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Dr. Ashley Agan on the BackTable ENT Podcast

Dr. Ashley Agan

Otolaryngologist

Dr. Ashley Agan is a practicing ENT and assistant professor at UT Southwestern Medical Center in Dallas, TX.

Listen to Dr. Ashley Agan on the BackTable ENT Podcast

The BackTable Podcast is a knowledge resource by physicians for physicians. Learn from the experiences and expertise of Dr. Ashley Agan and get practical advice on how to build your practice by listening to the BackTable ENT Podcast.

Ep 160 What I Wish I Knew My 1st Year Out in Practice with Dr. Christopher Gentile
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About Dr. Ashley Agan

Dr. Ashley Agan is a practicing Otolaryngologist and Assistant Professor at UT Southwestern. She performs surgeries of the head and neck including endoscopic sinus surgery, thyroidectomy, salivary gland surgery, and more. With BackTable, Dr. Agan is the co-host of our brand new ENT series, sharing the mic with thought leaders in the field.

Podcasts Featuring Dr. Ashley Agan

Episode #159

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In this episode, host Dr. Ashley Agan discusses eustachian tube (ET) dilation with Dr. Dennis Poe, neurotologist and Professor of Otolaryngology at Harvard Medical School.

First, the surgeons describe clinically meaningful differences between adult and pediatric ETs. Then, Dr. Poe reviews workup of pediatric ET disorders. Since inflammation accounts for most ET dysfunction, controlling comorbid allergies and/or performing adenoidectomy provides relief to some patients. For patients with continued symptoms, balloon dilation – now approved for children as young as eight years of age– directly counteracts obstructive inflammation in the tube lumen. To conclude, Dr. Poe describes how to select patients for, perform, and avoid complications of balloon dilation.

Episode #158

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In this episode, Dr. Nora Perkins (Albany ENT & Allergy Services), discusses in-office procedural management of nasal airway obstruction with hosts Dr. Ashley Agan and Dr. Gopi Shah.

First, the surgeons discuss the advantages of in-office procedures. Then, Dr. Perkins describes different presentations of nasal airway obstruction and their medical management. Diving deeper, Dr. Perkins shares her procedural workflow, including anesthetic protocols, her VivAer Aerin device technique, and billing considerations. Finally, the episode concludes with Dr. Perkins’ advice to otolaryngologists interested in performing more in-office procedures.

Episode #156

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In this episode, Dr. Spencer Payne, a rhinologist at the University of Virginia School of Medicine, shares his journey developing RefluxRaft, a natural, alginate-based reflux therapy, with host Dr. Ashley Agan.

First, Dr. Payne describes how his research interests and father’s premature death spurred his interest in functional medicine. Wary of side effects associated with conventional reflux medications, he teamed up with fellow UVA faculty member and laryngologist Dr. James (Jim) Daniero to develop RefluxRaft, a natural dietary supplement. Starting from his initial concept, Dr. Payne delves into challenges marketing, manufacturing, and distributing RefluxRaft. He then explains how RefluxRaft uses alginates to combine with stomach acid and form a gel-like “raft” that stops movement of acid into the esophagus. The episode concludes with an overview of how to dose and order RefluxRaft.

Episode #155

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In this episode, Dr. Gerard Gianoli of The Ear & Balance Institute (Covington, Louisiana), joins host Dr. Ashley Agan to discuss his experience with the third-party-free practice model.

First, Dr. Gianoli describes how his work treating vestibular disorders spurred his interest in the third-party-free practice model, where patients pay upfront for services, then submit insurance claims for reimbursement as appropriate. Dr. Gianoli walks listeners through his practice’s transition, focusing on referral patterns and patient concerns. Then, the surgeons speak to the model’s advantages, including reduced rates of physician burnout, higher-value patient care, and reduced administrative burden. Looking ahead, Dr. Gianoli assesses the role of third-party-free practices in the U.S. healthcare landscape. Finally, the episode wraps with a discussion of Dr. Gianoli’s recent book on Third Mobile Window Syndrome.

Episode #154

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In this episode, Dr. Sujana Chandrashekar, neurotologist with New York City’s ENT and Allergy Associates, joins host Dr. Ashley Agan to discuss labyrinthitis.

The podcast begins by reviewing the clinical presentation of labyrinthitis, drawing on Dr. Agan’s personal experience with the condition. Then, Dr. Chandrashekar explains in-depth the physical exam of the dizzy patient, focusing on differentiating central vestibular lesions (such as strokes) from peripheral ones (such as labyrinthitis). While labyrinthitis is a self-limited condition, Dr. Chandrashekar shares strategies to mitigate the associated nausea, imbalance, and hearing loss patients find debilitating. Finally, the surgeons discuss how vestibular physical therapy and adequate rest enable prompt recovery.

