At Quail Creek ENT we want you to have the best quality of life possible and that means quality of hearing and otolaryngological health. There is no disorder of the ear, nose OR throat in children or adults that we are not prepared to address. 

Source: By Adam Felman

Allergies are hypersensitive responses from the immune system to substances that either enter or come into contact with the body.

These substances commonly include materials such as pet dander, pollen, or bee venom. Anything can be an allergen if the immune system has an adverse reaction.

A substance that causes an allergic reaction is called an allergen. Allergens can be found in food, drinks, or the environment.

Many allergens are harmless and do not affect most people.

If a person is allergic to a substance, such as pollen, their immune system reacts to the substance as if it was foreign and harmful, and tries to destroy it.

Research indicates that 30 percent of adults and 40 percent of children in the United States have allergies.

Fast facts on allergies Allergies are the result of an inappropriate immune response to a normally harmless substance. Some of the most common allergens are dust, pollen, and nuts. They can cause sneezing, peeling skin, and vomiting. Anaphylaxis is a serious allergic reaction that can be life-threatening. To diagnose an allergy, a clinician may take a blood sample. The symptoms of an allergy can be treated with drugs. However, the allergy itself requires desensitization. Anaphylaxis requires emergency treatment. Epinephrine injectors can help reduce the severity of an anaphylactic reaction.

What is an allergy?

Allergies occur when the immune system overreacts to ordinarily harmless substances.

Allergies are a very common overreaction of the immune system to usually harmless substances.

When a person with an allergy comes into contact with an allergen, the allergic reaction is not immediate. The immune system gradually builds up a sensitivity to the substance before overreacting.

The immune system needs time to recognize and remember the allergen. As it becomes sensitive to the substance, the immune system starts making antibodies to attack it. This process is called sensitization.

Sensitization can take a few days or several years. In many cases, the sensitization process is not completed. The patient experiences some symptoms but not a full allergy.

Allergies may also be seasonal. For example, hay fever symptoms can peak between April and May, as the pollen count in the air is much higher.

A study published in JAMA Pediatrics reported that food allergies in children cost the U.S. economy nearly $25 billion annually.

The number of people worldwide with allergies is increasing.


An allergic reaction causes inflammation and irritation. The signs and symptoms depend on the type of allergen. Allergic reactions may occur in the gut, skin, sinuses, airways, eyes, and nasal passages.

Allergic reactions may be confused for other conditions. Hay fever, for example, creates similar irritations to the common cold but the causes are different.

Below is a range of various triggers and the symptoms they regularly cause in people who are allergic.

Dust and pollen

blocked nose itchy eyes and nose runny nose swollen and watery eyes cough

Skin reactions

flaking itching peeling rashes


vomiting swollen tongue tingling in the mouth swelling of the lips, face, and throat stomach cramps shortness of breath rectal bleeding, mainly in children itchiness in the mouth diarrhea

Insect stings

wheezing swelling at the site of the sting a sudden drop in blood pressure itchy skin shortness of breath restlessness hives, a red and very itchy rash that spreads across the body dizziness cough chest tightness anxiety possible anaphylaxis


wheezing swollen tongue, lips, and face skin rash itchiness possible anaphylaxis


Anaphylaxis is a quickly escalating, serious allergic reaction that sets in rapidly. It can be life-threatening and must be treated as a medical emergency.

This type of allergic reaction presents several different symptoms that can appear minutes or hours after exposure to the allergen. If the exposure is intravenous, the onset is usually between 5 to 30 minutes. A food allergen will take longer to trigger an anaphylactic reaction.

Researchers reported in The Journal of Allergy & Clinical Immunology that the most commonly affected areas in anaphylaxis are the skin and respiratory system.

Symptoms of anaphylaxis include:

hives all over the body, flushing, and itchiness swollen tissues a burning sensation swelling of the tongue and throat a possible blue tint to the skin from lack of oxygen a runny nose shortness of breath and wheezing hoarseness pain when swallowing cough a drop in blood pressure that can speed up or slow down the heart rate abdominal cramps diarrhea vomiting loss of bladder control pelvic pain similar to uterine cramps coronary artery spasm low blood pressure leading to high or low heart rate dizziness and fainting

Recognizing these symptoms can be crucial to receiving timely treatment.


A particular antibody called immunoglobin (IgE) causes allergic reactions. Antibodies are released to combat foreign and potentially harmful substances in the body.

IgE is released to destroy the allergen and causes the production of chemicals that trigger the allergic reaction.

One of these chemicals is called histamine. Histamine causes tightening of the muscles in the airways and the walls of blood vessels. It also instructs the lining of the nose to produce more mucus.

Risk factors

The following can be risk factors for developing allergies:

a family history of asthma or allergies, being a child, having asthma, not being exposed to enough sunlight, having a different allergy.

