The quintessential how-to guide on treating allergies for day-to-day practice While encyclopedic tomes on the treatment of allergies have a place on the library shelves of otolaryngologists, Handbook of Otolaryngic Allergy provides a user-friendly office resource clinicians can consult on a daily basis. Written by Christine Franzese, Cecelia Damask, Sarah Wise, and Matthew Ryan, the book encompasses the basic science of allergies, essential knowledge, and how to perform each procedure. Part one starts with basic immunology and allergic rhinitis definition and classifications, followed by discussion.

• Handbook of Otolaryngic Allergy
• Title Page
• Copyright
• Dedication
• Contents
• Foreword
• Preface
• Acknowledgments
• Contributors
• Part 1: The Basics
  • 1 Basics of Immunology
    • 1.1 Introduction
    • 1.2 Hypersensitivity Reactions
    • 1.3 Adaptive Immunity
    • 1.4 Adaptive Immune Responses
    • 1.5 The Major Players
    • 1.6 Tolerance and Immune System Bias
    • 1.7 A Word on the Simplification of the Immune System
    • Bibliography
  • 2 Allergic Rhinitis: Definition and Classifications
    • 2.1 The Keys to Success
    • 2.2 The Definition
    • 2.3 The Not-So-Perfect Classification System
    • 2.4 Severity
    • Bibliography
  • 3 Sensitization versus Allergy
    • 3.1 A Most Interesting Conundrum
    • 3.2 Serious Stuff
    • 3.3 Mischief Management
    • 3.4 One Last Frustration...
    • Bibliography
  • 4 Unified Airway Concept
    • 4.1 What It Is
    • 4.2 How Might This Work?
    • 4.3 What About Postnasal Drip? Can That Cause Lung Inflammation?
    • 4.4 Why It Is Important
    • Bibliography
  • 5 Inhalant Allergens: Grasses
    • 5.1 When Summer Isn’t Something to Look Forward To
    • 5.2 Serious Stuff
      • 5.2.1 Quick Review… What Is an Antigen? And What Is an Allergen?
      • 5.2.2 Tell Me a Bit More About Allergens… Please?
      • 5.2.3 What Are Standardized and Nonstandardized Allergen Extracts?
      • 5.2.4 What Is Cross-Reactivity?
      • 5.2.5 What Are Thommen’s Postulates?
      • 5.2.6 What Exactly Is Pollen?
      • 5.2.7 What Types of Plants Produce Allergenic Pollens?
      • 5.2.8 What Are Some Highlights About Grass Allergens?
      • 5.2.9 When Do Grasses Pollinate?
      • 5.2.10 What Are Some Common Allergenic Grasses?
    • Bibliography
  • 6 Inhalant Allergens: Trees
    • 6.1 Springtime Tree Troubles
    • 6.2 Serious Stuff
      • 6.2.1 What Are the Common Types of Allergenic Trees in North America?
      • 6.2.2 When Do Trees Pollinate?
      • 6.2.3 What Are Some Common Allergenic Trees?
      • 6.2.4 Which Trees Have Major Allergens That Are Known?
      • 6.2.5 Which Trees Have Standard Allergen Extracts Available?
    • Bibliography
  • 7 Inhalant Allergens: Molds
    • 7.1 Spores Can Get You Down
    • 7.2 Serious Stuff
      • 7.2.1 What Do I Need to Know About Mold Allergy?
      • 7.2.2 What Are Some Common Allergenic Molds?
      • 7.2.3 Which Molds Have Major Allergens That Are Known?
      • 7.2.4 Which Molds Have Standard Allergen Extracts Available?
    • Bibliography
  • 8 Inhalant Allergens: Epidermals and Danders
    • 8.1 Dust and Danders
    • 8.2 Serious Stuff
      • 8.2.1 What Potential Allergens Do We Encounter Year-Round?
      • 8.2.2 Information About Dust Mites… Lay It On Me!
      • 8.2.3 What About Pet Dander?
      • 8.2.4 Which Epidermals and Danders Have Major Allergens That Are Known?
      • 8.2.5 Which Epidermals and Danders Have Standard Allergen Extracts Available?
    • Bibliography
  • 9 Inhalant Allergens: Weeds
    • 9.1 When Weeds Are the Worst
    • 9.2 Serious Stuff
      • 9.2.1 What Are the Common Types of Allergenic Weeds in North America?
