Provided by: Roger Friedman, MD (Allergist/Immunologist)

Oral Immunotherapy, also called OIT, has been a life-changing therapy for patients, parents and physicians. Food allergies have been dramatically increasing over the last 25 years and affect 8% of the population. Most concerning has been the severe food allergies, especially to peanuts and tree nuts.
One year ago, we began a program at Ohio ENT and Allergy Physicians for OIT.  Since that time, we have enrolled 50 patients, and seven of them are now graduates of the program.

Provided by: David Hauswirth, MD (Allergist / Immunologist)

Often we are asked to evaluate someone with ear problems and asked, “do allergies cause ear problems?” The simple answer is yes. The Eustachian tube drains the middle ear into the back of the nose. In someone suffering from allergies, the Eustachian tube can swell or not work correctly. This lack of function and drainage will cause fluid to build in the middle ear, leading to temporary hearing loss and sometimes ear infections.

Patients with allergies will often have ear symptoms. Sometimes the ears will itch, feel full, pop or have pressure. Manytimes clear fluid is found in the middle ear when someone has allergies. This fluid will often drain as allergies are treated. However, if allergies are not treated, this fluid can stay in the middle ear and become infected. Once someone develops an ear infection, the cause and the infection must both be treated.

Provided by: Michael Goodman, MD (Allergist/Immunologist)

Sinusitis is a common problem seen in both ENT and allergy offices. Sinusitis is inflammation of the sinuses, air-filled cavities located in facial bones around the nose. Sinusitis is often due to an infection in these cavities. It can feel like a bad cold with facial pain, runny nose (rhinorrhea), headache, nasal congestion, and a sore throat. While the common cold is a viral infection, sinus infections are often bacterial and treated with antibiotics (antibiotics are not of help in the treatment of viruses).

Many conditions can contribute to the onset of a sinus infection. Many of them involve blockage of the natural drainage of the sinuses and the nose. When this drainage is blocked, bacteria present in the nose have an easier time replicating and increasing their numbers to the point that a sinus infection occurs. Inflammation that starts as a cold can increase the chances of a sinus infection starting. Allergic rhinitis (allergic inflammation of the nose) can also create inflammation that results in blockage and increase the likelihood that a bacterial infection will take hold and cause sinusitis.

Provided by: Roger Friedman, MD (Allergist/Immunologist)

This is a unique and challenging time for all of us! A question I often hear is, “Could this be COVID-19 or is it my allergies?” First of all, allergies, asthma and COVID-19 do have some similar symptoms, including a runny nose, sneezing and cough. Allergies will often also cause itchy nose, eyes and throat; COVID-19 does not. In addition, most allergy sufferers know they are allergic to the tree pollen that is currently out, so their symptoms will be worse after being outside.

With COVID-19, patients will often have a fever which doesn’t occur with allergies. The sudden loss of the senses of smell and taste is a newly discovered symptom of COVID-19.

Provided By: Evan Tobin, MD

Everyone deals with a sensation of a stuffy or blocked nose from time to time. Usually we know why this is happening—we may have a cold, springtime allergies are here, etc. We are designed to breathe through the nose.  It is uncomfortable to us to feel a sensation of congestion. This can also affect our sense of smell and our ability to appreciate flavors. Chronic mouth breathing over a long period of time can lead to dental problems. And for children it can lead to misalignment of the teeth and they can develop bite problems. Nasal congestion can contribute to snoring and sleep apnea as well.

Sometimes nasal blockage or congestion becomes more recurrent or chronic or its cause is unknown. This will be a brief discussion of a variety of things that can cause nasal congestion, how they are diagnosed and treated and which may be serious enough to require a trip to your PCP or even a specialist.

Provided by: Roger Friedman, MD (Allergist)

Hay Fever Season is Here – What Can You Do?

Ragweed pollen is the cause of allergic rhinitis that begins in early August and lasts until it frosts a few times, which kills the weed. Ragweed pollen is everywhere – especially in the woods, fields and in the center strip of highways. The pollen counts can be over a thousand, especially during the heavy pollination times (early in the morning and late afternoons).

