Episodios

  • Ep. 229 Sialendoscopy: Office-Based Techniques and Best Practices with Dr. Wais Rahmati
    Jul 1 2025
    The sour candy myth: why it’s not always the right Rx for salivary gland obstruction. In this episode, Dr. Wais Rahmati, a board-certified otolaryngologist at Mass Eye and Ear and Harvard Medical School, discusses the development of a comprehensive salivary gland center and the focus on office-based sialendoscopy with host Dr. Ashley Agan. --- SYNPOSIS The doctors explore the benefits of incorporating salivary endoscopy in the office setting, including minimally invasive and gland-sparing approaches to treat obstructive salivary gland diseases. Dr. Rahmati shares the criteria for patient selection, techniques in the procedure, and post-operative care. They also touch upon the challenges and strategies for reimbursement and the significance of tracking codes to eventually establish dedicated CPT codes for sialendoscopy. --- RESOURCES Wais Rahmati MD:https://doctors.masseyeandear.org/details/447/rahmatullah-wais_rahmati-rahmati-otolaryngology-head_and_neck_surgery-boston
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    1 h
  • Ep. 228 Sinus Headaches vs. Migraines: Diagnosis and Treatment with Dr. Jessica Lee
    Jun 24 2025
    Sinusitis or migraine? Understanding the difference between rhinogenic and primary headaches could change your treatment algorithm. In this episode of Backtable ENT, Dr. Jessica Lee, an otolaryngologist from Charleston ENT and Allergy, discusses the prevalence and treatment of sinus headaches with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS The doctors discuss how half of sinus infection diagnoses are often misdiagnosed, with many patients having normal CT scans and nasal endoscopies. Dr. Lee emphasizes the importance of distinguishing between sinus-related headaches and migraines, noting that 80% of sinus headache complaints meet migraine criteria. The conversation covers the use of lifestyle medicine, supplements, medications, and the role of neurologists in managing chronic headaches. Dr. Lee also touches on the role of mycotoxins, drawing from evidence-based practices while stressing patient education and collaboration in treatment. --- TIMESTAMPS 00:00 - Introduction 04:10 - Differentiating Sinus Headaches from Other Conditions10:07 - Lifestyle Factors and Migraine Management25:45 - Supplements and Treatments for Migraine30:01 - Iron Supplementation and Dietary Adjustments31:42 - Medication Management for Migraines34:52 - Botox as a Treatment Option44:50 - Mycotoxins and Mold Illness50:11 - Non-Pharmacologic Options for Headaches54:00 - Final Thoughts and Recommendations --- RESOURCES Dr. Jessica Leehttps://charlestonent.com/bio/jessica-lee/
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    1 h
  • Ep. 227 Healthcare Leadership Strategies for Otolaryngologists with Dr. Carol Bradford
    Jun 17 2025
    Leadership isn’t just about saying yes—it’s about knowing when to say no too. In this episode of Backtable ENT, Dr. Carol Bradford, Dean of the Ohio State University College of Medicine and Vice President for Health Sciences at the Ohio State University Wexner Medical Center, shares her leadership journey with hosts Dr. Gopi Shah and Dr. Sunil Verma. --- SYNPOSIS Dr. Bradford shares insights into her journey in otolaryngology, emphasizing the importance of feedback, emotional intelligence, and leadership development. She discusses her experiences in various leadership roles, the significance of maintaining clinical practice, and strategies for fostering future leaders. The conversation touches on the challenges and rewards of leadership in academic medicine, the impact of change, and the enduring mission to improve patient care and education. --- TIMESTAMPS 00:00 - Introduction 04:32 - Role and Responsibilities of a Dean & Balancing Clinical Practice 10:25 - Leadership Development & Mentorship21:41 - Building and Leading Effective Teams28:23 - Challenges in Leadership Roles30:40 - Balancing Academic and Clinical Missions33:41 - Leadership Style and Meeting Management39:07 - Emotional Intelligence in Medicine47:12 - Navigating Change and Future Goals51:45 - Final Advice for Aspiring Leaders --- RESOURCES Dr. Carol Bradford:https://wexnermedical.osu.edu/about-us/our-people/carol-bradford Dr. Sunil Verma:https://www.ucihealth.org/clinicians/sunil-verma-1124279344