      • 9.2.2 What About Minor Weed Families, or Locally Important Weeds?
      • 9.2.3 What Else Should I Know About Weeds… or Weed “Imposters”?
      • 9.2.4 When Do Weeds Pollinate?
      • 9.2.5 What Are Some Common Allergenic Weeds?
      • 9.2.6 Which Weeds Have Major Allergens That Are Known?
      • 9.2.7 Which Weeds Have Standard Allergen Extracts Available?
    • Bibliography
• Part 2: Diagnosis of Allergy
  • 10 History
    • 10.1 History of Present Illness
    • 10.2 Past Medical History
    • 10.3 Past Surgical History
    • 10.4 Medications
    • 10.5 Family/Social History
    • 10.6 Review of Systems
    • Bibliography
  • 11 Patient Surveys and Questionnaires
    • 11.1 To Use or Not to Use
    • 11.2 The Basics
    • 11.3 My Humble Suggestions
    • Bibliography
  • 12 Physical Examination
    • 12.1 Not All That Sniffles Is Allergic
    • 12.2 The Physical
    • Bibliography
  • 13 Differential Diagnosis
    • 13.1 The Mimics and Imposters
    • Bibliography
• Part 3: Testing Methods
  • 14 Conditions That Can Impact Skin Testing
    • 14.1 Setting the Stage for Success
    • 14.2 Medical Conditions
    • 14.3 Medications
    • 14.4 Author’s Experience
    • 14.5 A Special Word About Beta-Blockers
    • Bibliography
  • 15 Skin Testing: Prick
    • 15.1 Most Interesting Information
    • 15.2 Serious Stuff
      • 15.2.1 Who’s a Good Candidate for Skin Testing?
      • 15.2.2 What Does This Test Tell Me?
      • 15.2.3 How Long Does This Test Take? When Can I Read This Test?
      • 15.2.4 What Is a Positive Test? What Does It Tell Me?
      • 15.2.5 What Is a Negative Test? What Does It Tell Me?
      • 15.2.6 What’s This Negative Control and What’s a Wheal?
      • 15.2.7 And the Wheal?
      • 15.2.8 Do You Need a Positive and Negative Control? Why?
      • 15.2.9 What’s the Positive Control?
      • 15.2.10 What Antigens Do I Test for?
      • 15.2.11 Where Do I Test?
      • 15.2.12 No, I Mean, Where on the Patient Do I Place These Tests?
      • 15.2.13 Could Anaphylaxis Really Happen During Skin-Prick Testing?
      • 15.2.14 Tools of the Trade (What You’ll Need)
    • 15.3 Shocking Information (How To Actually Do This!)
    • 15.4 Single Prick Device Technique
      • 15.4.1 Step 1
      • 15.4.2 Step 2
      • 15.4.3 Step 3
      • 15.4.4 Step 4
      • 15.4.5 Step 5
      • 15.4.6 Step 6
      • 15.4.7 Step 7
    • 15.5 Multi-Prick Device Technique
      • 15.5.1 Step 1
      • 15.5.2 Step 2
      • 15.5.3 Step 3
      • 15.5.4 Step 4
      • 15.5.5 Step 5
      • 15.5.6 Step 6
      • 15.5.7 Step 7
    • Bibliography
  • 16 Skin Testing: Intradermal
    • 16.1 Getting into (not under) Someone’s skin
    • 16.2 Serious Stuff
    • 16.3 Tools of the Trade (What Are Needed)
    • 16.4 Shocking Information (How to Actually Do This!)
      • 16.4.1 Preparation of Dilutions for the Testing/Treatment Board
      • 16.4.2 Preparation of Controls
      • 16.4.3 Single Intradermal Testing Technique
      • 16.4.4 Intradermal Dilutional Testing Technique
    • Bibliography
  • 17 Skin Testing: Blended Techniques
    • 17.1 Most Interesting Information
    • 17.2 Serious Stuff
    • 17.3 Shocking Information (How to Actually Do This!)