Episode #151

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In this episode, host Dr. Ashley Agan discusses management of synkinesis with Dr. Shiayin (Shi) Yang, facial plastic surgeon at Vanderbilt University Medical Center.

The surgeons begin by defining synkinesis, a condition in which voluntary facial muscle movement triggers involuntary contraction of other facial muscles. Though the pathophysiology of synkinesis remains incompletely understood, damage to and aberrant “rewiring” of the facial nerve is thought to trigger these symptoms. Causes of synkinesis include Bell’s Palsy, facial tumors, and intra-operative injury. Dr. Yang explains the importance of appropriate patient counseling, especially given the misperception that synkinesis is a “disease of vanity.” The discussion then transitions to treatment options, including physical therapy, Botox injections, and surgical intervention (including myectomy and selective neurectomy). The podcast finishes with Dr. Yang’s insights into the mental health impact of synkinesis.

Episode #147

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In this episode, Dr. Gopi Shah and Dr. Ashley Agan invite Dr. Omar Ahmed, rhinologist at Houston Methodist Hospital, to discuss innovative treatments for chronic rhinitis.

First, Dr. Ahmed shares his experience with treating chronic rhinitis using medications, in-office procedures, and surgery. Patients who fail to respond to medication find rhinitis relief up to 95% of the time following posterior nasal nerve ablation. He explains the difference between radiofrequency ablation (RhinAer and Neurent) and cryoablation (ClariFix). Then, Dr. Ahmed explains relevant anatomy, patient counseling, and potential adverse effects of ablation. Finally, he touches on recent developments in billing for these treatments.

Episode #146

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In this episode, Dr. Ashley Agan and Dr. Gopi Shah cover in-office laryngology procedures with Dr. Lesley Childs, Associate Professor of Laryngology, Neuro-Laryngology, and Professional Voice at the University of Texas Southwestern Medical Center.

The surgeons cover laryngologic diseases commonly treated in the clinic. Dr. Childs describes procedures she performs, including video stroboscopy for mucosal wave assessment, steroid injections for subglottic stenosis, and Botox injections for neurologic voice disorders. She also speaks to the benefits of treating patients in-office, anesthesia for in-office procedures, and the role her medical assistants play during various in-office procedures.

Episode #145

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In this podcast, Dr. Gopi Shah invites Dr. Nicole Schmitt, an associate professor in the Department of Otolaryngology at Emory University to discuss drug repurposing for head and neck cancer.

Dr. Schmitt explains that drug repurposing involves using a drug developed for one purpose for an entirely different purpose. She highlights some of the main drugs being repurposed for head and neck cancer treatment, including statins and NSAIDs. For example, Dr. Schmitt shares how manipulating cholesterol levels can enhance antineoplastic T lymphocyte responses to increase survival and treatment tolerability. The surgeons then consider the therapeutic, safety, and financial benefits of repurposed drugs. Special attention is given to drug repurposing in HPV-positive cancer. Lastly, Dr. Schmitt describes the pleiotropic effect and how it applies to drug repurposing efforts.

Episode #143

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In this episode of BackTable ENT, Dr. Ashley Agan interviews Dr. Gene Brown, a private practice otolaryngologist in Charleston, South Carolina about collaboration in the Otolaryngology field. Dr. Brown is a member of the Board of Directors for the American Academy of Otolaryngology (AAO-HNS) and founded the Otolaryngology and Allergy Specialists Integrated Solutions (OASIS).

Episode #135

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In this episode of BackTable ENT, hosts Dr. Ashley Agan and Dr. Gopi Shah sit down with Dr. Gina Jefferson, professor and division chief of head and neck surgery at the University of Mississippi, to discuss the challenges of cutaneous squamous cell carcinoma (CSCC).

Episode #131

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In this episode of BackTable ENT, Dr. Jordan Schramm of Peak Pediatric ENT in Provo, Utah, chats with hosts Dr. Gopi Shah and Dr. Ashley Agan about in-office ear tubes for children.

Episode #128

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In this episode of BackTable ENT, Dr. Eli Gordin, microvascular surgeon at UT Southwestern, joins hosts Dr. Gopi Shah and Dr. Ashley Agan to discuss free flap surgery. This high-yield episode walks listeners through the basics of microvascular surgery, from indications to management of surgical complications.

Episode #126

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In this week’s episode of Backtable ENT, Dr. Ashley Agan and Dr. Gopi Shah talk with Dr. John Craig, chief of Rhinology and co-director of the Skull Base Center at Henry Ford Health in Detroit, about odontogenic sinusitis (ODS).

Episode #121

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In this episode of BackTable ENT, Robert Glazer, executive vice president of ENT and Allergy Associates LLP joins Dr. Ashley Agan to speak about his process for recruiting the next generation of otolaryngologists, things otolaryngologists should look for in choosing a practice to join, and general tips and advice for otolaryngology residents to think of in their plans post residency.

