Welcome

Celebrating Over 75 Years Of Service

The American Academy of Otolaryngic Allergy (AAOA) represents over 2,700 Board-certified otolaryngologists and health care providers. Otolaryngology, frequently referred to as Ear, Nose, and Throat (ENT), uniquely combines medical and surgical expertise to care for patients with a variety of conditions affecting the ears, nose, and throat, as well as commonly related conditions. AAOA members devote part of their practice to the diagnosis and treatment of allergic disease. The AAOA actively supports its membership through education, research, and advocacy in the care of allergic patients.

"Dedicated to enhancing knowledge and skill in the care of the allergic patient."

ADVOCACY UPDATES

Impact OF 2019 Physician Fee Schedule on Allergy and Sinus Services

Specialty Impact The conversion factor for 2019 will be $36.0391 and remains essentially flat.  The changes…

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Your AAOA at the AMA

I want to urge you to consider membership in the AMA because your membership in…

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Fall Advocacy Update: USP 797, E/M Documentation and Payment

Revisions to USP Chapter 797 Open for Comment Since the United States Pharmacopeia (USP) released…

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Changes in MACRA

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Before the close of 2017, all physicians must take action to avoid the 4 percent cut that will be assessed in 2019 for not participating in the new Quality Payment Program (QPP) authorized by the Medicare Access and CHIP Reauthorization Act (MACRA).  Read More

CMS Announces Changes in MACRA Implementation Timeline. The Centers for Medicare and Medicaid Services (CMS) announced major changes to the implementation of the Medicare Access and CHIP Re-authorization (MACRA).
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Upcoming Dates

02/15/19: Call For Proposals Deadline
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04/01/19: Fellow Exam Application Deadline
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06/01/19: Research Grant Cycle
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06/7/19: Membership Application Deadline to be eligible for AAOA Member rate for the 2019 Basic Course

07/31/19: Membership Application Deadline to be voted in at the 2019 Annual Meeting and to be eligible for AAOA Member Rate (FREE) for the 2019 Annual Meeting
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12/01/19: Research Grant Cycle
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EDUCATION

Call For Proposals

We want your input to help build a program that delivers on your expectations! Blending clinical and practice management content, the AAOA is now accepting proposals for a number of exciting new formats. Submit Proposal

IFAR

IFAR Impact Factor: 2.454

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Now Available

Changes in Managing Practices

Mission

Working together with AAOA staff, volunteer leadership and members will enable us to have a positive impact on our members’ practices.

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Live and Online CME

2019 Basic Course in Allergy & Immunology
June 27-29 | Minneapolis, MN
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2019 AAOA Annual Meeting
September 13-15 | New Orleans, LA
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2019 Advanced Course in Allergy & Immunology
December 12-14 | Austin, TX
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AAOA Clinical Insights
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PATIENT CORNER

History of Allergy Treatment

The history of modern allergy treatment dates back to the early decades of the twentieth century with the demonstration of decreased response to grass pollens following conjunctival challenge done by Noon and Freeman.

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News and Updates

Americans May be Over-diagnosing Themselves with Food Allergies

"Food allergy is a costly, potentially life-threatening health condition that can adversely affect patients’ well-being". A study…

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FDA Approval of First and Only Digital Inhaler with Built-In Sensors

The Food and Drug Administration (FDA) has approved ProAir Digihaler (albuterol sulfate) inhalation powder for…

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From the AAOA President, Matthew Ryan, MD

...the AAOA continues to be the organization that Otolaryngologists look to for up-to-date education and information on the…

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AAOA SCOPE OF KNOWLEDGE: ALLERGY AND ASTHMA

You can also download The Scope of Knowledge PDF.

I Epidemiology

A. Prevalence

  • i Regional
  • ii Change Over Time

B. Populations at risk

  • i Genetic associations
  • ii Environmental associations

C. Socioeconomic impact of disease

  • i Direct cost
  • ii Indirect costs
  • iii Quality of life

II Science of the Sites of Allergic Inflammation

A. Anatomy, Histology, physiology, pathophysiology of:

  • i Nose and paranasal sinuses
  • ii Pharynx
  • iii Ear/Eustachian Tubes
  • iv Larynx/Trachea
  • v Lungs
  • vi Eye
  • vii Skin
  • viii Gastrointestinal tract

B. Basic physiology, pathophysiology, and principles of:

  • i Mucociliary function
  • ii Smell and taste
  • iii Auditory/vestibular function
  • iv Voice
  • v Respiratory function
  • vi Deglutition
  • vii Ocular protection mechanisms
    • 1 Naso–lacrimal function
    • 2 Conjunctival function
  • viii GI function

