Sinus Center

Otolaryngic Allergy: The Diagnosis and Treatment of Inhalant (Pollens), Mold and Food Allergies

by Mas Takashima, M.D.

Affecting one in four, allergies are among the nation's most common and costly health problems. More than 50 million Americans suffer from allergic disorders. Yearly sales of anti-allergy medications now exceed 5 billion dollars. An essential part of otolaryngology, 50 percent of problems seen are attributable in some ways to hypersensitivity reactions. The American Academy of Otolaryngic Allergy is the second largest society in otolaryngology and the fastest growing subspecialty in the field.

Allergy is a condition, often inherited, in which the immune system of the affected person reacts to something in the environment or ingested that does not affect most other people. Allergy is often regarded as only "hay fever," with rhinorrhea, nasal congestion, sneezing, pruritic and watery eyes. Recent literature has, however, demonstrated a compelling association of allergy and many ENT disorders. Diseases as chronic sinusitis, post nasal drip, cold symptoms, recurring otitis media and externa, the dizziness of Meniere's syndrome, hearing loss, tinnitus, chronic cough, asthma, headaches, chronic fatigue and skin eczema are included.

Otolaryngic allergy has evolved out of the need to care for patients with allergic ENT disorders. An ENT allergist is a general ENT physician and surgeon with specialty training in the field of allergy, combining specialized knowledge of the head and neck anatomy and allergy to maximize treatment of allergic and ear, nose and throat disorders. Thus, a unified modality of treatment can be achieved by complementing allergy treatment with necessary surgery, such as polyp removal, placement of middle ear ventilating tubes, straightening of the nasal septum or decreasing turbinate size, and sinus surgery.

A patient's history and physical exam yields the presumptive diagnosis of allergy. Initial treatment is maximal medical therapy. If this fails, patients undergo allergen confirmation tests or the determination of the offending foods. Levels of sensitivities to specific offending allergens are measured by a combination of prick testing, skin endpoint titration, and under certain circumstances RAST testing. This quantification enables a rapid escalation of immunotherapy to the effective antigen doses.

Treatment of allergies includes avoidance, pharmacotherapy, immunotherapy, and dietary modification. Unfortunately, avoiding most allergens is often difficult and by itself may not be effective. Antihistamines, decongestants, prescription nasal spray, mast cell stabilizers and leukotriene inhibitors can often control allergy symptoms, but may also produce unwanted side effects. If avoidance and medications are unsuccessful, immunotherapy can alter the body's overactive response. Over time, it may be possible to alter a person's excessive response to these allergens, both improving symptoms and decreasing the need for medications and allergen avoidance. With food and mold allergies, dietary avoidance along with a rotational diet and dietary supplements are effective in the treatment of these sensitivities.

The Otolaryngology Allergy and Sinus Center is located on the 17th floor of the Smith Tower in the Otolaryngology - Head and Neck Clinic. Testing and treatment of inhalant allergens, mold and food sensitivities are offered.

Consultation With an Otolaryngic Allergist May Help:

  • When allergy symptoms are not adequately controlled
  • When ENT symptoms are not responding to traditional therapies
  • When special diagnostic allergy skin testing or RAST testing is needed
  • When specialized treatment such as allergy shots are needed
  • Concerns of food or mold sensitivities