Allergy, Nose & Sinus
Allergy Testing & Treatment
Nasal Congestion
Sinus Infections
Nosebleeds
Welcome to the Allergy Services at Virginia Ear, Nose and Throat. Under the direction of Dr. E. Thomas Newbill, we specialize in allergies that affect the ear, nose and throat causing sinusitis, hearing loss and dizziness.
By incorporating allergy testing and treatment into our ENT practice, we are able to treat our patients much more effectively. If patients are experiencing trouble breathing through their nose, post nasal drainage, rhinitis or frequent sinus infection, we can explore whether allergies might be an underlying cause of these ailments.
Testing
Allergy tests are designed to gather the most specific information possible so your doctor can determine what you are allergic to and provide the best treatment. We can safely and efficiently test your skin (or sometimes your blood) using tiny amounts of commonly troublesome allergens. Skin testing is performed by the “prick” and “endpoint titration” methods, which are often more sensitive in detecting allergies and allow for desensitization to begin at a more efficient and safe level. When a patient’s skin is too sensitive or if the patient’s medications interfere with skin testing, a blood test will be done.
Treatment
Allergy Shots (Subcutaneous Immunotherapy)
Subcutaneous allergy immunotherapy is a form of treatment aimed at decreasing your sensitivity to substances called allergens. Allergens are the substances that trigger your allergy symptoms when you are exposed to them. They are identified by allergy testing. Allergen immunotherapy involves injecting increasing amounts of an allergen into a patient over a 3 to 5 year period. Allergen immunotherapy can lead to the long lasting relief of allergy symptoms after treatment is stopped.
Sublingual (under the tongue) Immunotherapy
Sublingual immunotherapy (SLIT) is a method of allergy treatment that uses a solution of allergens which is administered under the tongue, by the patient in his/her own home. Just as in subcutaneous immunotherapy (SCIT), SLIT is used to reduce the patient's underlying allergic sensitivities.
SLIT is taken in drop form and is a solution which is specific to the patient's sensitivities to allergens as determined by skin or blood testing. It interacts with the immune system to decrease allergic symptoms and reduce the need for medications.
The use of SLIT has been more routinely available in Europe than in the United States and is still considered experimental here and therefore not covered by health insurance at this time. However, it is currently being studied by multiple Allergy Societies in the U.S.
SLIT is noted to be a safer alternative to allergy injections. There have been no life threatening reactions recorded with this type of immunotherapy making it safe to use at home. Within six to eight months patients usually experience some symptom relief.
Treatment may extend from 3-5 years. Retesting at the end of this period is often done to determine if any sensitivities persist. Symptom resolution may last 3-5 years or longer after stopping immunotherapy.
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NASAL CONGESTION
Have you lost your sense of smell? Do you constantly breath through your mouth? Anything that causes increased swelling within the nose can cause nasal congestion. Allergies and viral illnesses are the most common culprits, although there are a myriad of disorders and medicines that will result in nasal congestion. In addition, various anatomic deformities, such as a deviated nasal septum, can obstruct airflow through the nasal passages
Chronic nasal congestion can be a frustrating problem that significantly interferes with one's quality of life. When standard medical treatments fail, there may be surgical options that will correct the underlying problem and restore airflow through the nasal passages. The physicians at Virginia Ear, Nose, & Throat Associates can thoroughly evaluate the nasal airway to correct the underlying problem and restore your nasal breathing.
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SINUS INFECTIONS
Nasal congestion, yellowish or greenish nasal drainage, facial pressure and pain, and chronic post nasal drainage-- these are all signs that you may have a sinus infection. Sinus infections typically are caused by a prior upper respiratory infection. However, any disorder that causes inflammation of the nasal passages, such as allergies, may predispose you to a sinus infection. Inflammatory nasal polyps, which result from chronic inflammation of the nasal passages, can also block nasal breathing and cause sinus drainage, resulting in symptoms of chronic sinusitis.
When standard medical therapy fails to relieve symptoms, it may be time to consult the physicians at Virginia Ear, Nose, and Throat Associates. After a complete examination, using advanced fiberoptic tools to clarify the cause of your chronic symptoms, our physicians can recommend the best treatment options for you. This may include aggressive medical therapy, allergy testing (possibly followed by immunotherapy if indicated), or surgical intervention. Our physicians are trained in endoscopic sinus surgery, which is the gold standard for establishing permanent drainage pathways for the sinus cavities to relieve the symptoms of persistent sinusitis.
Pre- and post-operative instructions
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NOSEBLEEDS
Unpredictable and always inconvenient, nosebleeds can sometimes result in serious blood loss. Generally, most episodes are caused from drying out of the nasal mucosa (lining of the nasal cavity). Nosebleeds usually occur in clusters, and are worsened by blood thinning medicines (including aspirin) and high blood pressure.
Most nosebleeds will resolve with preventative measures and time. Rarely, nosebleeds can be the first signs of a cancer in the nasal cavity. Any recurrent nosebleeds should be evaluated by a physician to rule out any serious cause of the bleeding as well as to prevent recurrence. Sometimes, an in-office cauterization of the offending blood vessels can stop the recurrent nosebleeds.
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