III Basic Science

A. Basic components, concepts and applications pertinent to Allergy:

  • i Immunology
    • 1. Function
      • a. General aspects
        • i Recognition
        • ii Surveillance
        • iii Amplification
        • iv Memory
      • b. Triggers of the immune response
        • i Allergens, haptens, epitopes, parasites, macromolecules
      • c. Categories of response
        • i Innate
        • ii Adaptive
    • 2. Components
      • a. Inflammatory cells
        • i Macrophages (APC)
        • ii Lymphoid
          • 1 T–cells
          • 2 B–Cells
          • 3 Null cells
        • iii Granulocytes
          • 1 Mast Cells/basophils
          • 2 Eosinophils
          • 3 Neutrophils
          • 4 Platelets
      • b. Immunoglobulins
        • i G
        • ii A
        • iii M
        • iv D
        • v E
      • c. Inflammatory mediators
        • i Cytokines
        • ii Chemokines
        • iii Vasoactive amines
        • iv Leukotrienes
        • v Prostaglandins
        • vi Complement
  • ii Endocrinology
  • iii Neurology
  • iv Molecular cell biology
  • v Genetics

B. Physiology and pathophysiology

  • i Immunology
    • 1. Cellular communication
      • a. Direct contact
        • i Antigen specific
      • b. Cytokine/Chemokine mediated
        • i Non-antigen specific
    • 2. Inflammatory pathways
      • a. Cellular
        • i Microphage
        • ii Granulocyte
          • 1 Mast Cell/Basophils
          • 2 Eosinophil
      • b Non-cellular
        • i Complement
        • ii Arachadonic Acid cascade
        • iii Other
    • 3. Immune sensitization
      • a Memory
    • 4. Hypersensitivity (Gel and Coombs)
      • a I
      • b II
      • c III
      • d IV
      • e V
      • f VI
  • ii Allergic response (Type I)
    • 1 Allergy sensitization
      • a Antigen processing
      • b T-cell
      • c B-cell
      • d IgE
      • e Mast cell
    • 2 Subsequent exposure—trigger
      • a Mast Cell
        • i Antigen crosslinking
        • ii Degranulation
          • 1 Preformed mediators
          • 2 Newly synthesized mediators
          • 3 Cytokines
      • b Early phase response
      • c Late phase response
        • i Cellular Components
      • d Priming
  • iii Microbiology
    • 1 Parasitology
    • 2 Bacteriology
    • 3 Virology
    • 4 Mycology
  • iv Endocrinology
  • v Neurology
  • vi Molecular cell biology
  • vii Genetics
  • viii Nutrition

IV Diseases, Disorders, and Conditions

A. Differential diagnosis of inflammatory disease:

  • i Nose/paranasal sinus
  • ii Otologic
  • iii Laryngopharyngeal
  • iv Tracheobronchial
  • v Thoracic/Pulmonary
  • vi Gastrointestinal
  • vii Ocular
  • viii Cutaneous

B. Immunologic disorders

  • i. Allergic diseases
    • 1. Allergic Rhinitis
    • 2. Allergic conjunctivitis
    • 3. Otologic disease
      • a. Otitis media
      • b. Meniere’s
      • c. Otitis externa
      • d. Eustachian tube dysfunction
    • 4. Asthma
    • 5 Dermatitis
      • a. Eczema
      • b. Contact
      • c. Urticaria/Angioedema
    • 6. Allergic laryngitis
    • 7. Gastrointestinal
      • a. Eosinophilic esophagitis
  • ii Co-morbid conditions impacted by allergy
    • 1. Rhinosinusitiss
    • 2. Otitis media
    • 3. Eustachian tube dysfunction
    • 4. Disordered sleep
    • 5. Laryngeal/pharyngeal/esophageal disorders
      • a. GERD
    • 6. Asthma
  • iii Immunodeficiency
  • iv Autoimmune diseases

V Diagnostics and Assessment Procedures

A. History

  • i Symptoms
    • 1. Onset, duration, severity
    • 2. Triggers
    • 3. Exacerbating or ameliorating factors
  • ii Exposures
    • 1. Temporal relationships
      • a. Intermittent
      • b. Persistent
    • 2. Identifiable antigen
      • a. Aeroantigens (Inhalants)
      • b. Ingestants
      • c. Contactants
      • d. Injectants
  • iii Co-morbid conditions
    • 1. Rhinosinusitiss
    • 2. Otitis media
    • 3. Eustachian tube dysfunction
    • 4. Disordered sleep
    • 5. Laryngeal/pharyngeal/esophageal disorders
      • a. GERD
    • 6. Asthma
    • 7. Ocular
  • iv Family/childhood history

