BackTable ENT
BackTable ENT
  • 277
  • 113 299
Thyroglossal Duct Cysts in Children w/ Dr. Christopher Liu | BackTable ENT Ep. 184
What is the best way to manage an infected thyroglossal duct cyst? In this episode, hosts Dr. Gopi Shah and Dr. Ashley Agan welcome Dr. Christopher Liu, associate professor of pediatric otolaryngology at UT Southwestern, to learn about his vast experience with evaluation and management of thyroglossal duct cysts and the nuances of other congenital neck masses.
---
CHECK OUT OUR SPONSOR
Medtronic ENT
www.medtronic.com/us-en/healthcare-professionals/medical-specialties/ear-nose-throat.html?cmpid=Vanity_URL_MIX_medtronicent-com_202212_US_EN_NS_ENT_FY23
---
SYNPOSIS
First, Dr. Liu describes how thyroglossal duct cysts present. Patients often become aware of their cyst when a parent palpates a midline neck mass or when the cyst gets infected. Then, Dr. Liu describes non-operative management of thyroglossal duct cysts, including antibiotics to treat infection and cases in which drainage is appropriate. The conversation proceeds to surgical strategy, with Dr. Liu describing how his approach to cyst excision evolved over the years. The episode concludes with pearls on post-operative management and potential surgical complications.
---
TIMESTAMPS
00:00 - Introduction
02:53 - Understanding Thyroglossal Duct Cysts
11:48 - Managing Infected Thyroglossal Duct Cysts
14:02 - Antibiotic Choices & Drainage Techniques
21:05 - Imaging & Workup
25:39 - Surgical Approach and Techniques
27:29 - Koempel’s Technique for Thyroglossal Duct Cyst Surgery
39:04 - Surgical Complications, Risk of Recurrence, & Post-Operative Care
52:37 - Key Takeaways for Thyroglossal Duct Cyst Surgery
---
RESOURCES
Dr. Christopher Liu’s UT Southwestern Profile:
utswmed.org/doctors/christopher-liu/
Jeffrey Koempel, “Thyroglossal Duct Remnant Surgery: A Reliable, Reproducible Approach to the Suprahyoid Region”:
pubmed.ncbi.nlm.nih.gov/25193588/
---
The BackTable ENT Podcast is a resource for otolaryngologists to learn tips, techniques, and practical advice on all things ear, nose, and throat. Tune in to the BackTable ENT Podcast every week for candid conversations about rhinology, laryngology, otology, and head and neck surgery.
Get notified when new episodes drop! Subscribe to the BackTable ENT Podcast on your go-to podcast platform, and follow us on your social media platform of choice for regular otolaryngology updates.
► www.backtable.com/shows/ent/subscribe
#ENT184 #thryoglossalductcysts #pediatricent
#otolaryngology
Переглядів: 9