Episode #117

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In this episode of BackTable ENT, Dr. Agan and UT Southwestern laryngologist Dr. Shumon Dhar discuss new approaches to managing Zenker's diverticulum, including flexible scope techniques.

Episode #115

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In this episode of BackTable ENT, Dr. Agan and Dr. Shah invite Dr. Rohan Walvekar, Chair in Head and Neck Surgery at Louisiana State University, to discuss his experience with innovating procedures for sialendoscopy and ranula excision.

Episode #110

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In this episode of BackTable ENT, Dr. Shah interviews pediatric otolaryngologist Dr. Kevin Huoh about intracapsular tonsillectomy, including the postoperative benefits of the procedure and his personal techniques.

Episode #103

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In this episode of BackTable ENT, Dr. Shah and Dr. Agan invite two comprehensive dentists, Dr. Abhishek Nagaraj and Dr. Anushka Gaglani, back to the show to discuss diagnosis and treatment of xerostomia.

Episode #101

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In this episode of BackTable ENT, Dr. Shah and Dr. Agan speak with two comprehensive dentists, Dr. Abhishek Nagaraj and Dr. Anushka Gaglani, about common dentistry complaints and their treatments in head and neck cancer patients.

Episode #99

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In this episode of BackTable ENT, Dr. Ashley Agan interviews Dr. Rebecca Howell, division chief of laryngology at University of Cincinnati, about her diagnosis and management of Zenker’s diverticulum.

Episode #94

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In this episode of BackTable ENT, Dr. Gopi Shah, Dr. Ashley Agan, and Dr. Sarah Bowe discuss new developments in the ENT residency match process as well as advice for future applicants.

Episode #89

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In this episode of BackTable ENT, Dr. Shah and Dr. Agan discuss turbinate hypertrophy, turbinate reduction, and empty nose syndrome with Dr. Jayakar V. Nayak, associate professor of otolaryngology at Stanford University.

Episode #88

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In this episode of BackTable ENT, Dr. Shah and Dr. Agan talk about in-office management of salivary stones and tips for sialolithotomy.

Articles Featuring Dr. Ashley Agan

Planning Free Flap Surgery: Patient Counseling, History-Taking & Imaging

Free tissue transfer, commonly known as “free flap surgery,” represents a major technical challenge to the head and neck surgeon. Join BackTable ENT as we learn about how one expert plans for these operations.

Free Flap Surgery in Head and Neck Cancer: Strategies for Success

A successful free flap surgery in head and neck cancer requires ICU level care and effective collaboration between nursing & surgical teams. Interested in learning more? Keep reading to acquire expert insight with BackTable ENT.

Working Up Cutaneous Squamous Cell Carcinoma: A Surgeon’s Perspective

Cutaneous squamous cell carcinoma is one of the most common cancers in the United States. Though rarely deadly, cutaneous “squames” can have devastating cosmetic and functional consequences. Join BackTable ENT to gain a surgeon’s perspective on how to work up this condition.

Cutaneous Squamous Cell Carcinoma Treatment

Treatment options for cutaneous squamous cell carcinoma (SCC) include surgery, radiation, and immunotherapy. Join BackTable ENT to learn more about when to consider each option.

Navigating Zenker’s Diverticulum: Pathophysiology & Workup

Zenker’s Diverticulum is an acquired pharyngeal outpouching that causes regurgitation and swallowing problems in older adults. Learn about Zenker's diverticulum symptoms, diagnosis, and more!

Zenker’s Diverticulum Surgery Decision Making

Zenker’s diverticulum treatment is exclusively surgical, with open and endoscopic approaches available. Most Zenker’s diverticulum surgeries are successful and complications are rare.

Allergic Fungal Rhinosinusitis Treatment: Clearing Out the “Peanut Butter”

Allergic fungal rhinosinusitis (AFRS) is a form of chronic rhinosinusitis that can cause orbital/intracranial spread and distortion of sinonasal anatomy if untreated. Learn more about allergic fungal rhinosinusitis treatment, sinus rinses, and endoscopic sinus surgery.

Evaluating Allergic Fungal Rhinosinusitis (ARFS): Focus on Symptoms & Diagnostic Criteria

Allergic fungal rhinosinusitis (AFRS) is a subset of chronic rhinosinusitis with nasal polyps. Learn more about AFRS symptoms and diagnostic criteria.

Odontogenic Sinusitis Symptoms & Diagnosis

Odontogenic sinusitis is a maxillary sinus disease of dental origin. It presents with unilateral sinusitis symptoms and foul odor. Learn more about the symptoms and diagnosis of odontogenic sinusitis.

Odontogenic Sinusitis Treatment

Odontogenic sinusitis is the result of dental infection spreading to the maxillary sinus. Given the interdisciplinary nature of this disease, a combination of medical, surgical, and dental treatment strategies enable cure in 95% of affected patients.

