Allergic Rhinitis: Immunology vs. ENT Treatment Approaches

Allergic rhinitis

Can I also see the immunology department? May I ask if your treatment methods in immunology involve regular appointments for medication management? What is the difference between immunology and otolaryngology?

bu, 40~49 year old female. Ask Date: 2024/04/06

Dr. Gao Jiankai reply Internal Medicine

Hello, thank you for your question.
Personally, I believe the differences between our department and the otolaryngology department are as follows: 1.
We primarily focus on medication, while otolaryngologists can use endoscopy to observe changes in the nasal cavity, throat, and ears, and can also perform local treatments.
2.
For stubborn cases, we arrange further blood tests and consult with the otolaryngology department for evaluation to rule out the possibility of immune diseases associated with rhinitis.
If there is a possibility of immune disease associated with rhinitis, we will intensify medication management and, if necessary, add immunomodulatory drugs to achieve the best treatment outcomes.
3.
The otolaryngology department may perform surgery when necessary, while the immunology department does not.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, cares about you.

Reply Date: 2024/04/06

More Info

Allergic rhinitis is a common condition characterized by an allergic response to airborne allergens, such as pollen, dust mites, mold, and pet dander. The symptoms typically include sneezing, nasal congestion, runny nose, and itchy eyes. Understanding the treatment approaches from both immunology and ENT (ear, nose, and throat) specialists can help patients make informed decisions about their care.

Immunology Treatment Approaches:
Immunologists focus on the underlying immune system response to allergens. Their treatment strategies often include:
1. Allergen Immunotherapy: This is a long-term treatment that involves gradually exposing the patient to increasing amounts of the allergen, with the goal of desensitizing the immune system. This can be done through subcutaneous injections (allergy shots) or sublingual tablets. Immunotherapy can significantly reduce symptoms and the need for medications over time.

2. Medication Management: Immunologists may prescribe antihistamines, corticosteroids, or leukotriene receptor antagonists to manage symptoms. They may also recommend biologic therapies for patients with severe allergic rhinitis that is not controlled by standard medications.

3. Allergy Testing: Immunologists often perform skin prick tests or specific IgE blood tests to identify the specific allergens causing the symptoms. This information is crucial for developing a personalized treatment plan.

ENT Treatment Approaches:
ENT specialists focus on the anatomical and physiological aspects of the nasal passages and sinuses. Their treatment strategies may include:
1. Medical Management: Similar to immunologists, ENT doctors prescribe antihistamines, nasal corticosteroids, and decongestants to alleviate symptoms. They may also recommend saline nasal sprays to help keep the nasal passages moist.

2. Surgical Interventions: In cases where allergic rhinitis leads to complications such as chronic sinusitis or nasal polyps, ENT specialists may recommend surgical procedures. These can include endoscopic sinus surgery to remove blockages or correct structural issues in the nasal passages.

3. Management of Comorbid Conditions: ENT specialists are also trained to manage related conditions, such as sinus infections or ear problems that may arise from allergic rhinitis.

Differences Between Immunology and ENT Approaches:
The primary difference between the two specialties lies in their focus and treatment philosophy. Immunologists concentrate on the immune response and long-term management through desensitization, while ENT specialists address the physical manifestations of allergic rhinitis and its complications.
Patients may choose to see an immunologist for a comprehensive evaluation of their allergies and to explore immunotherapy options, especially if they have persistent symptoms despite standard treatments. On the other hand, if a patient experiences significant nasal obstruction, sinus infections, or other ENT-related issues, they may benefit from an ENT specialist's expertise.

Consultation and Ongoing Care:
In many cases, patients may benefit from a collaborative approach, where both an immunologist and an ENT specialist work together to provide comprehensive care. Regular follow-up appointments are essential for monitoring symptoms, adjusting treatment plans, and ensuring optimal management of allergic rhinitis.

In conclusion, both immunology and ENT specialists play vital roles in managing allergic rhinitis, but their approaches differ significantly. Understanding these differences can help patients navigate their treatment options and choose the best path for their individual needs. If you have persistent symptoms or complications, it is advisable to consult with both specialists to develop a comprehensive management plan tailored to your specific situation.

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