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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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  • 22 episodes
  • weekly
  • Avg 55 min
  • English

Episodes 22

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  • 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

Showing 21–22 of 22 episodes