Відео

Office-Based Ear Tubes in Children w/ Dr. Shelagh Cofer | BackTable ENT Podcast Ep. 183
Переглядів 3721 годину тому
Given that recurrent otitis media can expose children to hearing loss, delayed speech development, and repeated antibiotic use, it is not at all surprising that ear tube insertion is the most common ambulatory procedure performed in the United States. But what if there was a way to insert ear tubes in children without going to the operating room? In this episode, host Dr. Ashley Agan speaks wit...
Understanding OSA in Women w/ Dr. Megan Durr | BackTable ENT Podcast Ep. 182
Переглядів 3714 днів тому
Epidemiological studies reveal that women make up 25% of all obstructive sleep apnea (OSA) patients, yet only 11% of patients carrying OSA diagnoses are women. What drives this disparity? In this episode of the BackTable ENT Podcast, sleep surgeon and UCSF Associate Professor Dr. Megan Durr joins host Dr. Gopi Shah to discuss OSA in women. CHECK OUT OUR SPONSOR Medtronic ENT www.medtronic.com/u...
Localized Drug Delivery for CRS w/ Dr. Rajiv Pandit | BackTable ENT Podcast Ep. 181
Переглядів 4221 день тому
Before bringing a new device into your practice, it’s prudent to understand the science behind, indications for, and insurance coverage of that device. In this episode, Dr. Rajiv Pandit, comprehensive otolaryngologist at Dallas ENT Head & Neck Surgery Center, joins BackTable to discuss his success treating sinusitis with drug-eluting stents. CHECK OUT OUR SPONSOR Medtronic ENT Propel Implants w...
Aural Rehabilitation After Pediatric Cochlear Implantation w/ Dr. Sarah Cordingley | ENT Ep. 180
Переглядів 1628 днів тому
Any otolaryngologist or cochlear implant (CI) patient can tell you that the journey to better hearing begins in earnest after CI activation. When the patient in question is a child, what does that journey look like? In this episode of the BackTable ENT podcast, Dr. Sarah Cordingley, audiologist with Peak ENT (Provo, Utah), joins host Dr. Gopi Shah to discuss aural rehabilitation for pediatric C...
What postoperative instructions are given for eustachian tube dilation?
Переглядів 25Місяць тому
What postoperative instructions are given for eustachian tube dilation?
What are common risks in Eustachian procedures and what techniques help prevent them?
Переглядів 49Місяць тому
What are common risks in Eustachian procedures and what techniques help prevent them?
How does performing Eustachian tube balloon dilation differ in children compared to adults?
Переглядів 29Місяць тому
How does performing Eustachian tube balloon dilation differ in children compared to adults?
Decision Fatigue in Medicine: Insights from Dr. Steven Goudy | BackTable ENT Podcast Ep.179
Переглядів 40Місяць тому
Decision Fatigue in Medicine: Insights from Dr. Steven Goudy | BackTable ENT Podcast Ep.179
What are the methods for evaluating and treating Eustachian Tube Dysfunction in children?
Переглядів 9Місяць тому
What are the methods for evaluating and treating Eustachian Tube Dysfunction in children?
Describe your approach to adenoidectomy and eustachian tube balloon dilation
Переглядів 31Місяць тому
Describe your approach to adenoidectomy and eustachian tube balloon dilation
When and how are balloons used to address post-tympanoplasty complications in patients?
Переглядів 21Місяць тому
When and how are balloons used to address post-tympanoplasty complications in patients?
How do you decide balloon dilation vs repeating tubes when treating Eustachian Tube Dysfunction?
Переглядів 36Місяць тому
How do you decide balloon dilation vs repeating tubes when treating Eustachian Tube Dysfunction?
Teaching Surgical Residents in the XXI Century w/ Dr. Oswaldo Henriquez | ENT Podcast Ep. 178
Переглядів 18Місяць тому
Teaching Surgical Residents in the XXI Century w/ Dr. Oswaldo Henriquez | ENT Podcast Ep. 178
What do you do when there is a lot of adenoid tissue limiting visualization?
Переглядів 35Місяць тому
What do you do when there is a lot of adenoid tissue limiting visualization?
What is your exam for eustachian tube dysfunction in children?
Переглядів 21Місяць тому
What is your exam for eustachian tube dysfunction in children?
AI Scribes: Enhancing Patient & Physician Interaction w/ Elie Toubiana | BackTable ENT Ep. 177
Переглядів 13Місяць тому
AI Scribes: Enhancing Patient & Physician Interaction w/ Elie Toubiana | BackTable ENT Ep. 177
How are eustachian tube dysfunction causes and treatments different in children compared to adults?
Переглядів 75Місяць тому
How are eustachian tube dysfunction causes and treatments different in children compared to adults?
How do anatomical differences in adult and pediatric eustachian tubes impact balloon dilation?
Переглядів 29Місяць тому
How do anatomical differences in adult and pediatric eustachian tubes impact balloon dilation?
Advancing Surgical Education: 3D Models & Videos w/ Dr. François Simon | BackTable ENT Ep. 176
Переглядів 30Місяць тому
Advancing Surgical Education: 3D Models & Videos w/ Dr. François Simon | BackTable ENT Ep. 176
Atypical Laryngopharyngeal Reflux w/ Dr. Inna Husain | BackTable ENT Podcast Ep. 175
Переглядів 589Місяць тому
Atypical Laryngopharyngeal Reflux w/ Dr. Inna Husain | BackTable ENT Podcast Ep. 175
Advanced Navigation Systems for Functional Endoscopic Sinus Surgery w/ Dr. Raj Sindwani | Ep. 174
Переглядів 892 місяці тому
Advanced Navigation Systems for Functional Endoscopic Sinus Surgery w/ Dr. Raj Sindwani | Ep. 174
Hypothyroidism Symptoms, Diagnosis & Treatment w/ Dr. Dana Gibbs | BackTable ENT Ep. 173
Переглядів 1022 місяці тому
Hypothyroidism Symptoms, Diagnosis & Treatment w/ Dr. Dana Gibbs | BackTable ENT Ep. 173
HPV & Oropharyngeal Cancer w/ Dr. Mihir Patel | BackTable ENT Ep. 172
Переглядів 1542 місяці тому
HPV & Oropharyngeal Cancer w/ Dr. Mihir Patel | BackTable ENT Ep. 172
RefluxRaft Recommendations in Specific Patient Groups | BackTable ENT Clips
Переглядів 312 місяці тому
RefluxRaft Recommendations in Specific Patient Groups | BackTable ENT Clips
Navigating ENT Advocacy: Strategies & Impact w/ Dr. Peter Manes | ENT Ep. 170
Переглядів 232 місяці тому
Navigating ENT Advocacy: Strategies & Impact w/ Dr. Peter Manes | ENT Ep. 170
The Role of Alginates in Acid Reflux Treatment | BackTable ENT Clips
Переглядів 292 місяці тому
The Role of Alginates in Acid Reflux Treatment | BackTable ENT Clips
Deglycerinated Licorice & Reflux | BackTable ENT Clips
Переглядів 212 місяці тому
Deglycerinated Licorice & Reflux | BackTable ENT Clips
Workforce Analysis & Why It’s Important w/ Dr. Andrew Tompkins | BackTable ENT Podcast Ep. 171
Переглядів 232 місяці тому
Workforce Analysis & Why It’s Important w/ Dr. Andrew Tompkins | BackTable ENT Podcast Ep. 171
The Origin of RefluxRaft Alginate Treatment for GERD | BackTable ENT Clips
Переглядів 572 місяці тому
The Origin of RefluxRaft Alginate Treatment for GERD | BackTable ENT Clips

