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Celebrating 80 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.

"Advance the comprehensive management of allergy and inflammatory disease in Otolaryngology-Head and Neck Surgery through training, education, and advocacy."


CY 2022 Physician Fee Schedule Proposed Rule Summary

On July 13, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician…

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Congress Considers Extension of Telehealth Flexibilities Post-Pandemic

The COVID-19 pandemic forced Congress and the Centers for Medicare & Medicaid Services (CMS) to…

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Changes To E/M Codes Beginning On January 1st

Effective January 1, 2021, the Centers for Medicare & Medicaid (CMS) finalized significant changes to…

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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

12/01/21: Research Grant Cycle
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02/22/22: Deadline For Call For Proposals
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04/01/22: Fellow Exam Application Deadline
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06/01/22: Research Grant Cycle
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06/26/22: Membership Application Deadline to be eligible for AAOA Member rate for the 2022 Basic Course

08/01/22: Scientific Abstract Submission Deadline

09/01/22: Membership Application Deadline to be voted in at the 2022 Annual Meeting


The live stream of the 2021 AAOA Annual Meeting concluded on October 21st, but you can still register and earn CME/MOC credits. 4 hours of Pre-Work On-Demand content will be accessible until November 15, 2021. If you missed a lecture during our live-streamed content, do not worry. Most of the lectures will be available within the next week until November 15, 2021. Learn More


Available Now

IFAR Impact Factor: 2.454


IFAR Featured Content: COVID-19 - Free Access
Endonasal instrumentation and aerosolization risk in the era of COVID‐19: simulation, literature review, and proposed mitigation strategies . Read More

Changes in Managing Practices

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

2022 AAOA Advanced Course
Hybrid! Santa Fe, NM & Virtually
January 13-15, 2022
Learn More and Register

2022 AAOA Basic Course
The Diptomat Beach Resort, Hollywood, FL
June 30-July 2, 2022

2022 AAOA Annual Meeting
Loews Philadelphia, PA
September 9-11, 2022

USP 797 Online Module
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News and Updates

DosedDaily: A Free Resource For Residents

The AAOA has partnered with DosedDaily to offer a free resource for residents to support…

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OSHA COVID-19 Vaccination & Testing Emergency Temporary Standard

On Friday, November 5, the Occupational Safety and Health Administration (OSHA) issued an interim final…

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College Allergy Symptoms Treatment Back to Shcool


AAOA Practice Resource Tool Kit

The American Academy of Otolaryngic Allergy (AAOA) Practice Resource Tool Kit is intended as a guide to help AAOA members integrate allergy into their otolaryngology practice and to continually improve on this integration as new information, regulations, and resources become available.

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AAOA has launched a Partner Resource Center to bring you partner resources that can assist your practice and patient care.

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Allergy to Cannabis

James Connolly, MD;  Alfred Sassler, MD – AAOA PPR Commitee

The past few years have seen increasing legalization of both medical and recreational marijuana across the United States. Concurrently, there has also been burgeoning use of cannabis-derived products such as hemp in the textile industry to produce fiber, yarn, and rope and hempseed for protein rich supplement therapy. As a result, many of us are seeing, or at least fielding questions about, marijuana allergy.

In 1996, the state of California legalized medical marijuana leading to many other states following suite. Now there are 36 states with access to medical marijuana. In 2012, the states of Colorado and Washington legalized recreational marijuana leading to many other states following their lead to presently 17 total states. Currently, only 3 states have no public cannabis access programs (Kansas, Nebraska, and Idaho). From a regulatory perspective, marijuana remains a Schedule 1 substance by federal law. However, United States Department of Justice is currently respecting the autonomy of each state the establish state-based enforcement efforts should the state legalize marijuana. There is also an increasing market for CBD oil to treat muscle and joint pain, as well as many other medical issues. With the increasing availability, the risk of allergies due to both accidental and prescribed exposures is also on the rise. Physicians treating allergy must keep in mind that their patients could be exposed to this antigen.

 LegalizedStates & Territories
Medical Marijuana36 statesAlaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Illinois, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, New Hampshire, New Jersey, New Mexico, New York, Nevada, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, West Virginia  
Recreational Marijuana18 statesAlaska, Arizona, California, Colorado, Connecticut, Illinois, Maine, Massachusetts, Michigan, Montana, Nevada, New Jersey, New Mexico, New York, Oregon, Vermont, Virginia, Washington and Washington, DC.

Cannabis sativa (marijuana/hemp) is an annual, dioecious, and anemophilous flowering plant that belongs to the Cannabaceae family and native to Central and South Asia but thrives in the southwest US. It pollenates during late summer to early fall. Its pollen is typically 23-28 mu in diameter, very buoyant allowing for wind distribution miles away from the male plant. Cannabis sensitization can occur from inhalation, smoking, touching, or ingestion marijuana, hemp, or cannabis products like CBD, CBN, and THC. Cannabis allergy can cause the usual allergic rhinitis, allergic conjunctiva, and asthma symptoms, but can occasionally cause anaphylaxis. This has been noted mostly in hempseed oral exposure. It has also been seen to have cross-reactivity with cypress tree and certain foods, like tomato, hazelnut, peach, apple, and gold kiwi.

Currently, cannabis allergy diagnosis relies heavily on history.  Confirmation testing can only be done by non-standardized technique of skin prick testing, using clinic made extract from leaves, buds, and flowers with seeds crushed and blended. Because extraction techniques and source material can vary between extract preparation each time, a standardized mass-produced extract is needed to improve accuracy. In vitro testing also has limitation because it requires assistance from research laboratories and currently the only federally approved Cannabis sources in the United States is located at the University of Mississippi.

Difficulty in creating a mass-produced extract or in vitro test arises from multiple potential cannabis major antigens: Delta-9-tetrahydrocannabinol (THC), nonspecific lipid transfer protein (Can s 3), Thaumatin-like protein, Riblose-1,5-biphosphonate carboxylase/oxygenase (RuBisCO), and/or Oxygen-evolving enhancer protein 2. Also, there are multiple potential cannabis minor antigens: profilins (panallergen), poly-galacturonase, adenosine triphosphate synthase (bovine), phosphoglycerate kinase (candida), glyceralderhyde-3-phosphate dehydrogenase kinase (wheat, fungi, and rambutan), luminal binding protein in root (hazel pollen and fungi), and carbohydrate determinants.

Treatment should be avoidance, since at this time there is no standardized extract to provide a reasonable safe way to offer desensitization with immunotherapy. Additionally, routine allergic rhinitis medications can be used for symptom relief, like topical and systemic steroids, topical and systemic antihistamines, and anti-leukotrienes.

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