Allergist Interview: Dr. Bryan Tigner on Sinusitis and Sinus Surgery
This month we really enjoyed talking to Dr. Bryan Tigner who's practice is close to our location right here in Atlanta, Georgia. He specializes in otolaryngic allergy and surgical disease of the nose and sinuses at Georgia's ENT Institute. He is board certified in otolaryngology and practices ENT medicine on patients of all ages. He is very interested in treating chronic sinusitis and problems related to food allergies.
Please tell us a little bit about yourself and your history as an allergist.
|"My interest in allergy began during my training at UTSW in Dallas, Texas. I trained under one of the most recognized allergist in the country, Dr Richard Mabry. Although now retired, Dr Mabry contributed significantly to the understanding of the role allergy plays in chronic sinusitis. He is co-author on the landmark paper describing allergic fungal sinusitis. His passion for allergy is contagious. I brought this passion to my practice where I started my first allergy clinic in Knoxville, TN in 2006."|
Is there a particular type of allergy or treatment your practice specializes in?
"We specialize in the treatment of allergies affecting the generalized areas of the ear, nose, and throat. We focus primarily on inhalant allergies and those food allergies that contribute to illnesses affecting the ears, nose and throat."
What do you love about your job?
"I love the fact that I have the opportunity to positively impact someone's life on a daily basis."
If you could suggest one thing for your patients what would it be?
"Be open-minded regarding the treatment of your chronic sinusitis. Another antibiotic is not always the answer."
What is your favorite allergy relief product?
"There are many useful tools to combat allergies like avoidance measures, medications, and allergy immunotherapy. The best bang for your buck comes in the form of a simple room dehumidifier. This simple product significantly reduces both dust mite allergen and mold spores."
Where do you see allergy treatment going in the near future? In the distant future?
"I am really excited about sublingual immunotherapy (SLIT). Research has shown SLIT to be as effective as allergy shots in the treatment of allergic rhinitis. SLIT is safer and more convenient for allergy sufferers allowing me to reach more patients. In the distant future, we may see therapy that is targeted to the actual T-cells where allergy starts."
You have some interesting thoughts on sinusitis. Please discuss the role of surgery in treating sinusitis.
"One of the biggest challenges facing any provider that treats chronic sinusitis is debunking two long standing myths. We have believed and been taught for many years that chronic sinusitis is mostly due to bacterial infection and that chronic sinusitis can be cured by the right sinus surgery. Therefore, we have fallen into the pitfall of trying to eradicate sinus disease by giving more and more antibiotics and offering patient's surgery after revision surgery in attempt to cure the disease.
"Recently, there has been a paradigm shift in the treatment of chronic sinusitis. Chronic sinusitis is now recognized as an inflammatory disorder with many etiologies. Yes, bacteria may play a role, but it is not the only factor. Surgery is needed in many patients, but it is not the cure. Consequently, we need to recognize the role allergy and other inflammatory mediators play in chronic sinusitis. I counsel my patients to consider chronic sinusitis to be a disease similar to asthma. Similarly, we seek to decrease exposure to things our chronic sinusitis sufferers are allergic to just as we do in asthma patients. Patients are healthier and feel better longer when we minimize allergy exacerbation and the subsequent sinus inflammation. Finally, when we recognize the role allergy plays in chronic sinusitis then address allergy as part of disease management, our surgeries are more effective."