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BackTable ENT & Allergy

BackTable Inc.

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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  • 37 episodes
  • weekly
  • Avg 55 min
  • English

Episodes 37

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  • May 26 · 53 min

    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 app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:18 - Classic Symptoms of Vocal Fold Paralysis 04:15 - Etiology and Imaging Workup 08:40 - Injection Timing and Materials 23:20 - Permanent Options and Framework Surgery 28:41 - Arytenoid Adduction Risks and When to Add Adduction 30:56 - Awake Thyroplasty Technique compared to Sedation and OR Setup 35:48 - Reinnervation and Bilateral Medialization Choices 42:10 - Vocal Fold Long-term Injectables 51:54 - 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

  • May 19 · 1 hr

    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 app https://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 Outcomes 08:50 - Initial workup 13:42 - Ultrasound Interpretation 16:07 - Lymph Node Mapping and CT 19:58 - Incidental Findings 24:14 - Role of FNA, Molecular Testing, and Radiofrequency Ablation 32:40 - Molecular Testing Results and Counseling 38:04 - Neck Dissection Strategy 40:44 - Hypocalcemia Protocol Considerations 44:01 - 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

  • May 12 · 36 min

    Ep. 273 Integrating Narrative Medicine into Patient Care with Dr. Alessandra Colaianni

    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 app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 05:53 - What is Narrative Medicine? 11:36 - Narrative Medicine in Clinic 17:28 - Narrative Medicine in the OR 21:09 - Patient Case Presentation and Boundaries 25:05 - Writing For Reflection and the impact of AI 29:35 - Resources And Podcasts 33:19 - 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 Wang https://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

  • May 5 · 56 min

    Ep. 272 Allergy Education on Social Media and Beyond: Challenges and Strategies with Dr. Zachary Rubin

    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 app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 05:21 - Learning the Creator Playbook 10:10 - Authenticity and Creating a Personal Brand 16:51 - Writing for Patients and Clinicians 20:41 - Balancing Clinic and Content Creation 26:15 - How to Start Your Public Voice 29:11 - Professional Boundaries and Handling Criticism Online 36:34 - How Patients Following Your Content Impacts the Clinic 43:08 - The Unexpected Doors Content Creation Can Open 48:44 - Future of Public Health 53:09 - 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 Rubin https://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

  • April 28 · 32 min

    Ep. 271 The OR Surgical Tech in Pediatric ENT with Jose Flores

    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 Tech 05:41 - Daily Responsibilities and Preparation 10:11 - Communication and Teamwork in the OR 15:30 - Building Strong Surgical Tech Relationships 18:51 - Advice for New Surgical Techs 21:25 - The Role of Techs in Quality and Safety 23:15 - Giving and Receiving Feedback 27:02 - Fostering Respect and Recognition 30:40 - Final Thoughts and Contact Information --- RESOURCES Jose Flores’s Story: https://vimeo.com/1096085041

  • April 21 · 45 min

    Ep. 270 Management of Sinonasal Tumors with Skull Base Involvement: Part 2 with Dr. Zara Patel, Dr. JP Almeida and Dr. Garret Choby

    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 app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 01:20 - Case 1: Juvenile Nasopharyngeal Angiofibroma 05:03 - Considerations for Pre-Operative Embolization 08:10 - Disaster Scenario: High Volume Loss 09:21 - Operative Approach 18:10 - Post-Op Imaging Considerations 21:00 - Case 2: Invasive Keratinizing Squamous Cell Carcinoma 24:40 - Operative Approach vs. Neoadjuvant Treatment Strategies 28:30 - Importance of Diagnostic Nasal Endoscopy 30:15 - Operative Approach 32:37 - 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, PhD https://medicine.iu.edu/faculty/68351/almeida-joao-paulo Satyan B. Sreenath, MD https://medicine.iu.edu/faculty/60724/sreenath-satyan Zara M. Patel, MD https://med.stanford.edu/profiles/zara-patel Garret W. Choby, MD https://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

  • April 14 · 43 min

    Ep. 269 Management of Sinonasal Tumors with Skull Base Involvement: Part 1 with Dr. Zara Patel, Dr. JP Almeida, & Dr. Garret Choby

