Otorhinolaryngology

with I49.82, so cardiology teams should review existing coding selections and definitely update their references and their favorites on this.

Okay, for ENT practices, odotogenic sinusitis.

So these are, again, sinus conditions involved in odontogenic sinusitis.

These start at J43.830 for the maxillary sinus, J43.831 for the ethmoid sinus, and then J43.832 for the frontal sinus.

Boom, a whopping 186 pediatric patients successfully got their flu vaccine under general anesthesia during this pilot.

Looking at the clinical service breakdown, pediatric surgery and ENT cases absolutely led the pack here.

The age distribution heavily favored toddlers and preschoolers.

Interestingly, two-year-olds were the absolute most common demographic.

Okay, two-year-olds, and specifically pediatric surgery and ENT cases, which tells me these were not otherwise healthy kids, that they were putting them under for something else.

So we're going to talk about that.

Joining me today is Dr. Madhava Sethi.

So can you explain what does that mean, post-induction and pre-emergence? And what do you make of the population that they're experimenting on?

There are two primary components of our treatment in the ED.

The first one is administering broad-spectrum antibiotics and the second is speaking with ophthalmology and potentially ENT and neurosurgery if there's intracranial extension.

Let's talk about the antibiotics first.

There are no clear guidelines that provide a standardized management algorithm or protocol for the antibiotics.

Patients who are older and have diplopia more commonly need surgery.

If they have a subperiosteal abscess over one centimeter or an orbital abscess or intracranial abscess, they're going to need surgery.

This is when you'll want to speak with ENT and neurosurgery.

The last part of our management is the complications.

Sorry.

It's in the German journal HNO.

H-N-O.

Meaning Hals, Nase, Ohren.

And treatment of vestibular migraine, menial disease, and functional dissonance should be offered in close collaboration with a neuro-otology specialist.

And that is our paper by...

Alexander Andrea Tarnitzer et al diagnosis and treatment of vertigo and dizziness in the journal HNO halls NASA on 2025 73 supplement 3357 369.

There you go.

It doesn't have to be integrative, functional, or any doctor that, you know, do extensive testing, but at least they have a medical doctor where we can share saliva testing result with, where we can ask for the blood work, because I don't do blood work in my practice.

I ask the patient to bring the blood work and share with me, where we can ask, can you order a genetic testing for the patient? Can you order, you know, a referral to an ENT? Like, we want to work as a team.

Mm-hmm.

And interestingly, in the U.S., because of our healthcare system, or we also call it the sick care system, most patients tell me they don't like their doctor.

Something I see quite a lot in my CT scans, um, that I take for implant patients, for example, is let's say maxillary posterior molars with old root treatments with, uh, periapical areas at the apex and then a large overgrowth of the, um, uh, of the membrane of the sinus, um, in very close proximity to that and oftentimes the the radiologist that runs the report on the scan will say the the hyperplasia appears to be linked of dental origin or something like that with that sort of tooth when you when you see that how does that fit into the conversation how would you raise that with your patient and what conversation would you have

Yeah, there's always risks in everything that we do.

And I'd love you to bring that up because we work really closely with a very proactive ENT, EN nose and throat doctor in Houston.

They're a big part of our airway team.

It's all management.

And I think in dentistry, we are trained We are one of the few professions other than like, you know, ENTs use their hands a lot.

Ear, nose, throat doctors, surgeons use their hands a lot.

Dentists use their hands.

Yeah, I must say, Nick, I once had hearing loss, which I also thought was due to blocked eustachian tubes.

I went to see an ENT bloke and he said, no, it's not, it's earwax.

And he cleaned it out and he was right.

Oh, well, I'll check that out, Philip.