In-Office Salivary Stone Removal

In-office salivary stone removal is a straightforward procedure suitable for many patients with sialoliths, including select sialadenitis patients. Learn how doctors perform the removal of a salivary gland stone.

Salivary Stones: Patient Workup for In-Office Management

Salivary stones block the flow of saliva, increasing the risk of sialadenitis and pain. Learn more about the patient presentation, physical exam considerations, and candidacy for in-office management of salivary stones.

Rock Solid: Procedural Considerations for In-Office Sialolithiasis Treatment

A large proportion of patients can have their sialolithasis treated in-office. Learn about procedural considerations, potential complications, and patient selection for in-office removal of salivary stones.

No OR Time, No Problem: In-Office Pediatric Ear Tube Placement with the Tula System

Until recently, pediatric ear tube insertion has required a trip to the operating room. Join Dr. Jordan Schramm and BackTable ENT to learn more about the Tula ear tube system, which enables ENTs to insert ear tubes in-office.

How to Integrate In-Office Ear Tube Placement into Your Pediatric ENT Practice

In-office ear tube placement allows for no general anesthesia and potentially lower costs to families, but also brings challenges. ENT Dr. Jordan Schramm shares how he does in-office ear tube placements.

Sudden Sensorineural Hearing Loss Treatment

Sudden sensorineural hearing loss presents, often unilaterally, as acute-onset hearing loss of 30 dB or more over three consecutive frequencies. Learn more about the presentation, evaluation, and SSHL treatment options.

Causes of Sudden Sensorineural Hearing Loss (SSHL): Many Potential Etiologies, One Otologic Emergency

While 90% of cases are idiopathic, sudden sensorineural hearing loss (SSHL) can result from a diverse set of causes. This article explores the many causes of sudden sensorineural hearing loss and the guideline-recommended workup of SSHL.

Evaluating Sudden Sensorineural Hearing Loss (SSHL) Symptoms

Sudden sensorineural hearing loss presents, often unilaterally, as acute-onset hearing loss of 30 dB or more over three consecutive frequencies. Learn more about the presentation and evaluation of this otologic emergency from guideline author Dr. Sujana Chandrashekar..

LPR Diagnosis: Laryngoscopy, Stroboscopy & pH Impedance

Laryngopharyngeal reflux (LPR) diagnosis can involve the use of diagnostic tools like laryngoscopy, stroboscopy, and pH impedance probe monitoring. Learn more about the efficacy of different laryngoscopic examinations, the role of pH impedance probe monitoring in symptom correlation, and the complexities involved in interpreting probe results.

Laryngopharyngeal Reflux (LPR) Treatment

Laryngopharyngeal reflux (LPR) treatment is expanding beyond medications, emphasizing personalized, natural, & innovative treatments. Learn more about lifestyle adjustments, the risks of proton pump inhibitors, & alginate therapies for LPR.

Laryngopharyngeal Reflux (LPR): Symptoms, Subtypes & Patient Presentation

Laryngopharyngeal reflux (LPR) is a complex condition that impacts the upper aero-digestive tract through both acidic and non-acidic agents. Learn more about LPR symptoms, subtypes, common patient presentations.

Preparing for sublingual gland excision.

Plunging ranulae are salivary pseudocysts from the sublingual gland that present as painful neck swellings and often cause patients considerable distress. Learn more about indications, operative technique, and complications of sublingual gland removal in this article.

Otolaryngologists prepare to discuss plunging ranula pathophysiology with a patient.

Plunging ranula is a condition that presents as painful neck swelling, often in younger patients. BackTable guest Dr. Rohan Walvekar, Head & Neck surgeon, helps readers better understand plunging ranula.

Nasal Obstruction Treatment: The Impact of Turbinates & Swell Bodies

Nasal obstruction can cause a wide variety of symptoms. Effective nasal obstruction treatment involves an appreciation for the role of nasal turbinates and nasal swell bodies.

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Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Podcasts

Eustachian Tube Dilation In The Pediatric Population with Dr. Dennis Poe on the BackTable ENT Podcast)
Nasal Airway Management: Evolving Practices in Diagnosis and Treatment with Dr. Nora Perkins on the BackTable ENT Podcast)
RefluxRaft: A New Option Beyond Conventional Therapy with Dr. Spencer Payne on the BackTable ENT Podcast)
The Third-Party-Free Model: Redefining Patient Care with Dr. Gerard Gianoli on the BackTable ENT Podcast)
Labyrinthitis Unpacked: Clinical Perspectives & Management with Dr. Sujana Chandrasekhar on the BackTable ENT Podcast)
Balloon Sinuplasty: Evolution, Efficacy & Expert Insights with Dr. Ayesha Khalid on the BackTable ENT Podcast)

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