The most common allergens

Animal dander is a very common allergen.

Potential allergens can appear almost anywhere.

Any food can theoretically cause an allergy. Specific components of food can also trigger allergic reactions, such as gluten, the protein found in wheat. The eight foods most likely to cause allergies are:

eggs, especially egg-white fish milk nuts from trees peanuts wheat soy shellfish

Other allergens include:

animal materials, such as dust mite excrement, wool, fur, dander, or skin flakes, as well as Fel d 1, a protein found in cat saliva, medications, such as penicillin, salicylates, and sulfonamides, foods such as corn, celery, pumpkin, sesame, and beans, insect stings, including wasp and bee sting venom, mosquito stings, and fire ants.insect bites from horseflies, blackflies, fleas, and kissing bugs, cockroaches, caddis and lake flies, midges, and moths, plant pollens from grass, trees, and weeds, household chemicals, metals, such as nickel, cobalt, chromium, and zinclatex.


The doctor will ask the patient questions regarding symptoms when they occur, how often, and what seems to cause them. They will also ask the person with symptoms whether there is a family history of allergies and if other household members have allergies.

The doctor will either recommend some tests to find out which allergen is causing symptoms or refer the patient to a specialist.

Below are some examples of allergy tests:

Blood test: This measures the level of IgE antibodies released by the immune system. This test is sometimes called the radioallergosorbent test (RAST) Skin prick test: This is also known as puncture testing or prick testing. The skin is pricked with a small amount of a possible allergen. If the skin reacts and becomes itchy, red, and swollen, it may mean an allergy is present. Patch test: A patch test can identify eczema. Special metal discs with very small amounts of a suspected allergen are taped onto the individual's back. The doctor checks for a skin reaction 48 hours later, and then again after a couple of days.

The American College of Allergy, Asthma and Immunology can help you find a certified allergist.

Even if the patient knows what triggers the allergy, the doctor will carry out tests to determine which particular substance is causing symptoms.


The most effective treatment and management of an allergy is the avoidance of the allergen.

However, sometimes it is not possible to completely avoid an allergen. Pollen, for example, is constantly floating in the air, especially during hay fever season.


Drugs can help treat the symptoms of an allergic reaction, but they will not cure the allergy. The majority of allergy medications are over-the-counter (OTC). Before taking a particular type of medication, speak to a pharmacist or doctor.

Antihistamines: These block the action of histamine. Caution is recommended, as some antihistamines are not suitable for children. Decongestants: These can help with a blocked nose in cases of hay fever, pet allergy, or dust allergy. Decongestants are short-term medications. Leukotriene receptor antagonists, or anti-leukotrienes: When other asthma treatments have not worked, anti-leukotrienes can block the effects of leukotrienes. These are the chemicals that cause swelling. The body releases leukotrienes during an allergic reaction. Steroid sprays: Applied to the inside lining of the nose, corticosteroid sprays help reduce nasal congestion.


Immunotherapy is also known as hyposensitization. This type of therapy rehabilitates the immune system. The doctor administers gradually increasing doses of allergens over a period of years.

The aim is to induce long-term tolerance by reducing the tendency of the allergen to trigger IgE production.

Immunotherapy is only used to treat severe allergies.

Treatment for anaphylaxis

The EpiPen is one example of an epinephrine injector. They can be vital for stopping anaphylactic reactions.

Anaphylaxis is a medical emergency. The patient may require resuscitation, including airway management, supplemental oxygen, intravenous fluids, and close monitoring.

The person experiencing anaphylaxis will need an injection of adrenaline into the muscle. Antihistamines and steroids are often used alongside the adrenaline injection.

After the patient has been stabilized, doctors may recommend remaining in the hospital under observation for up to 24 hours to rule out biphasic anaphylaxis. Biphasic anaphylaxis is the recurrence of anaphylaxis within 72 hours with no further exposure to the allergen.

Patients who have had severe allergic reactions should carry an epinephrine autoinjector with them, such as the EpiPen, EpiPen Jr, Twinject, or Anapen.

Many doctors and health authorities advise patients to wear a medical information bracelet or necklace with information about their condition.

How to prevent allergies

There is no way to prevent an allergy. However, it is possible to limit symptoms.

Even though treatments can help alleviate allergy symptoms, patients will need to try to avoid exposure to specific allergens. In some cases, this is not easy. Avoiding pollen in late spring and summer is virtually impossible, and even the cleanest houses have fungal spores or dust mites.

If you have friends or family with pets, avoiding them might be difficult. Food allergies can be challenging to manage because traces of allergens can appear in unlikely meals. However, being vigilant about checking food packages can be a key way to avoid consuming certain allergens.