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    57 m
  • Ep. 226 Managing Allergy Symptoms Amid Environmental Changes with Dr. Jennifer Villwock and Dr. William Reisacher
    Jun 10 2025
    Are your allergies getting worse, or is it the environment? In this episode of Backtable ENT, Dr. Jennifer Villwock, a rhinologist at the University of Kansas, and Dr. William Reisacher, an otolaryngologist at New York Presbyterian Hospital, join the podcast to discuss the impact of environmental extremes on the unified airway with hosts Dr. Ashley Agan and Dr. Gopi Shah. --- SYNPOSIS Topics include the increasing prevalence of allergies and asthma due to climate change, the effects of environmental pollutants and particulates on respiratory health, and the role of healthcare providers in educating and advocating for patients. The conversation also addresses practical strategies for managing symptoms, the importance of urban planning and sustainable practices, and the hope that collective individual efforts can lead to meaningful change. --- TIMESTAMPS 00:00 - Introduction 01:43 - Understanding the Unified Airway03:09 - Patient Concerns and Environmental Factors10:24 - Impact of Temperature and CO2 on Allergies14:57 - Barometric Pressure and Migraines21:03 - Pollution, Particulate Matter, and Solutions24:49 - Urban Planning29:32 - Epigenetics and Environmental Impact34:15 - Indoor Air Quality and Mold Issues41:01 - Advocacy and Environmental Health45:46 - Final Thoughts and Hope for the Future --- RESOURCES Dr. Jennifer Villwockhttps://www.kumc.edu/jvillwock.html Dr. William Reisacher https://weillcornell.org/wreisacher
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    51 m
  • Ep. 225 Sinusitis and Cognitive Impairment: Exploring the Inflammatory Pathway with Dr. Aria Jafari
    Jun 3 2025
    Chronic sinusitis might be doing more than just clogging your nose–it could be clouding your brain. In this episode of Backtable ENT, Dr. Aria Jafari, an assistant professor at the University of Washington and co-director of the Neuroendocrinology Advanced Sinus and Skull-base Surgery Fellowship, discusses the connection between sinusitis and cognitive dysfunction with hosts Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS Dr. Jafari shares how his interest in this field developed and details his research on the relationship between chronic rhinosinusitis (CRS) and brain function. The conversation highlights the comprehensive impact of sinus inflammation on overall health, emphasizing the importance of viewing CRS as a whole-body condition. They also discuss patient experiences, the methodologies used to assess cognitive dysfunction, potential treatments, and what’s next in the research frontier.---TIMESTAMPS00:00 - Introduction 06:18 - The Impact of CRS on Quality of Life14:02 - Understanding Brain Fog and Cognitive Dysfunction24:29 - Pathophysiology and Theories of Cognitive Dysfunction27:44 - Chronic Inflammation and Cognitive Effects28:59 - Impact of Biologics on Cognitive Function31:28 - Risk Factors for Cognitive Dysfunction35:02 - Olfactory Symptoms 37:13 - Future Research and Treatment Approaches45:31 - Conclusion and Final Thoughts --- RESOURCES Dr. Aria Jafari https://www.uwmedicine.org/bios/aria-jafari
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    51 m
  • Ep. 224 Safety & Preparedness in Office Based Procedures with Dr. Scott Fortune
    May 27 2025
    The best doctors aren’t lucky—they’re prepared. Discover how to keep your office safe during in-office procedures. In this episode of BackTable ENT, Dr. Scott Fortune, an otolaryngologist from Allergy and ENT Associates of Middle Tennessee, discusses office-based procedural safety with Dr. Gopi Shah and Dr. Ashley Agan. --- SYNPOSIS The doctors delve into the importance of preparedness in handling potential complications, emphasizing the necessity of having the right equipment and protocols in place. Dr. Fortune provides detailed guidelines on managing anesthesia, preventing and handling bleeding, and addressing possible complications such as vasovagal reactions and anaphylaxis. The conversation covers practical tips, including the use of local anesthetics, sedatives, and the importance of patient history and clearance forms. This comprehensive discussion is a valuable resource for ENT