B. Physical examination

  • i Face
  • ii Ears
  • iii Nose/Paranasal sinues
  • iv Oro/Nasopharynx
  • v Laryngotracheal
  • vi Pulmonary
  • vii Skin

C. Adjunctive testing: Indications, limitations, and normal and pathologic findings:

  • i Ears
    • 1. Audiovestibular testing
  • ii Nose
    • 1. Acoustic rhinometry/rhinomanometry
    • 2. Nasal cytology/biopsy
    • 3. Nasal/paranasal sinus culture
    • 4. Nasal endoscopy
    • 5. Olfactory testing
    • 6. Radiologic testing
  • iii Larynx
    • 1. Laryngoscopy
  • iv Pulmonary
    • 1. Pulmonary function testing
    • 2. Radiologic testing
  • v Sleep
    • 1. Polysomnography

D. Allergy testing:

    • i Antigen selection
      • 1. Antigen characteristics
        • a. Aeroallergen physical characteristics
        • b. Biologic activity/potency
        • c. Antigen cross reactivity
        • d. Antigen extraction/standardization
      • 2. Aeroallergen distribution
        • a. Principles of distribution
        • b. Local and Regional differences
      • ii Aeroallergen tests
        • 1. Expanded specific allergen testing
          • a. In vivo
            • i Principles of in vivo testing
              • 1. Pathophysiology of the skin whealing response
                • a. Immediate response
                • b. Delayed response
              • 2. Factors that affect the skin whealing response
            • ii Specific methodologies
              • 1. Percutaneous (Prick) testing
                • a. Single percutaneous (prick) testing
                • b. Multi percutaneous (prick) testing
              • 2. Intradermal testing
                • a. Single intradermal testing
                • b. Intradermal dilutional testing
              • 3. Blended techniques of in vivo testing
              • 4. Scratch testing (mentioned only for historical purposes)
              • 5. Provocation
          • b. In vitro
            • i Principles of in vitro testing
            • ii Methodologies
    • 2. Principles of the allergen screen
      • iii Ingestants (Food Allergy)
        • 1. History
          • a. Food diary
          • b. Anaphylaxis
        • 2. Testing
      • iv Injectants
      • v Contactants
        • 1. Contact tests (patch)

E. Immunologic Evaluation (including rheumatologic)

      • i Humoral
      • ii Cellular

VI Allergy Treatment

A. Environmental control
B. Pharmacotherapy/pharmacology

      • i Antihistamines
      • ii Decongestants
      • iii Mast cell stabilizers
      • iv Mucolytics
      • v Leukotriene modifiers
      • vi Corticosteroids

C. Dietary control

D. Immunotherapy

    • i. Desensitization
      • 1. Route of delivery
        • a. Subcutaneous
        • b. Mucosal (e.g., sublingual)
      • 2. Mechanism of action/li>
      • 3. Indications/contraindications
      • 4. Antigen dosing
        • a. Starting dose
        • b. Escalation
        • c. Maintenance
        • d Withdrawal
      • 5. Mixing of treatment vial
      • 6. Duration of therapy
      • 7. Outcomes of immunotherapy
    • ii Monoclonal antibody

VII Allergy Emergencies


A. Epidemiology

  • i Risk factors
  • ii Recognition
  • iii Differential diagnosis

B. Management

  • i High-risk population recognition
  • ii Preparation
  • iii Prevention
  • iii Intervention
scope

Register For Live Classes

2017 Advanced Course in Allergy & Immunology
December 6-9 | Vail, CO.
Learn more and Register

2018 Interactive Allergy & Rhinology Course
February 22-24 | Dallas, TX
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2018 Basic Course in Allergy & Immunology
July 5-7 | Hollywood, FL
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2018 AAOA Annual Meeting
September 14-16 | Philadelphia, PA
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Spotlight/News

Recent Blog Articles

Americans May be Over-diagnosing Themselves with Food Allergies

"Food allergy is a costly, potentially life-threatening health condition that can…

read more

FDA Approval of First and Only Digital Inhaler with Built-In Sensors

The Food and Drug Administration (FDA) has approved ProAir…

read more

From the AAOA President, Matthew Ryan, MD

...the AAOA continues to be the organization that Otolaryngologists look to…

read more

* Adapted from Marple, BF, et al. “American Academy of Otolaryngic Allergy CME Report: Allergy, Scope of Knowledge.” Otolaryngology—Head and Neck Surgery, 136(1): 8-10, 2007 Jan