Kevin C. Welch, MD

@JamesSuckling When are you bringing back your Italian wine tour to Chicago!?!

Tasted my first 2019 Brunello di Montalcino yesterday and was impressed with the wonderful aromatics and racy, polished tannin structure of the red. I thought right away about it being comparable to 2016 but with better tannins that have finesse with form. Released in Jan 2024.

Starting to appreciate more and more Languedoc-Roussillon these days. This one is IGP rather than AOC, but no less an amazing GSM blend! #languedoc #roussillon

@JohnCraigNose Of course. I'm making it an issue of semantics. It's sinusitis. Neutrophils. Subepithelial edema. Basement membrane thickening. And, it's odontogenic in origin 🤣. But, yes, it should be without passion or prejudice dismissed as clinically insignificant. 💯

Yes there will be inflammatory cells :). Different nomenclature needed. Whether we call this mucositis or something else, it’s just not the infectious sinusitis of #ODS, and generally not clinically meaningful ‘sinusitis.’ Would you agree?

@ent_ams @JohnCraigNose @henryfordent What's under the microscope?

@JohnCraigNose @henryfordent Repeat after me: Mucosal thickening is not sinusitis Mucosal thickening is not sinusitis Mucosal thickening is not sinusitis Mucosal thickening is not sinusitis Mucosal thickening is not sinusitis Mucosal thickening is not sinusitis

Feeling odontogenic? Let’s hit this point home. Patient got a molar extracted. No sinus symptoms and normal nasal endo. CT read: periapical bone expanded and dehisced, adjacent maxillary sinusitis. NOTE: this is reactive sinus mucosal thickening, NOT #ODS. @ent_ams @henryfordent

@KU_ENT @AmRhinoSociety @sd01race Proud of you, @sd01race! Representing @NM_ENT! 👊🏻

Sam Racette MD, Rhinology & Skull Base Surgery Fellow @KU_ENT presents @AmRhinoSociety #WeAreOto #ENTsurgery #OtoHNS #OHNS

Was an honor and privilege to moderate a panel on the Unified Airway at the annual meeting of @AmRhinoSociety. Always have to step up my game when experts like @jbossomd, Cecilia Damask, @SnotSurgeon, and Anju Peters from @NorthwesternMed are sitting at the table!

Professor Vining talking about post operative medical management in #chronicsinusitis at @PennRhinology @JohnCraigNose @ChandraRickK @NAdappaMD @davidgudismd

When the fire alarm goes off at @PennRhinology 2022!

@NAdappaMD @davidgudismd @JohnCraigNose @DwayneHallman @PennRhinology Thrilled to be back at @PennMedicine for the @PennRhinology meeting!

1st day of our Penn International Rhinology & Skull Base Course in the books! Had some amazing lectures today from @igotsinus @davidgudismd @JohnCraigNose to name a few, finishing off with a full house lab set up by long time friend @DwayneHallman and sponsors! @PennRhinology

@SEMiNurse @MaddieMierMD @300ZXNA @lizditz QED. See how we're quibbling over phraseology? The tone and the tenor of the entire encounter sets the pathway and opens the door for engagement, not simple phraseology.

@igotsinus @MaddieMierMD @300ZXNA @lizditz Phrasing matters, it’s not just semantics. I’d suggest you listen to how many patients respond to “any questions?” with an initial “no” yet go on to say “except I’m wondering about…” or similar. Just opening the door isn’t always enough. Many people are intimidated & afraid.

Three of the most powerful phrases in medicine are - “How can I help?” “Thank you for your flexibility” “I believe you” What else would you add?

@MaddieMierMD @300ZXNA @lizditz I think this is an issue of semantics. Either one opens the door for the patient. I've used both. Sometimes there aren't any questions. Sometimes the response is "what should I be asking?" to the "what ?s do you have?" Maybe you do or don't have a quick response to that one.

@300ZXNA @lizditz Totally agree.. but I like “what questions do you have?” a little more. To me it makes it the assumption that there WILL be questions, which I’m happy to answer, because I think some families worry they’ll be wasting our time by asking questions, when it’s our actual job

@Rileycaf @JohnCraigNose @henryfordent Unzip!

More cases to be discussed at the 3rd annual #HFSNS on Fri 10/7. When does an anterior septal deviation become cauda? Rhinologist or Rhinoplasty surgeon? Plenty to discuss on managing these, and why failures arise. Register! @henryfordent #MedTwitter henryfordsinusnasalsymposium.com

@JohnCraigNose @jakeeide1 @henryfordent @DrAmritaRay Is that a shot of @FireballWhisky there @jakeeide1 ??

1st team dinner last night. Terrible picture lighting. But welcome @jakeeide1 to the @henryfordent Rhinology show w me and @DrAmritaRay. Nothing like discussing over drinks who uses antibiotics or steroids after sinus surgery! It's a bright rhinologic future! #medtwitter

@JohnCraigNose @TroyWoodardMD @henryford A lot of cautery around vidian gets PT ganglion too. For far lateral, corridor better in my opinion, as it preserves all nerves. But, YMMV and pathology is highly variable here!

@JohnCraigNose @TroyWoodardMD @henryford V2 complication is broad. It can from managing defect itself or approach. This approach works well (I use 2) if not 2 far lateral - stretch PT ganglion and sensory from V2 to l/g palatine nerves. No mention in manuscript about palate numbness - often overlooked and not asked.

I don't how many are repairing lateral recess encephaloceles this way, but it's the way to go. No need to dissect through the PPF! Props to Cleveland Clinic for publishing on it too. @TroyWoodardMD @henryford #Medtwitter youtu.be/SpIKeymZ0tI

@JohnCraigNose The dry eye rates are surprisingly low. But, I've definitely done Schirmer tests that have shown decreased rates in asymptomatic patients. Must be alternative pathways or post-traumatic regeneration.

3. Fortunately have not seen a bothersome dry eye from this yet. I just checked and I've done 10 so far. None of them have required interventions, I don't think even eye drops,l. But I know some groups have published higher rates than this.

2. Adherus autospray cmf.stryker.com/products/adher…

@ProfFeynman Surely you're joking, Mr. Feynman, about bullet 4! 😂

FIVE Productivity FEYNMAN- strategies: • Stop trying to know-it-all. • Don't worry about what others are thinking. • Don't think about what you want to be, but what you want to do. • Have a sense of humor and talk honestly. • Teach others what you know.