Ep. 233 CSF Leaks Part II: Techniques in Endoscopic Repair with Dr. Satyan Sreenath and Dr. Sanjeet Rangarajan
A 47 year old male presents with intermittent, unilateral nasal drainage and headache. What do you do? In this episode of the BackTable Podcast, Dr. Satyan Sreenath, a rhinologist at Indiana University, and Dr. Sanjeet Rangarajan, a rhinologist at Case Reserve University, examine complex cases involving CSF leaks and encephaloceles.
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SYNPOSIS
The doctors discuss diagnostic approaches, imaging techniques, and innovative surgical methods, using endoscopic and minimally invasive strategies. The conversation highlights the difficulties of diagnosing and surgically repairing these leaks, focusing on their personal experiences and preferred techniques. Through detailed case studies with imaging and surgical videos, they explore the importance of meticulous planning, interdisciplinary collaboration, and adaptive strategies to manage these challenging conditions effectively. A must watch on Youtube!
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TIMESTAMPS
00:00 - Introduction02:17 - Patient Case 1: “Headache and Drippy Nose..”02:58 - Diagnostic Imaging and Findings07:55 - Surgical Approach and Postoperative Care16:52 - Patient Case 2: “Drippy nose and nasal congestion… just allergies right?”17:32 - Diagnostic Imaging and Findings20:21 - Surgical Approach and Postoperative Care29:03 - Patient Case 3: “Runny nose after my MVC 3 years ago…”29:21 - Imaging and Surgical Approach Discussion31:46 - Post-Operative Challenges and Patient Follow-Up42:46 - Patient Case 4: “Continuous nasal drainage BOTH sides”43:31 - Imaging and Findings 44:43 - Surgical Approach for Bilateral Defects56:39 - Final Thoughts
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RESOURCES
Dr. Satyan Sreenath profile:https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999
Dr. Sanjeet Rangarajan’s profile:https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-164956839
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Ep. 232 CSF Leak Evaluation Part I: Presentation & Management with Dr. Satyan Sreenath and Dr. Sanjeet Rangarajan
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.
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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.
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TIMESTAMPS
00:00 - Introduction 02:48 - Patient Presentation and Initial Evaluation04:45 - Common Symptoms and Diagnostic Challenges06:02 - Risk Factors and Etiologies of CSF Leaks10:59 - Management and Treatment Approaches16:55 - Physical Examination and Diagnostic Techniques22:35 - Patient Instructions for Sample Collection24:29 - Differentiating CSF Leaks from Other Conditions26:12 - Endoscopic Examination Techniques30:21 - Imaging and Diagnostic Approaches33:14 - Surgical Planning and Considerations45:23 - Concluding Thoughts
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RESOURCES
Satyan Sreenath https://iuhealth.org/find-providers/provider/satyan-b-sreenath-md-1821999
Sanjeet Rangarajan https://www.uhhospitals.org/doctors/Rangarajan-Sanjeet-1649568395
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Ep. 231 Improving Surgical Outcomes Through Self-Awareness with Dr. Melinda Thacker
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.
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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.
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TIMESTAMPS
00:00 - Introduction03:04 - Discovering Coaching10:52 - Residency Reflections23:06 - Improving Patient Relationships29:48 - Coaching Surgeons and Addressing Emotional Growth37:49 - Serving vs. Fixing: A New Perspective on Patient Care44:09 - Daily Practices for Empathy and Self-Awareness44:40 - Three Essentials for Success in Medicine46:31 - Conclusion and Final Thoughts
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Ep. 230 Setting Up an Overseas ENT Career with Dr. Ananya Majumder
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.
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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.
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TIMESTAMPS
00:00 Introduction 01:40 Journey to New Zealand & Navigating Medical Licensing08:26 Understanding the Healthcare System15:24 Residency and Training Differences21:37 Visa Process and Moving28:49 Daily Practice in New Zealand29:44 Clinic Workflow Differences & Operating Room Culture37:14 Patient Relationships and Challenges42:42 Professional and Personal Growth48:02 Final Thoughts and Advice
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RESOURCES
Dr. Ananya Majumder https://www.enthealth.org/find-ent/ananya-majumder/
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Ep. 229 Sialendoscopy: Office-Based Techniques and Best Practices with Dr. Wais Rahmati
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.
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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.
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TIMESTAMPS
00:00 - Introduction02:40 - History and Evolution of Office-Based Endoscopy05:32 - Understanding Obstructive Salivary Gland Disease09:36 - Patient Selection and Office-Based Procedures14:45 -Imaging and Diagnostic Approaches20:50 - Office Setup and Procedure Details30:38 - Injecting Mucosa for Better Access31:10 - Using Sour Candy to Stimulate Saliva32:29 - Dilation and Anesthesia Techniques37:05 - Handling Stones and Stents40:44 - Treating Stenosis in the Office47:16 - Post-Procedure Care and Instructions49:42 - Billing and Reimbursement Challenges54:43 - Future of Salivary Gland Endoscopy
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RESOURCES
Wais Rahmati MD:https://doctors.masseyeandear.org/details/447/rahmatullah-wais_rahmati-rahmati-otolaryngology-head_and_neck_surgery-boston
The BackTable ENT Podcast is a resource for otolaryngologists to learn tips, techniques, and practical advice on all things ear, nose, and throat. Tune in to the BackTable ENT Podcast every week for candid conversations about rhinology, laryngology, otology, and head and neck surgery.
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