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Celebrating Over 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."

AAOA Member Benefits

  • Up to 60% discount for CME programs and free Annual Meeting. All AAOA’s CME programs meet ABOTOHNS Continuing Certification.
  • AAOA US ENT Affinity program, where AAOA members can gain savings on antigen, allergy supplies, and any of the other 5 service lines US ENT offers. For more email info@usentpartners.com.
  • Tools and resources to comply with US General Chapter 797 and practice management tools.
  • Advocacy support.
  • And much more! Learn More

PRACTICE MANAGEMENT CORNER

As part of our on-going member support, we are introducing a new website feature to help with common practice management challenges. We welcome your input with questions or challenges you would like to address. Read More

ADVOCACY UPDATES

Penicillin Allergy Verification and Evaluation (PAVE) Act

Penicillin Allergy Verification and Evaluation (PAVE) Act to be introduced by Rep. Bucshon. AAOA is one…

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CMS Released the Annual Medicare Physician Fee Schedule Proposed Rule

On July 10, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician…

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Latest on Federal Issues

This blog will feature weekly updates from our Socioeconomic Committee and Health Policy team to…

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Upcoming Dates

08/02/24: Scientific Abstract Submission Deadline
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12/01/24: Research Grant Cycle
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04/01/25: Fellow Exam Application Deadline
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06/01/25: Research Grant Cycle
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EDUCATION

AAOA Annual Meeting

Register for FREE* to attend the 2024 AAOA Annual Meeting in-person, in Las Vegas, or virtually!

*The 2024 AAOA Annual Meeting is FREE to all AAOA members in good standing

RESIDENTS

For information about Resident membership, opportunities, DosedDaily, research grants, and other resources. Learn More

IFAR

Available Now

aaoaf-ifar

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

2024 AAOA Annual Meeting - Hybrid
November 8-10, 2024
Four Seasons Hotel Las Vegas
Learn More and Register 

Coming Soon! New Explorers Course — Hybrid
90-days Access Feb 27 – May 27, 2025 
March 27-29, 2025 - Live
The Hythe, Vail, CO
Book Your Room

2025 AAOA Basic Course in Allergy & Immunology - Hybrid
90-days Access June 10 – Sep 15, 2025
July 10-12, 2025 - Live
The Chateaux Deer Valley, Park City, UT
Book Your Room

USP 797 Online Module
Learn More and Register

AAOA Educational Stacks
Available Now!

News and Updates

CEO Update, September 2024

“Life starts all over again when it gets crisp in the Fall”. F. Scott Fitzgerald…

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ABOHNS Practice Analysis Job Task Analysis Survey

On September 24 the ABOHNS initiated a Practice Analysis (Job Task Analysis) Survey. All ABOHNS…

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College Allergy Symptoms Treatment Back to Shcool

PRACTICE RESOURCES

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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PARTNER RESOURCE CENTER

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

Visit the New Center>

PATIENT CORNER

Gluten-Free or Not Gluten-Free?  That is the Question…

I never heard anything about gluten before 5 years ago, now you can’t swing a baguette without hearing about gluten. What gives?

Gluten is a naturally-occurring protein present in several cereal grains.  Wheat , Barley, and Rye are the principal gluten-containing grains.  The gluten molecule is made up of Glutenin and Gliadin.   Gliadin is rich in prolene and poorly degraded in the gut.

Coeliac Disease is the best-known  gluten sensitivity.  It is an auto-immune response to this protein that causes acute discomfort as well as long-term damage to the intestinal lining.  There does appear to be an increase in Coeliac Disease over the last several decades, though not to the degree proportionate with the media hype.

Also, better awareness and ability to establish diagnosis have increased numbers of identified case.

That said, much of the ado about gluten parallels the interest in low-carb/paleo diets touted as healthier and helpful for weight loss.

It seems like everyone I know is going gluten-free. Should I be gluten-free too?

This answer comes from the tautology department- Gluten is only a problem if it’s a problem…  The percentage of the population thought to have Coeliac Disease is thought to be slightly more than 1%. Meaning that about 99% of the population ain’t got it.

That said, there are 2 other reported problems with consumption of wheat and/or other gluten-containing grains.  The first is Wheat Allergy.  In true Wheat Allergy, patients have a true allergic (often anaphylactic!) response to Albumins and Globulins contained in wheat.  It is worth noting that these are not the proteins that constitute gluten.

While wheat allergy represents a true hypersensitivity to wheat, it does not represent a reaction to gluten itself in most cases.  There is another condition called Non-Coeliac Gluten Sensitivity in which patients suffer a variety of non-specific, but often quite serious symptoms surrounding the consumption of gluten-containing foods.

This condition is what is known as a “diagnosis of exclusion”, meaning that Coeliac Disease and Wheat Allergy must be ruled out first before arriving at this diagnosis.  There are no specific test that can be performed to establish this diagnosis.

How do I know if this is a thing (for me)?

One easy thing to do is to eliminate gluten-containing foods from the diet and see what happens.  Whatever the cause, it eliminating these foods is easy for a person to do and makes them feel better (for whatever reason!), it’s worth consideration.  That said, modern food is a majestic product of modern engineering that includes all sorts of additives that may affect digestion.  There also may be some risks to this strategy (see below).

If a person wants to investigate whether they have Coeliac Disease, this should be done under the direction of their physician.

There are blood tests that can be performed.  IgA Tissue Transglutaminase (tTG) is the best initial test for Coeliac Disease.  Small intestine biopsy is considered the “gold standard” confirmatory test.

Genetic testing may also be useful.  HLA-DQ2 is present in approximately 90% of patients with Coeliac Disease.  HLA-DQ8 is present in roughly 5% of Coeliac patients.

For Wheat Allergy, skin prick testing would be the initial screening method of choice.

While Skin prick testing is very specific for wheat allergy, some question the sensitivity of this test.  Because of this, it is often necessary to initiate confirmatory testing.  Food challenge is a valuable confirmatory test for wheat allergy.

Given the potential danger of wheat exposure in a sensitized individual, this should only be performed under strict guidance of a physician.

As mentioned above, NCGS is a diagnosis of exclusion. Once Wheat Allergy and Coeliac Disease have been ruled out, a formal food challenge would be the next appropriate step.  For this, the patient has already undertaken a strict gluten-free “washout” period.  The next step would be to re-introduce gluten and document reported symptoms.

The strongest support for this diagnosis would be provided by a double blind food challenge, although the logistics of this are complicated.  An open gluten challenge is also considered acceptable for diagnostic purposes.

Couldn’t hurt, might help, right?

Well, except that it can…  In the USA, wheat flour is enriched with several B vitamins (folic acid, niacin, riboflavin, and thiamine) and, in some cases, calcium.  There is some suggestion that elimination of enriched wheat from the diet may predispose towards deficiency of these vitamins.

While some fiber and protein is present in whole wheat flour, adherence to the other components of the food pyramid should provide adequate intake of these nutrients.  Daily supplementation with a multivitamin would adequately replace these and most other vitamin and trace mineral deficiencies.  Consultation with a dietician may be indicated to verify that all of an individual’s nutritional needs are being met.

With the many claims made about gluten, it is important to be able to separate the wheat from the chaff (so to speak…).

If concerned about these issues or other food related sensitivities, it may be worth consultation with your physician.

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