Make sure you receive proper allergy testing and know what substances to avoid.


Source: By Adam Felman

Source: By Article: Electro-Olfactograms in Humans in Response to Ortho- and Retronasal Chemosensory Stimulation, Hummel, T. et al., Chemosensory Perception, doi: 10.1007/s12078-016-9217-z, published online 30 September 2016.

Researchers probe the difference between odors picked up when breathing or chewing.

The marked difference in how much better you recognize odors you breathe in than those that are released when you chew something can be explained by the workings of the epithelium cells that line the nasal cavity. This was established when researchers had ten study participants stick probes into their noses, and then made electro-physical recordings of how the epithelium cells reacted to different odors presented to them. The study was led by Thomas Hummel of the Technische Universität Dresden in Germany and is published in Springer's journal Chemosensory Perception.

Olfaction refers to the action or capacity of smell. People are able to smell thanks to their noses (an ability referred to as their orthonasal sense of smell) and through their mouths (their retronasal smelling sense) when odorous molecules are released into the nasal cavity during the process of chewing and swallowing.

According to Hummel, retronasal olfaction, although not as sensitive, represents a particular aspect of the olfactory system in that it allows for smells to be evaluated within the interior of the body rather than from the external world. Retronasal olfaction adds to people's experience of eating or drinking, as it evokes different sensations compared to orthonasal smelling. It also helps to keep people out of harm's way when they put potentially harmful substances into their mouths.

Hummel's team used electro-olfactogram (EOG) recordings to evaluate how the epithelium lining in the nasal cavity reacts to stimuli that are either breathed in or are released thanks to the workings of the mouth. This electrographic technique is similar to electrocardiograms that provide neuronal information about the changing bioelectrical potential of the heart.

The experiment was performed on six men and four women, who had to insert a tubular electrode about seven centimeters deep into their nasal cavity. The reaction of the participants' epithelial lining to three odorants (phenylethyl alcohol, hydrogen sulfide, and carbon dioxide) was then recorded.

The epithelial lining responded more to orthonasal stimuli than to retronasal ones. This indicates that orthonasal stimuli are perceived with a higher intensity than retronasal ones.

The findings are in line with the thought that the odors of food and liquids, most often experienced through chewing and swallowing, are typically encountered at higher concentrations than orthonasal perceived ones, to allow them to be picked up adequately.

"Compared to the smell of a given food, such as cheese, odor release from that same food is higher intraorally due to salivation, warming, and chewing," explains Hummel. "Because of these conditions, retronasal perception of odors, compared with orthonasal olfaction, may be adjusted to a higher range of odor concentrations."

"This indicates that differences between ortho- and retronasal olfaction may start as early as on the mucosal level," adds Hummel, who says the current findings lend support to previous research showing that the intensity of physically identical stimuli is slightly lower after retronasal stimulation.


Source: By Article: Electro-Olfactograms in Humans in Response to Ortho- and Retronasal Chemosensory Stimulation, Hummel, T. et al., Chemosensory Perception, doi: 10.1007/s12078-016-9217-z, published online 30 September 2016.


Source: By Stuart Wilson

Cauliflower ear, also known as perichondrial hematoma, is a swelling of the ear caused by a blood clot. This blood clot causes tissue damage that leads to a lumpy appearance that is said to resemble a cauliflower.

Typically, those at risk can prevent the sorts of injuries that lead to this condition by wearing protective headgear.

The ear is particularly vulnerable to this sort of injury because it protrudes from the head. The blood supply to the cartilage that supports the ear and keeps its shape is provided by the overlying skin. When this supply is interrupted, by either multiple clots or pressure caused by swelling, this cartilage may die off.

This can lead to the thickening and scarring of tissue in the ear and the formation of new cartilage.


Repeated trauma to the ear from high-impact sports may raise the risk of cauliflower ear. Image credit: Newaza Apparel, October 2013

Cauliflower ear typically occurs when blunt trauma affects the ear. The trauma leads to a series of small blood clots that block blood flow, leading to tissue damage. Sometimes, the injury pulls the cartilage away from the skin.

However, the condition can also occur due to an ear infection, particularly those caused by piercings in the upper portion of the ear. Up to 35 percent of piercings result in complications. In many cases, these complications will be minor, but in some, they can lead to more serious issues.

In both cases, tissue damage can be relatively minor, resulting in scar tissue. In others, the cartilage may die as it is starved of essential nutrients. The ear then folds over because it lacks the support supplied by the cartilage.

Risk factors

Any sport that can involve blunt-force trauma raises the risk of a cauliflower ear. These sports include martial arts, boxing, rugby, and wrestling. Often, a cauliflower ear is the result of repeated impacts to the side of the head. These impacts may be from a fist, a shoulder, or repeated contact with the ground (such as during a wrestling match).

