Allergy testing is used to help identify the specific allergens that are causing the allergic symptoms by measuring how a person reacts to specific allergens such as food, tree pollen, pet dander, or mold. A "positive" allergy test means that a person has a specific allergic antibody to the substance tested. This often means that the person is allergic to the substance, and therefore may experience symptoms when exposed to the allergen.

Skin Testing (Intradermal Allergy Testing):

Skin testing is the oldest and most reliable form of allergy testing. Skin testing has been performed for over a 100 years and continues to be the test of choice for the diagnosis of allergic disease. A small amount of a suspected allergen (usually a commercially available diluted extract of allergens such as tree pollens, pet dander or mold) is injected into the skin to see if a reaction develops. Skin testing is not painful, and there is generally no bleeding involved. Usually, there are sixty-four skin tests performed, which are done in four sessions (sixteen tests at each visit). Each test takes fifteen minutes to complete. A positive skin test appears as a raised, red itchy bump. A negative test does not result in any skin reaction.

Allergy Shots (Immunotherapy):

The goal of allergy shots is to "train" the immune system over time to be better able to tolerate the allergens that trigger the allergy symptoms. The end result is that the patient becomes "immune" to the allergens, so that the patient can tolerate the allergens with fewer or no symptoms.

Testing and Treatment:

Skin testing is performed first to find out which allergens are causing the allergic symptoms. Treatment begins by receiving shots containing very small doses of the allergens. The dose is slowly increased with each shot to allow the immune system to safely adjust and build immunity to the allergens. The allergy shots are given once a week for eight weeks and then once a month for approximately a year. By giving small but increasing amounts of these allergens at regular intervals, tolerance to the allergen increases. Once higher doses of the allergens are administered, the patient will see relief of the allergy symptoms.

For more information on allergy testing and/or allergy shots, please contact Dr. Zadeh at Los Angeles Sinus Institute.

One of the best ways to diagnose sinus problems is with a CT (computed tomography) scan, also known as a CAT scan, a noninvasive, painless medical test that helps physicians diagnose and treat various medical conditions. CT scanners create 3 dimensional x-ray images of the sinus anatomy and thus provide physicians with valuable information for an accurate diagnosis.

Dr. Zadeh and his staff understand that time is precious and that suffering from sinus problems can deprive one of valuable time. We are committed to providing the highest quality and most efficient care possible so that patients achieve fast and effective relief. Therefore, at Los Angeles Sinus Institute, we have the most advanced diagnostic technology available to expedite diagnosis. By using the latest advancements in CT technology, sinus CT scans can now be performed in our office with the Xoran MiniCAT™ scanner, a small, upright CT scanner that creates fast and exceptional quality images of the sinuses.

CT of the sinuses is primarily used to:

• Detect the presence of inflammatory disease, polyps, fluid or thickened sinus membranes.
• Help diagnose sinusitis, nasal septal deviation or turbinate hypertrophy.
• Plan for surgery by defining the anatomy.
• Record the anatomy for image guided surgery.

At Los Angeles Sinus Institute, we use the quick and comfortable Xoran MiniCAT™ scan:

• The patient sits comfortably upright in the scanner chair.
• With the open and patient-friendly design of the CT scanner, the sense of claustrophobia that many people experience during CT scans taken on full-body CT scanners is eliminated.
• Scans are fast: ranging between 20 to 40 seconds, depending on the protocol selected.

Xoran MiniCAT™ scans are safe and convenient:

• Since the scanner in on site, no additional appointments are needed for the imaging studies when one is deemed necessary.
• The results of the CT scan are available immediately to the patient and Dr. Zadeh. With instant access to digital 3D images of the sinuses, the disease process is diagnosed faster and therefore no time is lost between the visit and initiation of therapy.
• The radiation dose is much lower than sinus scans taken on full-body CT scanners.
• The Xoran MiniCAT™ not only optimizes image quality, but it also minimizes the radiation dose in accordance with ALARA (As Low As Reasonably Achievable). For more information on the radiation dose, please visit http://xorantech.com/contentHTML/miniCAT_effective_dose.php.

For more information about Xoran MiniCAT™, please contact Dr. Zadeh at Los Angeles Sinus Institute or visit: www.xorantech.com

Diagnostic nasal endoscopy provides a safe and quick evaluation of the nasal passages using a nasal endoscope, a fiber-optic instrument used for examining the nasal cavity. The endoscope is slender, only 2.7-4.0 mm in diameter, and is passed easily through the nostril to allow a detailed examination of the nasal cavity and the sinuses. Dr. Zadeh may look directly through the endoscope or alternatively, a medical video camera can be attached to the endoscope, and the images may be viewed on a special video monitor. The patient may choose to view the images from his or her own examination.

Purpose:

• Nasal endoscopy provides for direct observation of the nasal passages, sinuses and other surrounding structures.
• Nasal endoscopy is used to help diagnose nasal polyps, nasal blockage, nasal tumors, recurrent sinusitis or chronic sinusitis.

Preparation:

• The patient sits in a comfortable chair.
• A topical nasal decongestant and numbing medicine may be applied to the lining of the nose by a nasal spray prior to endoscopy. The examination is easily tolerated and often can be completed without any numbing medicines at all.

Test procedure:

• Dr. Zadeh threads the endoscope into each nostril and through the nasal cavity.
• Dr. Zadeh will examine the internal structures of the nose as the endoscope is maneuvered easily through the nasal passages.

After the test:

• Once the endoscope is removed, the patient may immediately return to normal activities.

Interpretation:

• Direct observation of the nasal cavity allows Dr. Zadeh to immediately assess the patient's sinus and nasal problem. This immediate assessment allows Dr. Zadeh to discuss the results and courses of therapy with the patient during the same visit and therapy can be initiated right away.

For more information about nasal endoscopy, please contact Dr. Zadeh at Los Angeles Sinus Institute.

Nasal and sinus cultures are used to identify the organism causing the infection. Cultures are simple, quick and safe.

Cultures are frequently used when infections treated with the appropriate antibiotics have not completely resolved. Nasal and sinus cultures are becoming more important with the emergence of bacteria resistant to common antibiotics. Patients at the Los Angeles Sinus Institute have access to our in-house microbiology laboratory overseen by our experienced microbiologist. The cultures obtained allow Dr. Zadeh to determine the source of the patient's nasal and sinus infection.

Procedure:

A culture can be obtained by simply swabbing the discharge from the sinuses. This can be done with direct visualization or endoscopically. The procedure is pain free and takes seconds. Culture results return in about 2-3 days and include the type of bacteria and a list of antibiotics that will effectively treat the infection. All culture specimens are also tested for fungus.

For more information regarding cultures, please contact Dr. Zadeh at Los Angeles Sinus Institute.