BackTable ENT

A patient walks in with a persistent runny nose. Is it allergies, or something more dangerous? In this episode of the BackTable ENT Podcast, two renowned rhinologists, Dr. Satyan Sreenath and Dr. Sanjeet Rangarajan, delve into the evaluation and management of cerebrospinal fluid (CSF) leaks at the anterior skull base with host Dr. Gopi Shah. --- SYNPOSIS The discussion encompasses patient presentations, differential diagnosis, physical examination, and imaging techniques for localization. They also explore the impact of underlying conditions such as idiopathic intracranial hypertension (IIH) and obstructive sleep apnea (OSA) on CSF leaks. Dr. Sreenath and Dr. Rangarjan offer insight into diagnostic strategies, patient management, and surgical planning, providing a comprehensive overview of best practices in managing this complex condition. --- TIMESTAMPS 00:00 - Introduction 02:48 - Patient Presentation and Initial Evaluation 04:45 - Common Symptoms and Diagnostic Challenges 06:02 - Risk Factors and Etiologies of CSF Leaks 10:59 - Management and Treatment Approaches 16:55 - Physical Examination and Diagnostic Techniques 22:35 - Patient Instructions for Sample Collection 24:29 - Differentiating CSF Leaks from Other Conditions 26:12 - Endoscopic Examination Techniques 30:21 - Imaging and Diagnostic Approaches 33:14 - Surgical Planning and Considerations 45:23 - Concluding Thoughts --- RESOURCES Satyan Sreenath https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999 Sanjeet Rangarajan https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-1649568395

Let’s talk about what it really means to show up for your patients—and yourself—as a surgeon. In this episode of Backtable ENT, Dr. Mel Thacker, an otolaryngologist and founder of The Empowered Surgeon and the Surgeons with a Purpose Podcast, joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss humanity in surgery, and how to stay grounded in a profession that demands so much of us. --- SYNPOSIS Dr. Thacker shares her journey from experiencing anxiety and panic attacks in the operating room to becoming a coach who helps surgeons discover their purpose and practice medicine with greater humanity. They discuss the significance of self-awareness, the importance of protecting oneself as a valuable asset, and how to serve patients with compassion and empathy. Practical advice is offered on shifting mindset, engaging in meaningful connections with patients, and fostering a collaborative, rather than hierarchical, approach in medical practice. --- TIMESTAMPS 00:00 - Introduction 03:04 - Discovering Coaching 10:52 - Residency Reflections 23:06 - Improving Patient Relationships 29:48 - Coaching Surgeons and Addressing Emotional Growth 37:49 - Serving vs. Fixing: A New Perspective on Patient Care 44:09 - Daily Practices for Empathy and Self-Awareness 44:40 - Three Essentials for Success in Medicine 46:31 - Conclusion and Final Thoughts

How hard is it to move your medical practice across the globe? In this episode of BackTable ENT, otolaryngologist Dr. Ananya Majumder discusses her transition from practicing in Fort Worth, Texas to becoming a consultant otolaryngologist at North Shore Hospital in Auckland, New Zealand with host Dr. Gopi Shah. --- SYNPOSIS They explore Dr. Majumder’s career journey, the factors that led her to move abroad, the process of obtaining medical licensing and a visa in New Zealand, and the differences in medical practice and work culture between the U.S. and New Zealand. Dr. Majumder also shares insights into her daily routine, the challenges she faced during the transition, and the benefits of international experience in the medical field. --- TIMESTAMPS 00:00 Introduction 01:40 Journey to New Zealand & Navigating Medical Licensing 08:26 Understanding the Healthcare System 15:24 Residency and Training Differences 21:37 Visa Process and Moving 28:49 Daily Practice in New Zealand 29:44 Clinic Workflow Differences & Operating Room Culture 37:14 Patient Relationships and Challenges 42:42 Professional and Personal Growth 48:02 Final Thoughts and Advice --- RESOURCES Dr. Ananya Majumder https://www.enthealth.org/find-ent/ananya-majumder/

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. --- TIMESTAMPS 00:00 - Introduction 02:40 - History and Evolution of Office-Based Endoscopy 05:32 - Understanding Obstructive Salivary Gland Disease 09:36 - Patient Selection and Office-Based Procedures 14:45 -Imaging and Diagnostic Approaches 20:50 - Office Setup and Procedure Details 30:38 - Injecting Mucosa for Better Access 31:10 - Using Sour Candy to Stimulate Saliva 32:29 - Dilation and Anesthesia Techniques 37:05 - Handling Stones and Stents 40:44 - Treating Stenosis in the Office 47:16 - Post-Procedure Care and Instructions 49:42 - Billing and Reimbursement Challenges 54:43 - Future of Salivary Gland Endoscopy --- RESOURCES Wais Rahmati MD: https://doctors.masseyeandear.org/details/447/rahmatullah-wais_rahmati-rahmati-otolaryngology-head_and_neck_surgery-boston

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 Conditions 10:07 - Lifestyle Factors and Migraine Management 25:45 - Supplements and Treatments for Migraine 30:01 - Iron Supplementation and Dietary Adjustments 31:42 - Medication Management for Migraines 34:52 - Botox as a Treatment Option 44:50 - Mycotoxins and Mold Illness 50:11 - Non-Pharmacologic Options for Headaches 54:00 - Final Thoughts and Recommendations --- RESOURCES Dr. Jessica Lee https://charlestonent.com/bio/jessica-lee/