BackTable ENT

Ep. 251 Clinical Evaluation and Treatment of Tongue Tie in Pediatric OSA with Dr. Brennan Dodson and Allegra Bereszniewicz M.S., CCC-SLP, QOM

Does tongue tie impact pediatric sleep disordered breathing? In this episode of the Back Table ENT Podcast, otolaryngologist Dr. Brennan Dodson and speech language pathologist Allegra Bereszniewicz discuss tongue-tie and the pediatric airway with hosts Dr Ashley Agan and Dr. Gopi Shah. --- SYNPOSIS The discussion covers the anatomy and pathophysiology of tongue tie, surgical techniques for its release, and the importance of pre- and post-operative myofunctional therapy. They delve into patient selection, the impact of tongue tie on sleep-disordered breathing, and contrasting surgical methodologies, including frenuloplasty. The episode also features an insightful case study with visuals, examining Dr. Dodson's surgical approach in detail. Additionally, they touch on insurance considerations and the challenges within current medical practice regarding tongue tie diagnosis and treatment. Check out detailed surgical techniques at the end with case presentations! --- TIMESTAMPS 00:00 - Introduction 01:29 - Understanding Tongue Tie and Pediatric Airway 06:17 - The Role of Myofunctional Therapy 10:37 - Scientific Evidence and Research on Tongue Tie 15:52 - Clinical Approaches and Patient Evaluations 35:00 - Pre-Op and Post-Op Procedures 39:02 - Post-Surgery Recovery and Exercises 40:32 - Surgical Techniques and Tools 44:31 - Post-Operative Care and Pain Management 48:59 - Patient Selection and Considerations 01:02:41 - Sleep Studies and Outcome Measures 01:12:30 - Incision Techniques and Dissection Tools 01:17:24 - Closure and Post-Operative Care 01:23:51 - Innovations and Techniques in Surgery 01:28:09 - Final Thoughts --- RESOURCES Dr. Brennan Dodson https://www.bridgerent.com/ Allegra Bereszniewicz MS, CCC-SLP https://grospeech.com/about/

Ep. 250 Preauricular Pits: Workup & Surgical Management with Dr. Eric Berg and Dr. Eric Gantwerker

From asymptomatic dimples to chronic infections—here’s how experts navigate the spectrum of preauricular pits. In this episode of the Back Table ENT podcast, pediatric otolaryngologists Dr. Eric Gantwerker and Dr. Eric Berg discuss the surgical management of Preauricular Pits with host Dr. Gopi Shah. --- SYNPOSIS The conversation covers the etiology of preauricular pits, their presentations, decision-making for excision, surgical techniques, post-operative management, recurrence, and valuable tips in preauricular pit management. The doctors also touch upon collaboration with facial plastics and the importance of communication with families. --- TIMESTAMPS 00:00 - Introduction 03:11 - Common Presentations & Management of Preauricular Pits 06:17 - Differential Diagnoses and Imaging 13:56 - Surgical Considerations and Techniques 18:51 - Managing Recurrent Infections 19:07 - Skin Flap Techniques 19:55 - Excising Chronic Wounds 23:07 - Post-Op Management 24:46 - Revision Surgery Insights 29:08 - Final Tips and Pearls --- RESOURCES Dr. Eric Gantwerker https://www.northwell.edu/find-care/find-a-doctor/dr-eric-alan-gantwerker-md-ms-1144482662 Dr. Eric Berg https://www.wellstar.org/physicians/eric-berg-md

Ep. 249 Maximizing Your ENT Away Rotation: Tips for Success with Dr. Viraj Shah

Are you a med student with an upcoming away rotation? Get a head start with this episode of the BackTable ENT Podcast. Dr. Viraj Shah, a PGY-4 ENT resident at UT Southwestern and guest host Dr. Quynh-Chi Dang, PGY-1 at UC Davis Medical Center, discuss how to succeed on away rotations. --- SYNPOSIS They cover the basics of away rotations, factors to consider when applying, and effective strategies for excelling both in the operating room and within the residency team. Additionally, they delve into the importance of networking, securing recommendation letters, and making a positive impression through situational awareness and preparation. Personal anecdotes and practical tips make this a valuable listen for medical students gearing up for their rotations. --- TIMESTAMPS 00:00 Introduction 02:33 Diving into Away Rotations 05:20 Factors to Consider for Away Rotations 22:54 Handling Away Rotation Offers 28:33 Succeeding in the OR 34:30 Navigating OR Dynamics 40:49 Securing Recommendation Letters 46:11 Onsite Interviews: Preparation and Presentation 50:48 Housing for Away Rotations 56:03 Final Tips: Observing Team Dynamics and Being Proactive --- RESOURCES Chi Dang https://health.ucdavis.edu/otolaryngology/our-team/residents.html Viraj Shah https://www.utsouthwestern.edu/departments/otolaryngology/education-training/residency-program/residents/