      • 17.3.1 Modified Quantitative Testing Protocol
    • Bibliography
  • 18 Specific Immunoglobulin E Testing for Inhalant Allergy
    • 18.1 Getting Serious About Serum
    • 18.2 Technique for Measuring sIgE
      • 18.2.1 Step 1: Incubation
      • 18.2.2 Step 2: First rinse
      • 18.2.3 Step 3: Labeling
      • 18.2.4 Step 4: Second rinse
      • 18.2.5 Step 5: Measurement
    • 18.3 Comparisons Between IgE Testing and Skin Testing
    • 18.4 Sensitivity and Specificity
    • 18.5 Other Advantages and Disadvantages
    • 18.6 Interpretation of sIgE Testing
    • 18.7 Future of sIgE Testing
      • 18.7.1 “Component” Testing
    • Bibliography
• Part 4: Treatment
  • 19 Environmental Avoidance
    • 19.1 A Word About Avoidance
    • 19.2 Serious Stuff
      • 19.2.1 Do Dust Mite Environmental Control Measures Work?
      • 19.2.2 Little Johnny Has a Cat Allergy. He has to Get Rid of Fluffy the Cat. Right?
      • 19.2.3 Cockroaches. Disgusting! Can We Control Cockroaches to Alleviate Allergic Symptoms?
      • 19.2.4 It’s Spring Time and the Pollen Is Everywhere. There’s No Way to Control This, Is There?
    • Bibliography
  • 20 Pharmacotherapy: Decongestants
    • 20.1 A Word of Caution
    • 20.2 What Is This Class of Medication?
    • 20.3 What Symptoms Are Good for Treating?
    • 20.4 Examples of This Class
    • 20.5 Why and When to Use
    • 20.6 Risks and Side Effects
    • 20.7 A Special Word on Antihistamine–Decongestant Combinations (Oral, Ocular Preparations)
    • Bibliography
  • 21 Anticholinergics
    • 21.1 When the Nose Runs Like a Faucet
    • 21.2 What Is This Class of Medication?
    • 21.3 What Symptoms Are Good for Treating?
    • 21.4 Examples of This Class
    • 21.5 Why and When to Use
    • 21.6 Risks and Side Effects
    • Bibliography
  • 22 Antihistamines
    • 22.1 One of the Workhorses of Allergy Medications
    • 22.2 What is This Class of Medication?
    • 22.3 What Symptoms Are Good for Treating?
    • 22.4 Examples of This Class
    • 22.5 Why and When to Use
    • 22.6 Risks and Side Effects
    • 22.7 Ages for Use
    • Bibliography
  • 23 Corticosteroids
    • 23.1 Another Major Workhorse
    • 23.2 What Is This Class of Medication?
    • 23.3 What Symptoms Are Good for Treating?
    • 23.4 Examples of This Class
    • 23.5 Why and When to Use
    • 23.6 Risks and Side Effects
    • 23.7 A Word of Caution About Injectable Corticosteroid Preparations
    • 23.8 Age for FDA On-Label Use
    • Bibliography
  • 24 Leukotriene Receptor Antagonists
    • 24.1 Most Interesting Information
    • 24.2 Serious Stuff
      • 24.2.1 What Are Leukotrienes? (i.e. back to biochemistry class…)
      • 24.2.2 Now That the Science Is Over, Why Do We Care About Leukotrienes in Allergy?
      • 24.2.3 What Are Leukotriene Receptor Antagonists?
      • 24.2.4 For Completeness Sake… What Is a “Synthesis Inhibitor?”
      • 24.2.5 What Allergic Conditions Can Leukotriene Receptor Antagonists Treat?
      • 24.2.6 How Do Leukotriene Receptor Antagonists Compare to Other Allergic Rhinitis Medications?
      • 24.2.7 What Is the Best Way to Use Leukotriene Receptor Antagonists?
      • 24.2.8 Buyer (and Medical Provider) Beware! What Are the Adverse Effects of Leukotriene Receptor Antagonists?
    • Bibliography
  • 25 Mast Cell Stabilizers
    • 25.1 Preventing Degranulation
    • 25.2 Serious Stuff
      • 25.2.1 What Is Cromolyn?
      • 25.2.2 What Allergic Conditions Can Mast Cell Stabilizers Treat?
      • 25.2.3 What Is the Best Way to Use Cromolyn Products?
      • 25.2.4 What’s So Great About Mast Cell Stabilizers?
      • 25.2.5 What Is Not So Great About Mast Cell Stabilizers?
    • Bibliography
  • 26 Combination Therapies
    • 26.1 Working Together
    • 26.2 Serious Stuff
      • 26.2.1 What Are Combination Therapies?
      • 26.2.2 Lay It out for Me. Give Me the High Points. Just the Facts, Ma'am. What Do I Really Need to Know?