    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 app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:04 - First Principles of Workup 05:23 - Case 1: Maxillary Sinus Mass 06:23 - Imaging and Biopsy Strategy 08:11 - Inverted Papilloma Pathology and Surgical Planning 20:28 - Case 2: Unilateral Disease Red Flags 24:34 - MRI Clues for Malignancy 31:47 - Video Walkthrough of Endonasal Resection 38:51 - Surveillance 41:41 - 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. --- Resources Joao Paulo Almeida, MD, PhD https://medicine.iu.edu/faculty/68351/almeida-joao-paulo Satyan B. Sreenath, MD https://medicine.iu.edu/faculty/60724/sreenath-satyan Zara M. Patel, MD https://med.stanford.edu/profiles/zara-patel Garret W. Choby, MD https://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

  • March 24 · 1 hr 4 min

    Ep. 266 Clinical Steps for Efficient Anaphylaxis Diagnosis & Treatment with Dr. Payel Gupta

    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 app https://www.backtable.com/app --- Timestamps 00:00 - Introduction 02:02 - Defining Anaphylaxis and Key Signs 04:09 - Anaphylaxis Versus Shock 05:54 - Diagnostic Pitfalls 12:43 - Epi First Epi Fast 32:33 - ER Or Observe 42:31 - Allergy Testing Limits 47:16 - New Anaphylaxis Therapies 51:34 - Public Awareness and Advocacy 01:02:55 - 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

  • January 20 · 48 min

    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 Diagnosis 08:41 - Role of ENT in EoE Diagnosis 11:32 - Diagnostic Criteria for EoE 16:34 - Treatment Options for EoE 20:55 - Role of Allergists and Environmental Allergies 23:24 - Pharmacological Management of EoE 29:38 - Complications and Risks of EoE 36:21 - Follow-Up Endoscopies and Surveillance 40:34 - Future Directions in EoE Management 45:21 - Conclusion and Final Thoughts --- RESOURCES Dr. John Leung https://www.bostonspecialists.org/dr-leung-full-profile

  • Sep 30, 2025 · 1 hr 6 min

    Ep. 241 Chronic Rhinitis: Emerging Approaches & Treatments with Dr. Dennis Tang

    So many patients deal with a runny, stuffy nose every day, and sprays only go so far. Let’s talk about what’s new for chronic rhinitis. In this episode of the BackTable ENT podcast, Dr. Dennis Tang, a Rhinologist at Cedars-Sinai Medical Center discusses chronic rhinitis and the latest treatment advancements with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- This podcast is supported by: Aerin Medical https://aerinmedical.com/ --- SYNPOSIS Dr. Tang discusses the benefits of posterior nasal nerve (PNN) ablation and the recent approval of the procedure by Cigna Insurance, which expands accessibility for patients. The conversation covers the typical presentation of chronic rhinitis, the procedural details, patient selection, preoperative and postoperative care, and billing considerations. Dr. Tang also touches on the anatomy involved and the technological innovations that are enabling contemporary rhinitis treatment. --- TIMESTAMPS 00:00 - Introduction 03:01 - Insurance Coverage for Posterior Nasal Nerve Ablation 04:23 - Patient Presentation, Diagnostic & Treatment Approaches 11:07 - Posterior Nasal Nerve (PNN) Ablation Explained 17:57 - Physical Examination and In-Office Procedure 20:47 - Allergy Patients and Immunotherapy 22:21 - Chronic Rhinosinusitis vs. Chronic Rhinitis 32:33 - Radiofrequency Ablation Technology 39:49 - Procedure Techniques and Anatomical Considerations 46:42 - In-Office Procedure Logistics 01:06:10 - Final Thoughts --- RESOURCES Dr. Dennis Tang https://www.cedars-sinai.org/provider/dennis-tang-3316614.html

  • Apr 29, 2025 · 59 min

    Ep. 220 Managing Nasal Polyps: Treatments and Insights with Dr. Martin Citardi

    Is the future of nasal polyp treatment right under our nose? In this episode of Backtable ENT, Dr. Martin Citardi, a world-renowned rhinologist and skull-based surgeon at UTHealth Houston, discusses the latest advancements in the management of nasal polyps with hosts Dr. Gopi Shah and Dr. Ashley Agan.

  • Oct 8, 2024 · 56 min

    Ep. 194 Tinnitus and Migraine: Expert Insight with Dr. Hamid Djalilian

    Tinnitus remains one of otology’s greatest, most challenging, and unsolved clinical problems. In this episode of the BackTable ENT Podcast, Dr. Hamid Djalilian, chair of otolaryngology at University of California Irvine (UCI), joins guest host and fellow otologist Dr. Walter Kutz (UT Southwestern) to discuss contemporary tinnitus therapy.

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