In addition, fights can also result in similar injuries, as can accidents where the side of the head is injured. These accidents may include cycling accidents in which someone is not wearing a helmet and vehicle accidents.

Other risk factors include piercings to the upper ear in particular. Because these piercings penetrate the ear and can be hard to keep clean, the risk of infection increases.

Such infections can cause the cartilage to separate, resulting in further complications. Of particular concern is the bacteria Pseudomonas aeruginosa, according to a study published in the Brazilian Journal of Otorhinolaryngology.


The most common initial symptoms of a cauliflower ear are:

pain, swelling, bruising, deformation of the shape of the ear. Severe symptoms of cauliflower ear may be ringing in the ear and hearing loss.

In some cases, severe symptoms may occur. These include:

hearing loss, ringing in the ear, headache, severe bleeding, blurred vision, facial swelling.

Seek medical attention immediately for a hematoma, which is a large collection of blood outside of the blood vessels. The earlier a hematoma is treated, the less likely it is that it will progress to a cauliflower ear.

After a few days, the pain and swelling generally subside. Left untreated, the ear remains lumpy and the swelling gradually hardens over the course of 7 to 10 days. This can create a permanent change to the ear's appearance. In some cases, the ear may flop over as the cartilage dies.

Treatment options

Initial treatment can prevent a cauliflower ear from forming. Ice packs to the ear for approximately 15-minute stretches several times per day may help to reduce swelling.

Rapid removal of fluid by a medical professional reduces the likelihood of clots forming. The fluid is usually drained using a wide-bore needle in a process called aspiration. This fluid may contain the blood clots, preventing further blockages.

The injury requires constant compression to stop it from filling up with fluid again. Compression also keeps the skin close to the cartilage so that it does not rip out additional blood vessels. People should rest from training and other situations where blunt-force trauma is likely to reoccur.

In cases where simple draining is not sufficient, a surgeon may suture a temporary drain onto the ear. This may not be practical for those who play the sport professionally, as they must keep the drain clean to avoid infection. For most, however, this method is likely to be fine.

An alternative to the traditional compression bandage involves silicone molds. One mold fits in the ear, just like a traditional hearing aid, and another fits behind the ear. Together, they apply compression to the injury.

Those participating in sports can wear these molds under their headgear in order to reduce the risk of further injury. A case study in the British Journal of Sports Medicine described this treatment as being successful after a player with a newly developed cauliflower ear wore these molds for 10 days. The authors also noted that a hole in the in-ear mold would aid hearing. Because this is a new form of treatment, no long-term studies as to its effectiveness are available.

If a cauliflower ear is not treated quickly, there is potential for it to become permanent. The fluid builds up hardens within 7 to 10 days, causing the cartilage to thicken and harden. After that occurs, the condition requires surgery to restore the ear.

Corrective surgery is called otoplasty. If it is completed within 30 days of the initial clot and formation, it involves cutting out the newly formed scar tissue and stitching the wound up. This typically takes place under local anesthetic and requires the patient to wear a headband for a few days following the surgery. People can usually resume contact sports 12 weeks after the operation.

In cases where the cartilage has hardened and the scar tissue has settled in, the surgeon must reconstruct the ear cartilage, particularly when the cartilage has died. This surgery typically takes longer and has a longer recovery time, as it can involve taking cartilage from the ribs to reconstruct the ear.


Wearing protective headgear may help to prevent cauliflower ear.

Preventing a cauliflower ear typically means avoiding sports where multiple impacts to the side of the head are likely. Participants in these sports may choose to wear helmets where possible, reducing the impact of blows to the ear.

A well-fitting helmet is crucial. One that is too loose can result in shifting, potentially making the problem worse. A loose helmet can also fall off at inopportune moments. Some rugby players wear a band around the ears, but their effectiveness is debatable.

In some sports, such as in high-level boxing and wrestling, this is not possible. For these sports, rapid treatment of blunt-force trauma to the ear can prevent a cauliflower ear from forming.


Untreated, a cauliflower ear is usually harmless. Those who leave it untreated generally do not experience ill effects.

However, one preliminary study published in the Asian Journal of Sports Medicine showed that wrestlers with cauliflower ears are more likely to suffer from hearing loss. This, the authors suggested, could be because of the risk of infection is greater or because the swelling physically blocks the ears.

Cauliflower ear can cause practical issues, such as difficulty wearing headphones and problems with wax removal from the ear. Consequently, those with a cauliflower ear may experience more ear infections than others.

When treated quickly, a cauliflower ear can be cured. This process often takes a couple of days. The longer the cauliflower ear is left to develop, the longer it takes to resolve, and it may require reconstructive surgery if left too long.

Source: By Stuart Wilson