Episode 28 of Airway Answers: "Your ENT Questions Answered with Dr. David McIntosh"

Welcome to the "Airway Answers with Nicole Goldfarb: Expanding your Breath of Knowledge". In this episode, Nicole Goldfarb, M.A. CCC, SLP- COM® interviews the pediatric ENT, Dr. David McIntosh, and Dr. McIntosh answers your ENT questions!" 🤧 👂 👄This is Part 4 of a multiple-part ENT series.

Here are some of the questions answered in "Your ENT Questions Answered with Dr. David McIntosh"🎙:

❓Venus Pooling
✅ Can venous pooling be a sign of fatigue, even without allergies?

❓Nasal Steroid Sprays
✅ Should you use a nasal irrigant before applying a nasal steroid spray?
✅ Is there an ideal time of day to use a nasal steroid spray?
✅ Do nasal steroid sprays help with itchy eyes and throat?
✅ How do you know if a patient should use a nasal steroid spray once or twice a day?
✅ Should someone with frequent bloody noses use a nasal steroid spray?
✅ What is the best technique for applying a nasal steroid spray?

❓Deviated Septum
✅ Is it safe to tape a child's mouth shut if they have a deviated septum and are a mouth breather?
✅ At what age can a deviated septum be surgically corrected?

❓ENT Assessments
✅ When does an ENT choose to perform a nasoendoscopy versus an X-ray?
✅ Why is it inadequate to only visualize the tonsils during an ENT assessment?
✅ Can an otoscope be used to visualize the adenoids in children?
✅ Will ENTs acknowledge home sleep studies and recommend treatment based on patient report paired with the results?

❓Lateral Cephalometric X-rays
✅ How do you measure airway size on a lateral cephalometric X-ray?
✅ Can you draw conclusions from an X-ray where the child is not in the proper "flower sniffing" position?

❓Tonsillectomy
✅ When should a tonsillectomy be considered for a child who is not progressing with eating?

❓Inflammatory Foods
✅ Do you recommend cutting out inflammatory foods like dairy and gluten in children with nasal congestion, reflux, enlarged tonsils, or adenoids before recommending surgery?
✅ Does food quality play a role in inflammatory responses to dairy and gluten?

❓Myofunctional Therapy
✅ Should all patients be cleared by an ENT before beginning myofunctional therapy?
✅ What is your recommendation for myofunctional therapists to check for nasal patency?

❓Allergies
✅ If an ENT screen determines inflammation in the nose, is there a protocol to address this initially or is it a recommendation to look at a surgical approach?
✅ In what ways are allergies addressed prior to a surgical approach?

❓Laser Treatment
✅ Why is laser treatment not as readily used by ENTs instead of surgical procedures?

❓Tongue Tie and Jaw Size
✅ Do you look at tongue tie and jaw size when evaluating pediatric patients for sleep-disordered breathing?
✅ What are your thoughts on expansion of the maxilla to increase nasal cavity volume?

❓CPAP
✅ How does CPAP pressure affect the carbon dioxide-oxygen relationship and oxygen transfer from hemoglobin to cells short-term and over years of use?
✅ Can long-term CPAP use impact a person's breathing without the CPAP?

❓AirPods as Hearing Aids
✅ Are you aware of the new Apple AirPods that can function as hearing aids?
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ABOUT THE GUEST:
Dr. David McIntosh is a Pediatric ENT Specialist with a particular interest in airway obstruction, facial and dental development and its relationship to ENT airway problems, and middle ear disease.
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ABOUT THE HOST: 
Nicole Goldfarb, M.A. CCC, SLP- COM® is a Speech-Language Pathologist, Certified Orofacial Myologist, an International speaker, and author.
She is the owner of San Diego Center For Speech Therapy & Myofunctional Therapy. She currently serves as a mentor an