Allergy testing and immunotherapy in an academic otolaryngology practice: a 20-year review.
OBJECTIVE
Allergic disease plays a central role in the clinical practice of otolaryngology. The purpose of this study was to review the 20-year experience of an allergy clinic integrated within an otolaryngology practice at a major academic institution.


METHODS
We performed a retrospective database review of over 3300 otolaryngology patients referred for allergy skin testing between 1979 and 1999.


RESULTS
Approximately 80% of patients referred for allergy testing in our clinic had positive test results, of which 75.7% went on to undergo desensitization. The most common allergen was house dust, with allergies to mites, ragweed, and grass also prevalent. Among current allergy immunotherapy patients, 30.8% have undergone nasal septal, turbinate, and/or endoscopic sinus procedures in addition to allergy management. Nasal obstruction was the symptom most frequently persistent despite immunotherapy and the one most frequently reported to be improved by surgery.


CONCLUSIONS
The otolaryngologist-head and neck surgeon is uniquely qualified to perform comprehensive medical and surgical management for patients with complex disease processes involving a component of allergy. We believe that an integrated approach to allergy within an otolaryngology practice optimizes the treatment of such patients.
Division of Otolaryngology-Head and Neck Surgery, The University of North Carolina School of Medicine, Chapel Hill 27599-7070, USA.
A P
AP
Lane
H S
HS
Pine
H C
HC
Pillsbury
D000328:Adult; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D007167:Immunotherapy / Q000379:methods; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology / Q000601:surgery; D010036:Otolaryngology / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000601:surgery; D012882:Skin Tests / Q000379:methods; D011795:Surveys and Questionnaires; D016896:Treatment Outcome