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Rhinology Roundtable: Where Expertise Meets Honesty, and the Conversations Go Beyond the Slides

Rhinology Roundtable - brought to you by the American Rhinologic Society - is where the real conversations happen. This isn't another recap of what you already heard at national meetings or read in journals. Instead, Rhinology Roundtable pulls back the curtain on the unspoken, the under-discussed, and the clinically nuanced topics that shape everyday practice but rarely make it to the podium or the page.

Join candid, unscripted discussions between colleagues as they tackle high-yield clinical dilemmas, gray-zone decision making, and the practical realities of rhinologic care. From controversial management strategies to "what we actually do" in clinic and the OR, this podcast delivers insights you won't find in textbooks.

Whether you're a seasoned rhinologist, a general otolaryngologist, or a trainee looking for real-world perspective, expect thoughtful debate, expert opinion, and actionable takeaways - all in a conversational format that feels like sitting in on a trusted peer discussion.

Episode 4: Understanding Post-Nasal Drainage: Insights from Rhinology and Laryngology Experts

Release Date: Coming Soon!

Guest Speaker: Dr. Kathleen Tibbetts

Most cases of post-nasal drainage are dismissed as benign or overlooked, but beneath the surface lies a complex, under-researched challenge affecting millions. In this eye-opening episode of Rhinology Roundtable, host Dr. Ashleigh Halderman pulls back the curtain on the often-misunderstood world of post-nasal drainage—a symptom that can feel like drowning in mucus despite normal exam findings. Joining her is renowned laryngologist Dr. Kathleen Tibbetts from Jefferson University, who reveals surprising insights that challenge conventional thinking. From the pivotal role of mucus quality over quantity, to how medications, aging, and sleep apnea subtly sabotage the body's ability to clear secretions, this episode is packed with actionable knowledge. You'll learn:

  • How systemic factors like dehydration, medication side effects, and aging contribute to sticky, hard-to-clear mucus
  • The critical importance of comprehensive history-taking and nuanced examination, including flexible laryngoscopy
  • Practical, evidence-based strategies including a mucus management handout that has transformed patient care
  • The latest on reflux, sleep apnea, and how common ENT treatments may be contributing, not curing, these symptoms
  • When to consider imaging, swallow studies, and collaboration with GI or sleep specialists

Episode 3: Skull Base Osteomyelitis

Release Date: 5/21/2026

Guest Speakers: Dr Erin McKean and Dr Jacob Hunter

In this episode, Dr. Ashleigh Halderman and guests Dr. Erin McKean from the University of Michigan and Dr. Jacob Hunter from Thomas Jefferson University lean into their personal experience of treating skull base osteomyelitis and break down the diagnostic challenges, from interpreting MRI and CT findings to the critical role of biopsies, cultures, and laboratory markers like ESR, CRP, and IgG4. You'll learn why early suspicion and a thorough history can alter outcomes, highlighting recent advances like MRI for tracking disease activity, the potential role of PET scans in establishing cure, and the limitations of traditional imaging modalities.

Episode 2: The Last Cell Standing: How Far Should You Go?

Release Date: 5/8/2026

Guest Speakers: Dr Roy Casiano and Dr James Palmer

In this episode of “Rhinology Roundtable,” host Dr. Ashleigh Halderman is joined by renowned rhinologists Dr. Roy Casiano from the University of Miami Department of Otolaryngology Head and Neck Surgery and Dr. Jim Palmer from the University of Pennsylvania Department of Otolaryngology Head and Neck Surgery.  They discuss the importance of complete sinus surgery exploring how geographic differences and training eras influence surgical approaches. The conversation delves into the evolution of sinus surgery techniques, the role of biologics, and the need for standardized surgical practices. The guests emphasize continuous learning, collaboration, and self-evaluation to improve surgical outcomes. The episode concludes with insights on the future of rhinology and the importance of comprehensive patient care. 

Episode 1: Sinus and Cents – Billing in Rhinology

Release Date: 4/22/26

Guest Speaker: Dr Seth Brown

Dr. Seth Brown is a renowned rhinologist at the ENT Institute of Connecticut and a Clinical Associate Professor at the University of Connecticut, with expertise in rhinology and healthcare billing.

Unlock the secrets to proper medical billing in rhinology and safeguard your practice from costly mistakes. If you've ever felt overwhelmed by coding nuances, this episode will transform your understanding—saving you time, money, and compliance headaches. Most rhinologists underestimate how critical correct billing is. Dr. Seth Brown, a leading ENT specialist and billing expert, exposes common pitfalls—like misusing the 25 modifier, coding complex skull base surgeries, or improperly billing for scope. Whether you're a physician, coder, or administrator, you’ll discover the right way to bill everything from sinus surgery to high-stakes tumor resections.

In this episode, we break down:

  • The misunderstood magic of CPT modifier 25 and 79, including real-world examples on when and how to use them.
  • How to document complex cases like skull base surgeries to ensure fair reimbursement, including strategies for negotiating RVUs with hospitals.
  • The subtle art of differentiating between scope exams, follow-ups, and surveillance procedures to prevent costly rejections.
  • Practical tips for documenting medical decision-making at level 3 and 4, ensuring your coding reflects the true complexity of patient care.
  • Common reasons for claim denials—like unbundling, incorrect codes, or overusing diagnostic procedures—and how to address them proactively.

Why does this matter? Inaccurate coding not only threatens your practice’s revenue but also risks severe audits, penalties, or even legal issues. With the healthcare landscape evolving rapidly—especially with AI —knowing how to code ethically and correctly is more vital than ever. This episode arms you with the insider knowledge to confidently navigate billing, maximize reimbursements, and advocate for your expertise. Perfect for rhinologists aiming to boost revenue without risking compliance, or practice managers seeking pragmatic coding strategies, this episode is your essential guide to smarter billing. Tune in now and turn billing mistakes into revenue opportunities.