements in resident selection and continuing education.
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TIMESTAMPS
00:00 - Introduction
03:09 - Exploring the ENT Workforce: A Provocative Topic
08:09 - Unpacking the Challenges of ENT Workforce Data
22:16 - The Impact of Fellowship Training & Practice Shifts
31:59 - Previewing 2023 Data Insights
37:09 - Addressing Workforce Distribution and Access Issues
43:30 - How Technology & Training Influence the ENT Workforce
56:20 - Collaborations & Future Directions
01:01:24 - Concluding Thoughts on Workforce Dynamics
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RESOURCES
Dr. Andrew Tompkins’ Ohio ENT & Allergy Profile:
https://www.ohioentandallergy.com/physicians/andrew-tompkins-md-mba/
Triological Society Otolaryngology Workforce Analysis from 2016: https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.26238
“The 2022 Otolaryngology Workforce” Report from AAO-HNS:
https://www.entnet.org/wp-content/uploads/2023/07/2022-Otolaryngology-Workforce.pdf
Tompkins AJ. The Otolaryngology Workforce, Part I: Supply. ENTtoday. May 2022.
https://www.enttoday.org/article/some-studies-predict-a-shortage-of-otolaryngologists-do-the-numbers-support-them/
Tompkins AJ. The Otolaryngology Workforce, Part II: Structure & Rethinking Supply. ENTtoday. June 2022.
https://www.enttoday.org/article/transparent-regular-data-vital-to-reworking-how-we-think-about-workforce-supply/
Tompkins AJ. The Otolaryngology Workforce, Part III: Competition & Future Design. ENTtoday. July 2022.
https://www.enttoday.org/article/tips-for-creating-a-dynamic-otolaryngology-workforce/ -
Ep. 170 ENT Advocacy: Strategies and Impact with Dr. Peter Manes
In this episode of the BackTable ENT podcast, Dr. Pete Manes, associate professor of rhinology at Yale, discusses political advocacy with host Dr. Ashley Agan.
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SYNPOSIS
Dr. Manes begins by explaining how a life-long interest in government underlies his work as a physician-advocate with the American Academy of Otolaryngology-Head & Neck Surgery. Currently, he serves as the Academy’s Coordinator of Health Policy, where he contributes to private payer advocacy and Academy position statements. Drawing on this experience, he explains political challenges associated with being a smaller specialty, roles played by of Action Committees (PACs), and steps in legislative advocacy. Then, he shifts focus to cover how the Academy works with private payers to ensure fair reimbursement. The podcast concludes with resources to connect otolaryngologists with advocacy work.
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TIMESTAMPS
00:00 - Introduction
01:02 - Dr. Pete Manes’s Advocacy Role
08:04 - The Importance of Advocacy in Medicine
20:24 - Scope of Practice and Physician Payment Reform
30:02 - Building Relationships for Healthcare Advocacy
37:12 - Navigating Insurance Companies for Patient Advocacy
42:33 - Utilizing Position Statements in Healthcare Advocacy
48:29 - Accessing Academy Resources for Healthcare Advocacy
50:43 - Exploring Opportunities for Engagement and Advocacy
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RESOURCES
Dr. Pete Manes’s Yale University Profile:
https://medicine.yale.edu/surgery/otolaryngology/profile/rpeter-manes/
American Academy of Head & Neck Surgery (AAO-HNS) Position Statements:
https://www.entnet.org/business-of-medicine/position-statements/
AAO-HNS Health Policy Contact:
healthpolicy@entnet.org