КОМЕНТАРІ

  • @maximebecker4930
    @maximebecker4930 3 години тому

    as he explains some people have a diffferent perception of their nose obstruction ( some people will notice that one of their nostrils is blocked when other people will not notice anything), does it mean that it s completly safe to breath through one nostril? Especially at night?

  • @patriciamosca3983
    @patriciamosca3983 10 годин тому

    What does clipping a nerve do to remedy these situations

  • @maxdodgers
    @maxdodgers 20 годин тому

    any recommendations for doctors in los angeles? Had the condition for a decade and seen many doctors, most are dismissive because they don't understand the condition

  • @1stranktrading
    @1stranktrading 5 днів тому

    I've has this disorder for 30 years and I'm really excited that more people are talking about it and I'm desperate to get the surgery

  • @djdjiw87
    @djdjiw87 8 днів тому

    Sir why not create a device like pace maker which could be inserted inside and moisturize eustachian tube in such a way that there won't be need of salt saline solution or any other nasal drops or why not create an artificial eustachian tube,if we could create artificial heart why cannot we create artificial eustachian tube.

  • @timcepin3386
    @timcepin3386 9 днів тому

    How can I find out if my nerves were severed?

  • @rd2071
    @rd2071 18 днів тому

    Nayak and many ents still dos not get that volume is not everything when it comes to how the turbinates signal to the brain. They have a huge importance on the nervous/resperitory system.

  • @Shawnee_Rose
    @Shawnee_Rose 21 день тому

    I have had this since early childhood and remember the point in time when it began. My dad smoked heavily in the house and car and it would irritate my sinuses. My ears became clogged to where it caused pain. I don't even think I was 5 yet. I was in the car and the clog was driving me crazy until I got my ears to pop. I had several ear infections subsequently. The clog went away after recurring a few times, but my voice sounded like a blown out speaker when I talked and my own breath was irritatingly loud until I figured out if I sniffed it would stop...for a moment. The dysfunction is so severe that if I so much as open my jaw by half, it flaps open again. It's been that way ever since. I'm 38. We were poor when I was a kid and this wasn't something that would be addressed. Even now, I'm not able to bother with it financially, but I will be trying the patulend product. I'm so grateful you put this video up.