Ep. 248 Understanding Inducible Laryngeal Obstruction: Diagnosis & Management with Dr. Steven Sims

From misdiagnosed asthma to anxiety-related breathing issues, inducible laryngeal obstruction is often hiding in plain sight. In this episode of the BackTable ENT Podcast, Dr. Steven Sims from Rush University Medical Center discusses contemporary care for inducible laryngeal obstruction (ILO) with guest host Dr. Stephen Schoeff. --- SYNPOSIS The discussion elaborates on the evolution of the nomenclature surrounding vocal cord dysfunction and the clinical challenges in diagnosing and managing ILO. Dr. Sims shares his approach to patient evaluation, various presentations, and targeted treatment strategies, including the use of neuromodulators, speech pathology, and nerve blocks. He also delves into trauma-informed care, particularly focusing on patients with adverse childhood events and their impact on laryngeal function. The episode highlights the importance of an interdisciplinary approach, especially the role of speech pathologists in treating this complex condition. --- TIMESTAMPS 00:00 - Introduction 01:39 - Understanding Inducible Laryngeal Obstruction 04:53 - Patient Presentation and Evaluation 07:51 - Management Strategies and Patient Care 09:06 - Trauma and Mental Health Considerations 19:27 - Interdisciplinary Approach and Additional Testing 23:52 - Understanding Subglottic Stenosis and Asthma 27:08 - The Role of Botox in Treatment 31:49 - Biofeedback and Patient Empowerment 34:25 - Exercise-Induced Laryngeal Obstruction 39:05 - Advanced Treatment Approaches and Challenges 41:06 - Conclusion and Final Thoughts --- RESOURCES Dr. Stephen Schoeff https://www.enthealth.org/find-ent/stephen-s-schoeff/ Dr. H, Steven Sims https://doctors.rush.edu/details/22035

Ep. 247 Keynote 689: Implementation & Multidisciplinary Care for Immunotherapy in Head & Neck Cancer with Dr. Adam Luginbuhl, Dr. Jennifer Johnson, Dr. Mihir Patel and Dr. Siddharth Sheth

When treating head and neck cancer, how can you tell the difference between true disease progression and pseudoprogression? In this episode of the BackTable Podcast, we discuss the practical implementation of the KEYNOTE-689 trial published in the New England Journal of Medicine, which demonstrated the benefit of adding neoadjuvant and adjuvant immunotherapy to standard head and neck cancer care. Our tumor board panel includes Dr. Mihir Patel, a head and neck surgeon from UNC Chapel Hill, Dr. Siddharth Sheth, a head and neck medical oncologist from UNC, Dr. Jennifer Johnson, a professor of medical oncology and otolaryngology at Sidney Kimmel Comprehensive Cancer Center, and Dr. Adam Luginbuhl, a head and neck surgical oncologist at Thomas Jefferson University. --- SYNPOSIS The doctors address the trial's practical implications, patient selection, case management, dealing with tumor progression, and the integration of multidisciplinary care. They also emphasize the importance of communication, real-world application of trial protocols, and the potential benefits and challenges of such therapies. --- TIMESTAMPS 00:00 - Introduction 03:18 - Discussing the New Indication for Immunotherapy 11:42 - Challenges and Practical Implementation 22:48 - Managing Tumor Progression: A Case Study 28:07 - Exploring Treatment Options: Surgery vs. Chemotherapy 36:46 - Operational Challenges and Future Directions 43:58 - Concluding Thoughts and Future Directions --- RESOURCES Keynote 689 https://www.nejm.org/doi/full/10.1056/NEJMoa2415434