    • Bibliography
  • 27 Biologics
    • 27.1 Introduction to Biologics
    • 27.2 Immunoglobulin E
      • 27.2.1 Omalizumab
      • 27.2.2 Interleukin-5
      • 27.2.3 Mepolizumab
      • 27.2.4 Reslizumab
      • 27.2.5 Benralizumab
      • 27.2.6 Interleukin-4 and Interleukin-13
      • 27.2.7 Dupilumab
      • 27.2.8 Librikizumab and Tralokinumab
      • 27.2.9 Thymic Stromal Lymphopoietin
      • 27.2.10 Tezepelumab
    • 27.3 Interleukin-31
      • 27.3.1 Nemolizumab
      • 27.3.2 What Do We Still Not Know?
    • Bibliography
  • 28 Alternative Remedies
    • 28.1 The Mind Is a Powerful Thing
    • 28.2 Honey/Local Honey/Raw Honey
    • 28.3 Risks/Side Effects
    • 28.4 Acupuncture
    • 28.5 Risks/Side Effects
    • 28.6 Herbal Therapies
    • 28.7 Risks/Side Effects
    • Bibliography
  • 29 Immunotherapy: Subcutaneous Immunotherapy
    • 29.1 The Basics of Subcutaneous Immunotherapy
    • 29.2 To Endpoint or Not to Endpoint
    • 29.3 Can You Say That Again?
    • 29.4 A Few Words About Preservatives
    • 29.5 Recipe Examples
    • 29.6 Serious Stuff: Vial Mixing
    • 29.7 Tools of the Trade (What All Are Needed)
    • 29.8 Shocking Information (How to Actually Do This!)
    • 29.9 The Next Recipe
    • 29.10 Recipe Examples for Mixing the Next Patient Vial
    • 29.11 Shot Administration
    • 29.12 Injection Escalation Protocols
    • 29.13 How Much Concentration to Use? What’s Considered Therapeutic?
    • 29.14 What Is the Volume of the Maintenance Injection?
    • 29.15 How Long Does a Patient Stay on SCIT? When Do They Stop? Should They Be Retested?
    • Bibliography
  • 30 Immunotherapy: Sublingual Immunotherapy
    • 30.1 Desperately Seeking a Non-Shot Alternative
    • 30.2 Serious Stuff
      • 30.2.1 Why Immunotherapy? Why Sublingual Immunotherapy?
      • 30.2.2 How Does SLIT Work?
      • 30.2.3 What Evidence Do We Have for SLIT Efficacy?
      • 30.2.4 SLIT Is Safer Than SCIT. True or False?
      • 30.2.5 What Is the Best Dose of SLIT to Give to Patients?
      • 30.2.6 Now Let’s Get Practical. How to Do This?
      • 30.2.7 How to Mix an Aqueous SLIT Vial?
      • 30.2.8 How Long Do These Maintenance Vials Last? Do They Need to Be Refrigerated?
      • 30.2.9 What Don’t We Know About SLIT?
    • Bibliography
  • 31 Sublingual Tablets
    • 31.1 Looking for Unicorns
    • 31.2 Who Is a Candidate for Sublingual Immunotherapy Tablet?
    • 31.3 The Practical Applications of Tablets
    • 31.4 SLIT Tablets (Available in the United States)
      • 31.4.1 Timothy Grass
      • 31.4.2 Ragweed
      • 31.4.3 House Dust Mite
      • 31.4.4 Common to All SLIT Tablets
    • 31.5 Tablet Cannibalism and Bringing in New Patients to the Practice
    • Bibliography
  • 32 Oral Mucosal Immunotherapy
    • 32.1 Becoming Part of the Routine
    • 32.2 Allergy Toothpaste—Say What?
    • 32.3 A Word Before We Start
    • 32.4 Who Is a Candidate for OMIT?