  • @pa2707
    @pa2707 22 дні тому

    Sir, I have recurrent CSOM with TM perforation for many years, I also have a sclerosed mastoid. I want to get surgery done but none of my doctors ever give me any satisfying answers regarding my doubts and they just dismiss me and keep asking me to have the surgery done from them immediately. I ask them about complications and what might happen after the surgery regarding hearing and side effects and they mock me and call me stupid. Sir I want to know what will be done during the surgery since I also have a sclerosed mastoid. Will I also need a mastoid surgery or some kind of intervention for that along with eardrum repair? I am scared because when I ask my doctor he never gives me an answer to this. He tells me they will repair the TM and then "we will see". Sir I don't know what this means. Will they do the mastoid surgery also along with TM? Is this a normal way of managing this kind of cases?

  • @patriciawolanski3458
    @patriciawolanski3458 24 дні тому

    This was very helpful. LPR is challenging.

  • @timcepin3386
    @timcepin3386 25 днів тому

    Why the hell is my nasal breathing constantly changing?

  • @timcepin3386
    @timcepin3386 25 днів тому

    I’m about ready to drive into a lake!

  • @timcepin3386
    @timcepin3386 25 днів тому

    To those who unfortunately have ENS: Would it be better to have your nose removed as in a total or full rhimectomy?

  • @timcepin3386
    @timcepin3386 25 днів тому

    Turbinate reduction made my problem worse off. I hope I don’t get empty nose syndrome, but man did it not improve my condition. As a matter of fact, what I eat bothers me more now.

  • @grettalemabouchou6779
    @grettalemabouchou6779 26 днів тому

    Tinnitus can also be a symptom of toxicity. This happened to me.....too many chemicals in makeup and foods. Do an Epsom salt bath ....4 cups of it everyday for 5 days..this worked well for me. Use only clean soap, shampoo and cosmetics. No processed foods......go as clean as you can. Check ingredients on everything you put on and in your body. Nail polish is FILLED with poison....I no longer wear it. Good luck and God bless. And drink alot of water. Once you get relief, do the bath once a week.😊

  • @bradr2147
    @bradr2147 26 днів тому

    Had and EGD with Bravo placed and finding were normal with normal pH-yet I have been hoarse for over a year and it’s getting worse-lifestyle changes including eliminating caffeine, chocolate, carbonation, coffee, major weight loss, elevated bed etc have done nothing. I am so frustrated I am about to lose it-I had a strong voice and work remotely so it is effecting my job as well since I can’t speak well-what am I missing? Drinking alkaline water..nothing is helping!

  • @deeperrootsstrongerbranches
    @deeperrootsstrongerbranches Місяць тому

    i’ve had these issues for at least 4 years and has been finally improving for 6 months! so many tonsil stones and lymphatic clotting had to be cleared before i felt any relief

  • @Longuro
    @Longuro Місяць тому

    I've tried all the alginate products sold on Amazon. I was not happy with any of them because both RefluxRaft and Reflux Gourmet were too weak and I had to double up the dose as their stated 5 ml is just not enough. Made it too expensive. I recently found a new alginate product on Amazon called Nutritist Refluxter and I am very pleased with it as its a capsule and seems to be working great so far.

  • @Uglymonster_me
    @Uglymonster_me Місяць тому

    Hi, does my symptom belong to eustachian dysfunction? Like when i drink coffee or when im hungry, i started to hear my own voice very muffled..and i can hear my own inhale and exhale so loud, i feel like my exhale goes out to my ear.

    • @user-ey5tl5vq8w
      @user-ey5tl5vq8w 10 днів тому

      Do you have balance problems because of this? I also had muscle fasciculations, weakness, crackling in the ears, pain in the sinus area and internal tremors. Maybe this fluid behind the eardrum causes irritation of the labyrinth? I've had it since I was infected with the famous "C" virus.

    • @1stranktrading
      @1stranktrading 5 днів тому

      I've had this disorder for 30 years

  • @xx-thenightrider
    @xx-thenightrider Місяць тому

    thanks for the video. i have PET or something very similar in my right ear since i was young. i've never been treated for it. sometimes when i breathe through my nose for more than a few seconds i hear myself breathing loudly. for that reason i almost never breathe through my nose. it also happens whenever i'm breathing hard or commonly when i'm speaking. when that happens i hear myself speaking loudly. i have a habit of swallowing whenever it happens to temporarily fix the problem or sometimes i hold my nose and gently inhale which works nearly all of the time to reset it. i've noticed that my right ear seems to have a tiny bit more drainage than my left. i've had the ear cleaned and looked at. the ENT doctor said he didn't see anything abnormal when he cleaned it. what Dr. Poe said about leaning forward and tilting my head downward seemed to work and when i tried speaking it seemed to help. i've never wanted surgery but i'm considering trying some sort of nasal drops or other similar thing to help.