professionals looking to enhance the safety and efficacy of their office-based procedures. --- TIMESTAMPS 00:00 - Introduction 01:34 - Discussing Safety in Office Procedures07:47 - Safety Protocols and Equipment19:11 - Anesthesia and Sedation Protocols27:29 - Handling Emergencies and Reversal Agents30:00 - Local Anesthesia and Toxicity38:29 - Effective Anesthesia Techniques for Office Procedures41:25 - Bleeding Control in Office Procedures53:36 - Handling Office Procedure Complications01:00:19 - Final Thoughts and Contact Information --- RESOURCES Dr. Scott Fortune https://www.enthealth.org/find-ent/d-scott-fortune/ Patient Selection, Safety, and Preparedness for Office-Based Otolaryngology Procedureshttps://www.oto.theclinics.com/article/S0030-6665(25)00020-9/abstract AAOA anaphylaxis guidelineshttps://www.aaoallergy.org/wp-content/uploads/2017/05/2015-Clinical-Care-Statements-Anaphylaxis.pdf
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    1 h y 4 m
  • Ep. 223 Evaluation and Management of Bilateral Vocal Fold Paralysis with Dr. James Daniero
    May 20 2025
    Never let the sun set on bilateral vocal fold paralysis–timely diagnosis and intervention are key. In this episode of Backtable ENT, Dr. James Daniero, a laryngologist from the University of Virginia, discusses the evaluation and management of bilateral vocal fold paralysis with Dr. Gopi Shah and guest host Dr. Stephen Schoeff.---SYNPOSISThe trio delves into the complexities of diagnosing and managing bilateral vocal fold paralysis in adults, examining etiologies, diagnostic procedures, and current treatment options. They specifically highlight the differences between bilateral vocal fold immobility and paralysis, discuss innovative techniques such as bilateral selective reinnervation and laryngeal pacing, and share practical tips for securing the airway in an acute setting. The episode also emphasizes the evolving nature of treatments and the importance of timely intervention.---TIMESTAMPS00:00 - Introduction 02:05 - Understanding and Diagnosing Bilateral Vocal Fold Paralysis09:19 - Management and Treatment Options25:40 - Tracheotomy Techniques and Considerations31:31 - Exploring Surgical Options for Patients34:22 - Addressing Dysphagia in Airway Surgeries35:50 - Innovative Techniques in Laryngeal Reinnervation39:34 - Patient Selection for Advanced Surgeries47:11 - Laryngeal Pacing: A Future Option54:50 - Final Thoughts and Recommendations---RESOURCESDr. James Daniero https://uvahealth.com/findadoctor/James-Daniero-1386817484Dr. Stephen Schoeff https://www.enthealth.org/find-ent/stephen-s-schoeff/
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    59 m
  • Ep. 222 Survivorship in Head and Neck Cancer with Dr. Michael Moore and Heather Starmer, PhD, CCC-SLP
    May 13 2025
    What does it take to improve quality of life after head and neck cancer? In this episode of Backtable ENT, guests Dr. Heather Starmer, a speech and language pathologist at Stanford University, and Dr. Michael Moore, a head and neck cancer surgeon at Indiana University explore the topic of head and neck cancer survivorship.---SYNPOSISThe discussion centers on the multifaceted challenges faced by survivors, including dysphagia, dry mouth, chronic pain, and mental health issues. The experts emphasize the importance of early intervention, community support, and comprehensive care to enhance the quality of life for survivors. Various resources, such as the Head and Neck Cancer Alliance, are highlighted to assist patients and providers in navigating survivorship. The conversation also outlines future directions in research and the need for more qualitative studies to better understand long-term survivorship outcomes.---TIMESTAMPS00:00 - Introduction03:23 - Understanding Survivorship & Challenges in Head and Neck Cancer14:06 - Managing Mobility and Lymphedema18:47 - Addressing Chronic Pain and Mental Health21:37 - Dental Care and Trismus Therapy25:58 - Long-Term Survivorship and Quality of Life31:36 - Survivorship Clinics and Multidisciplinary Care34:39 - Resources for Patients and Providers38:49 - Future Research and Educational Gaps---RESOURCESDr. Heather Starmerhttps://med.stanford.edu/profiles/heather-starmerDr. Michael Moorehttps://iuhealth.org/find-providers/provider/michael-g-moore-md-64028
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    47 m