What is Otolaryngic Allergy?
Allergy is a very important cause of discomfort in the ears, nose, and throat. The congestion and inflammation that comes from the allergic reactions can contribute to chronic or recurring infections and nasal and sinus polyp formation.
Allergies In ENT
Allergies can solely or partially be responsible for many ear, nose, throat and lung problems, including:
- hearing loss
- nasal airway obstruction
- post-nasal drip
- ocular problems
- chronic laryngopharyngitis (throat clearing/choking) and voice disorders with weakness and hoarseness
Types of Allergy
- People can be allergic to inhalants, foods, or chemicals.
- Inhalant allergies can be seasonal and/or perennial.
- Food allergies are of 2 kinds -anaphylactic (IgE) type with immediate onset of symptoms (hives, tongue swelling, and airway compromise) or cyclic (IgG) type with delayed onset of congestive symptoms.
- Cyclic food allergies can affect any target organ and tend to worsen over time with repeated exposures.
Low Metabolism Aggravates Allergy
Low metabolism (especially low T3 hypothyroidism) will aggravate and cause allergic conditions. This is poorly understood by most ENT specialists, allergists and endocrinologists. Low metabolism should always be considered when patients complain of hives, urticaria, and eczema! The problem should be corrected prior to allergy testing.
Intradermal Allergy Testing for Diagnosis
Dr. Levine performs intradermal allergy testing for both inhalant and cyclic food allergies on adults and children. This is the “gold standard” and most sensitive testing method. Only through intradermal skin testing, can you determine both acute and delayed allergic reactions.
Mold (fungus) Allergy
One of the latest improvements in allergy testing and treatment comes in the area of mold (fungus) testing. Because molds can cause delayed reactions and may be negative at ten minutes after the testing injection is given, we measure the allergic reactions at 10 minutes, 24 hours, and 48 hours in order to take into account these important and often missed delayed reactions. This greatly improves accuracy in both diagnosis and treatment since the delayed reactions are then included in treatment serum. Molds are an important source of allergies especially in river valleys (Hudson River Valley) where moisture is high contributing to mold growth, exposure, and allergic sensitization.
Rast testing, prick testing, and standard intradermal testing cannot accurately diagnose and treat mold allergies. We now test for twenty different molds.
Cyclic Food Allergy
Cyclic food allergies can also be a source of congestion in different target organs. They can be difficult to figure out because the reactions may also be delayed in onset by hours. By that time new foods may already have been ingested confusing the picture.
Other Food Allergies
The other food allergy treatments consist of minimizing or eliminating that food. Anaphylactic or immediate type food allergies is diagnosed by history, can be verified by Rast testing, and is treated acutely with epinephrine and/or steroids, antihistamines, and long term by avoidance.
Skin Endpoint Titration
Testing for cyclic food allergies is done by a special type of Intradermal testing called Skin Endpoint Titration (SET). By performing SET testing we can determine the neutralizing dose (the highest negative reaction) for that particular food. This neutralizing dose may be given as part of the treatment for food allergies especially in cases where allergies exist to multiple common foods.
Standard Escalation Immunotherapy for Treatment
Standard Escalation Immunotherapy is provided by Dr. Levine’s expert office staff. These allergy shots dramatically reduce allergic reactions, especially when the shots include all of the offending allergens.