  • @nenadcubric2663
    @nenadcubric2663 Місяць тому

    Just a few get "ENS"

  • @user-cd8fz4qc2m
    @user-cd8fz4qc2m Місяць тому

    So true

  • @kendelmurray6473
    @kendelmurray6473 Місяць тому

    What about those with an open bite/ jaw issues? What type of doctor do I go to to get tested for this issue?

  • @nevillepillay1755
    @nevillepillay1755 Місяць тому

    Doctor said 2 options do the operation or take ppi for the rest of my life

  • @nevillepillay1755
    @nevillepillay1755 Місяць тому

    My ent said it was acid reflux sent me to the gastroenterologist I got a hiatus hernia put me on 40mg trustan this has helped me a lot

  • @victoriamanley9961
    @victoriamanley9961 Місяць тому

    Excellent

  • @Kate98755
    @Kate98755 Місяць тому

    i was diagnosed 2 weeks ago and now i have to have an upper gi to see any damage to my esophagus….i have EOE in my family…i was also diagnosed with Alpha 1 in Nov….working to learn to work with both these issues…and potentially may have a third with EOE.

  • @BFG12TR
    @BFG12TR Місяць тому

    Can you give me the name of the ascorbic acid he was speaking of? Patcholend? I can't find it.

  • @fuzzydunlop4175
    @fuzzydunlop4175 Місяць тому

    Recently was diagnosed with PET. Do patients normally regain hearing after their PET symptoms go away? I just had a grommet implanted to relieve pressure but experienced hearing loss - is this a normal side effect of tubes or is this just exacerbating PET symptoms? I'm just looking for some answers because the tinnitus/hearing loss/autophony are crippling me.

  • @fuzzydunlop4175
    @fuzzydunlop4175 Місяць тому

    Does tinnitus and hearing loss normally resolve itself when PET symptoms are relieved? I've been dealing with this for four months now and this channel is the only place that seems interested in addressing PET. Any feedback would be greatly appreciated.

  • @ChristFollower-dk5bg
    @ChristFollower-dk5bg Місяць тому

    Does anyone recommend a specialist in Cleveland area? Very frustrated with lack of knowledge or treatment of this. It's been 10 years, and I'm certain it's patelous eustachian tube

  • @asathora1819
    @asathora1819 Місяць тому

    Halfway through the video and I haven’t heard a single mention of antifungals. “First surgery,” “first surgery…”, “steroids,” “first surgery”……assuming there might be more surgeries…

  • @Omar-ho7rr
    @Omar-ho7rr Місяць тому

    Thank you for this nice video, when you have large adenoid hypertrophy, you may see tubal tonsil hypertrophy. please do you remove it ( at least lymphoid tissue, keeping muscle intact) at the same time of adenoidectomy?

  • @chrisbraunsdorf2547
    @chrisbraunsdorf2547 Місяць тому

    I’ve been diagnosed with PET, but I get far more loud crackling than the classic autophony symptoms.

  • @chrisbraunsdorf2547
    @chrisbraunsdorf2547 Місяць тому

    I’ve been diagnosed with PET, but I get far more loud crackling than the classic autophony symptoms.

  • @yanaison6200
    @yanaison6200 Місяць тому

    Does distraction work immediately to clear tongue obstruction or does the tongue have to acclimate to the increased space following the procedure?

  • @sharshabillian
    @sharshabillian Місяць тому

    When, you know, Dr. Agan made a point at the end, about, you know, like, you know, how nasal valves might be more prone to collapse in athletes as they subject them to more severe and frequent conditions, that's when Dr. Mourad, you know, like, you know, did not get her point and went on to talk about the you know, like, physics of a single inhalation and how the pressure gradient causes this bend, and how this phenomenon, you know, over like, time, you know, might cause, like, the nasal valves, you know, to like, weaken quicker, thereby proving her, you know, point.

  • @weichen5146
    @weichen5146 Місяць тому

    I once had acid relux and chronic bad breath for over 10 years and I visited so many States in the United States 😭😭seeking for help but it was all leading to spending thousands of dollars until I was watching a UA-cam series and I came across Dr.Emovon on UA-cam ads and I decided to order his herbal medication and today I'm fully well from this problems.#dremovon.

