Dr. Gibbs’ ENT Allergy Clinic Description

INTRODUCTION

Shortly after beginning my Otolaryngology practice in Arlington, I came to recognize an unmet need in the community for an ear, nose, and throat (ENT) physician who also has an advanced knowledge and interest in treating allergy. I noticed that so many of my patients upper respiratory disorders are caused by or worsened by allergy.  As allergy is part of any board certified Otolaryngologist’s training, I realized that many of my patients would get dramatically more benefit out of treating the root cause of their ear, sinus, throat, or breathing problems, rather than just addressing their immediate symptoms.  I became frustrated with attempts to get this need met by traditional allergists in the community, whose practices are crowded and who are not interested in treating patients whose allergies they consider to be “minor,” or whose symptoms don’t really fit into the traditional patterns.  I began seeking advanced training in allergy from the AAOA, a subspecialty society for allergy within ENT.

SCOPE OF PRACTICE

In 2002, I began performing inhalant allergy testing in my new office.  In January 2003, I enrolled my first immunotherapy patients.  Shortly thereafter, I began testing small children who required other surgical procedures (such as tubes) under general anesthesia, if their symptom pattern and history suggested allergy.  We currently test children as young as age 3 in the office.  Topical numbing gel makes this minimally traumatic for the young ones or for older patients with needle phobia.  In Summer 2003, I added food allergy testing and dietary counseling, with excellent results.  I then added sublingual drop immunotherapy as a way to treat patients who need but will not tolerate shots.  In 2006, I merged my practice into Central Park Ear Nose and Throat (CPENT) and became the medical director of our busy allergy department.

EDUCATION

The American Academy of Otolaryngic Allergy (AAOA) is the oldest subspecialty society within ENT, and was founded by the pioneers of the entire field of allergy.  The AAOA offers basic and advanced courses in otolaryngic allergy with the aim of complete, coordinated care for patients suffering from upper respiratory ENT disorders, skin allergies, and food allergies.  I completed their Fellowship program and passed the Fellow exam in September 2004.  More recently, I was involved with Pan American Allergy Society, a multi-Specialty nonprofit, whose mission is to educate practitioners who wish to add allergy to their practices.

HOW IS ENT ALLERGY DIFFERENT?

There are two major ways that ENT allergy treatment varies from traditional methods.  First, the testing is done for quantitative as well as qualitative information about inhalant sensitivities.  This allows a patient’s starting allergy shots to be mixed at the strongest dose possible for each antigen without compromising safety.  Because of this, patients usually experience symptom relief faster and only require one shot per week rather than two.  Second, patients with lower level skin reactions (and who usually are not offered shots by a general Allergist) can attain significant relief of their symptoms. Patients with much higher level skin reactions can also safely be treated with shots by customizing how quickly the strength of their serum is raised. These treatments can also be combined and coordinated with surgical treatment of obstructing nasal polyps, infections or other anatomic causes of upper respiratory disease.

The second major difference is the testing and treatment of non-Immunoglobulin E (IgE) mediated food sensitivities.  In contrast to anaphylactic shock type reactions, cyclic food reactions (or food intolerance) to commonly ingested foods can cause a broad range of vague symptoms in addition to typical upper respiratory congestion and eczema.  Recent scientific publications now point to Immunoglobulin G (IgG) immune complexes as being responsible for these conditions.  Rotation diets are very effective in managing these problems once the offending foods are identified.  I have also offered neutralization treatment by shot or drop to selected foods and to motivated patients. This appears to work by triggering endogenous prostaglandin release to block acute reactions. This is an old technique that has fallen out of favor in recent years because of the time and difficulty in interpreting the test results, which has become something of an art.

If you feel like you need this kind of personalized care, I can be reached at CentralParkENT.net in Dallas and Arlington at 817-261-9191.