The first strategy is avoidance of the pollen. You can do this by keeping the windows in the house closed and using the AC. When you exercise try to avoid early am and dusk.

We use a variety of medications to treat hay fever, including antihistamines, nasal steroids, nasal antihistamines and Singulair®. Each patient responds to these differently, so if one fails another may succeed. If these work then no further evaluation may be needed, but if patients continue to suffer it’s time to see your Allergist.

Provided by Mehmet Basaran, MD (Allergist)

Western medicine that we practice in the United States is currently based on observation, testing, diagnosis and treatment. Observation includes physical examination and a thorough history. Testing is selected based on the patient’s history and suspected causes of the patient’s problems. At Ohio ENT and Allergy Physicians, the board certified Allergist uses testing techniques and laboratory techniques that are proven to be safe and relevant, based on scientific study and published in peer-reviewed journals. Then the results, correlated with observations and physical examination, and plans of therapy are discussed with the patient.

Allergy prick skin testing is still the most physiologic form of testing for allergy. Blood tests such as RAST and Immunocap testing are helpful in that they determine if there is sensitization to a particular allergen. It must be correlated with physical and clinical symptoms. Another proven method of testing for allergies is a challenge. This can be an environmental challenge and done in research settings where patients are exposed to known allergens by breathing it in, or a food challenge when patients ingest a small increasing amounts of the food in question.

Provided by Carolyn Gigliotti, Au.D.


Provided by Ashish Shah, MD

Nosebleeds (epistaxis) are one of the most common issues seen by Ear, Nose and Throat doctors. Patients with recurrent nosebleeds have a strong desire to rid themselves of this issue, given that nosebleeds often occur at inopportune times and places and ruin clothing! The main risk factor is dryness, but the increasing use of blood thinning medication is also a strong risk factor. High blood pressure, allergic rhinitis, chronic sinus disease, nasal trauma and bleeding disorders are other possible factors.

Most commonly, nosebleeds arise from small pinpoint areas of mucous membrane blood vessel disruption, even in the case of a gushing nosebleed. You would be surprised how much bleeding can occur from a blood vessel the size of a pencil tip! You should be reassured that it is very rare that nosebleeds – even when severe – would represent any concerning intranasal process. The vast majority of nosebleeds occur on the septum, the cartilage structure that divides the nose into two passages. Nosebleeds in the back of the nose which drain primarily down to the throat are more commonly related to high blood pressure. Some of these nosebleeds can be severe and more difficult to manage.

Provided by John Eickholt, MD

Home sleep apnea tests have become increasingly popular over the past several years. Testing for obstructive sleep apnea in the home can be more convenient and can save money. Unfortunately, home sleep testing is not for everybody and is not for every situation. Home sleep tests are appropriate in selected patients when moderate to severe obstructive sleep apnea is suspected and there are no other medical or sleep issues that might preclude their accuracy or safety. Information obtained from home testing tends to be less reliable than traditional sleep tests. Further, they are not as thorough as tests performed in a sleep lab. They are prone to false negatives and cannot tell you that you do not have sleep apnea. Additionally, these tests are sometimes provided by companies not certified in sleep medicine or the interpretations are generated by physicians who are not part of our local community.

Provided by Darryl Willett, MD

At OhioENT and Allergy Physicians, we see a tremendous number of referrals for thyroid nodules. Many times, the patients are told by their primary care physician that they need a Fine Needle Aspiration Biopsy of their thyroid nodules to determine if they are cancerous or not. We do perform many Fine Needle Biopsies the same day as their initial appointment, but oftentimes, we may defer the biopsy or bypass the biopsy and go straight to surgery. This may confuse the patients who simply assumed that it was mandatory to see the surgeon for a Fine Needle Biopsy.

I would like to educate the public on the rationale that the thyroid surgeon goes through in their mind to determine what the best protocol might be for each patients’ needs. Understanding that in general, only 5% of all thyroid nodules are malignant may put the patient at ease, but there are certain nodule characteristics that may be more alarming and raise the index of suspicion for cancer than others.

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