    • 32.5 How to Mix Oral Mucosal Immunotherapy
    • 32.6 How to Use Oral Mucosal Immunotherapy
    • 32.7 A Word Before We End
    • Bibliography
  • 33 Treatment: Monosensitization Versus Polysensitization
    • 33.1 The Eternal Question
    • 33.2 Treating the Monosensitized/Monoallergic and the Paucisensitized/Pauciallergic Patient
    • 33.3 Treating the Polysensitized/Polyallergic Patient: Mono/Pauci Therapy
    • 33.4 Treating the Polysensitized/Polyallergic Patient: Polytherapy
    • 33.5 Financial Implications
    • Bibliography
• Part 5: Allergy Emergencies
  • 34 Anaphylaxis
    • 34.1 Keep Calm and Give Epinephrine
    • 34.2 An Ounce of Prevention
    • 34.3 Prepare for the Worst
    • 34.4 When Anaphylaxis Strikes
    • 34.5 A Word About Epinephrine
    • 34.6 Hope for the Best
    • Bibliography
  • 35 Other Urgencies and Emergencies
    • 35.1 A Horse with Stripes
    • 35.2 Local Reactions
    • 35.3 Vasovagal Reaction
    • 35.4 Asthma Exacerbation
    • 35.5 Isolated Urticaria
    • 35.6 Chest Pain/Hypoglycemia/Other Symptoms Not Related to Anaphylaxis
    • Bibliography
• Part 6: Associated Atopic Disorders
  • 36 Penicillin Allergy
    • 36.1 Fear and Labelling
    • 36.2 Serious Stuff
    • 36.3 History
    • 36.4 Diagnosis and Testing
    • 36.5 Shocking Information—How to Actually Do This!
    • Bibliography
  • 37 Asthma
    • 37.1 More Than Just Wheezing
    • 37.2 How Bad It Can Get
    • 37.3 Control
    • 37.4 The Undiagnosed
    • 37.5 The Future Understanding of Asthma
    • Bibliography
  • 38 Food Allergy
    • 38.1 Food Allergy in a Nutshell
    • 38.2 Definitions and Classification of Food Allergy
    • 38.3 Treatment
    • Bibliography
  • 39 Eosinophilic Esophagitis (EoE)
    • 39.1 Most Interesting Information
    • 39.2 What Do We Know?
    • 39.3 What Is Still Unknown at This Time?
    • 39.4 Prevalence
    • 39.5 Clinical Presentation
    • 39.6 Endoscopic Findings
    • 39.7 Management
    • Bibliography
  • 40 Atopic Dermatitis
    • 40.1 More than Skin Deep
    • 40.2 Skin Barrier Care and Repair Are Paramount
    • 40.3 Future of Atopic Dermatitis Treatment
    • Bibliography
• Part 7: Practice Makes Perfect
  • 41 Worksheets on Allergy Testing with Answers
  • 42 Worksheets on Vial Mixing/Preparation with Answers
• Part 8: Adding Allergy to Your Practice
  • 43 USP ˂797˃ and Compounding
    • 43.1 What Is USP Chapter ˂797˃?
    • 43.2 What Is Next Iteration of the USP Chapter ˂797˃ Draft?
    • 43.3 Who Does the Mixing?
    • 43.4 Where Does the Mixing Occur?
    • 43.5 What Is Aseptic Compounding Technique?
    • 43.6 How Is Aseptic Compounding Technique Measured?
    • 43.7 What Is Gloved Fingertip and Thumb Testing and Why Is That Needed or Being Added?
    • Bibliography
  • 44 Office Set-up
    • 44.1 Why Add Allergy to an Existing Practice?
    • 44.2 What Exactly Does It Mean to “Add Allergy” to the Office?
    • 44.3 Factors to Consider
    • 44.4 Preparing the Office
      • 44.4.1 Allergy Training
      • 44.4.2 Which Services to Offer
      • 44.4.3 Preparing Space for Allergy
    • 44.5 Necessary Equipment
      • 44.5.1 Refrigerator
      • 44.5.2 Patient Treatment Chair
      • 44.5.3 Sharps Containers
      • 44.5.4 Emergency Kit/Crash Cart
    • 44.6 Purchasing Supplies
      • 44.6.1 Testing and Treatment Boards
      • 44.6.2 Syringes
      • 44.6.3 Skin Prick Testing Devices
      • 44.6.4 Allergen Extracts
      • 44.6.5 Glass Vials, With or Without Diluent
      • 44.6.6 Diluent, Histamine, and Glycerin
      • 44.6.7 Other Supplies
    • 44.7 Documentation
    • Bibliography
  • 45 Patient Selection
    • 45.1 Putting the Pieces Together
    • 45.2 Serious Stuff
    • 45.3 Precautions to Consider
    • Bibliography
  • 46 Nurse Selection and Training
    • 46.1 Hiring Personnel
  • 47 Billing and Coding
    • 47.1 Most Important Information
    • 47.2 Billing and Coding
    • 47.3 Supervision Requirements
• Index