  • @weichen5146
    @weichen5146 Місяць тому

    I once had acid relux and chronic bad breath for over 10 years and I visited so many States in the United States 😭😭seeking for help but it was all leading to spending thousands of dollars until I was watching a UA-cam series and I came across Dr.Emovon on UA-cam ads and I decided to order his herbal medication and today I'm fully well from this problems.#dremovon.

  • @timcepin3386
    @timcepin3386 Місяць тому

    Is there any surgeon willing to give me a free total rhimectomy?

  • @haileysain7097
    @haileysain7097 Місяць тому

    How about hearing your eye move

  • @susanlee8609
    @susanlee8609 Місяць тому

    Sad how many doctors act like they don't even know LPR is a thing.

  • @nicholastsaclas2619
    @nicholastsaclas2619 Місяць тому

    Excellent! Bravo to you both. Highly recommend anyone with this condition to watch this.....twice! 👏

  • @TheBounceBack1996
    @TheBounceBack1996 2 місяці тому

    Honestly you can do all of this but you need to address the underlying cause. I did all of the lifestyle changes and it made minimal difference until I had surgery.

    • @giselr.4464
      @giselr.4464 27 днів тому

      What operation did you have to have?

  • @reginadzeagu3074
    @reginadzeagu3074 2 місяці тому

    This is what im going through now. After i eat. When i wake up in the morning too. Its bad

  • @anamoosilas6836
    @anamoosilas6836 2 місяці тому

    Thank you!

  • @TheBounceBack1996
    @TheBounceBack1996 2 місяці тому

    It did help me a bit. I ended up having surgery and I have been documenting all my progress. I was still miserable from lpr symptoms after the raft but it definitely helped a bit.

  • @glennchartrand5411
    @glennchartrand5411 2 місяці тому

    Born with it and it went undiagnosed until my late 40's, when it finally fixed itself. Both ears , the eustachian tubes are simply oversized so they couldn't ever close off I could always hear my heart beat, breathing , and If I tapped my finger on my sternum it sounded like a drum. I had to stop breathing to listen to someone talk. I couldn't hear most of the consonants I speak because the sound from my larynx drowned out everything when I spoke "Glass Grass and Gas" they all sounded like "gAHHs" when I said it, so I spent most of Grade School taking speech therapy classes , and half my life with ear aches. While in the Navy I had a lot of hearing loss because the hearing protection only blocked sound going into your ears but not the sound going into your sinus passages , which for me was the same thing. Somehow I made it to 50 without going completely deaf or my eardrums being seriously damaged 8 years ago my right ear "fixed itself" so I went to the doctor because I thought something was wrong He decided to go ahead and fix the left one. (Simple outpatient procedure) 1. Still getting used to not hearing my own heartbeat. 2. I still stop breathing out of habit when I'm listening to someone 3. People say my voice is a lot less annoying. 4.I now have trouble telling if a sound is in front of or behind me because I no longer "hear through my nose" 5. Now that my ears are no longer subjected to the "roar of my own breathing" I noticed that my hearing is slowly improving ,mainly the high frequencies in the left ear and low frequencies in the right ear. My niece was surprised when she realized I had no trouble hearing her talk.

    • @shemaroogaming1948
      @shemaroogaming1948 18 днів тому

      Brother how cure it please help us We need u support us please 🙏🏻❤ guide us

  • @MNDanno
    @MNDanno 2 місяці тому

    When my mother had timpanography done to check for PET, the person did not ask her to do anything with her mouth or breathing. I know my mothers intermittent weak croak voice is due to her Eustachian tubes, but every ENT seems to be uninterested.

  • @Acts-1322
    @Acts-1322 2 місяці тому

    If you have nasal polyps with sinusitis... It's likely your Vitamin D level. 3 research papers: 1) Vitamin D deficiency is associated with increased human sinonasal fibroblast proliferation in chronic rhinosinusitis with nasal polyps 2) Chronic rhinosinusitis with polyposis and serum vitamin D levels 3) The Correlation Between Vitamin D Deficiency and Chronic Rhinosinusitis: A Systematic Review That's the sunshine hormone, 40% UNFILTERED skin exposure 15min a day for 3x a week is most effective. UVB is best between 10am-2pm, but then go back to using sunblock! Diet is much harder to absorb, and certain food sources are not very biologically available