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For more information on treatment of ear, nose, and throat problems, contact:




Charles H. Mann, MD

Richard M. Jones, MD

Jared E. Spector, MD

601 Keisler Drive, Suite 200

Cary, NC 27518

Telephone: (919) 859-4744


Allergies Moving You to Tears?
SLIT May Ease Your Discomfort

Allergic to cats, dogs, trees, or pollen—or any of dozens of other substances? Dread the thought of weekly visits to your doctor, perhaps for years, for allergy shots?

With Dr. Spector looking on, Matt Butala, allergy technician at Mann ENT, offers the simple (andhighly effective) SLIT treatment for this patient.

You are not alone, and the three ear, nose and throat doctors at Mann ENT in Cary—Drs. Charles Mann, Richard Jones and Jared Spector, all experts in treating allergic conditions —when appropriate offer their patients a much simpler and highly effective option. Its shorthand name is SLIT, for sublingual immunotherapy.

“SLIT has been used in Europe and other places for years,” notes Dr. Spector, “and it is now gaining wider acceptance in the US. Allergy shots remain the gold standard for long-term treatment of a variety of allergic conditions, but up to a certain age you can’t do injection therapy with youngsters, so SLIT is often a terrific option for kids. And it’s also a great option for patients who have difficulty tolerating weekly shots on a long-term basis or are unable to make it to our office every week for injections.”

The SLIT Approach

The many patients who rely on Mann ENT for allergy diagnosis and treatment quickly become well acquainted with Matt Butala, a specialist allergy technician who, before coming to Mann ENT, spent seven years as a medic in the U.S. Air Force as head of an allergy and immunization clinic.

“After allergy patients go through an initial workup with one of our physicians, they are referred to me for extensive testing and ultimately for treatment,” he says. “We do basic skin testing, including serial endpoint titration, which lets us know with great precision the nature and extent of an allergic condition.

“In our experience SLIT,” he says, “proves to be effective for a wide range of allergic conditions, such as grass or cat allergies.

“Compliance is the name of the game. SLIT works extremely well for patients who faithfully use it every day. It simply requires the patient to put two drops of this specially prepared allergen under their tongue, hold it there for two minutes, and then swallow it. Once a day, every day, and for many of our patients, it works wonders.”

Most patients continue this treatment for three to five years, a time span similar for patients receiving allergy shots. Allergy shots, though, usually need to be given in the doctor’s office each week, while SLIT patients self-administer their two-minute treatment each day and check back with their doctor and Mr. Butala for a review of progress on a quarterly basis—or more often if they feel the need.

SLIT After Surgery

Carrie Richardson Fry, now 31, was first diagnosed with chronic sinusitis in 2004, caused in large part by a deviated septum and a variety of allergies. She had surgery with Dr. Spector which, she says, “made a huge difference—because, for the first time in a long time, any sinus issues I had didn’t linger for days and weeks.

“But I was still getting sick more often than I would like, and it was at this point that Dr. Spector recommended SLIT—principally because I have an aversion to needles.

“I began SLIT daily treatment early in 2010. For the first six months, I didn’t really notice much of a change. Matt Butala told me this was normal; that it could easily take a year or more for the difference to be perceptible. I was instructed to continue with my daily medication while doing SLIT, unless I spoke with Matt or Dr. Spector first.

“When I first realized that SLIT was helping me was on a day when I forgot to take my Zyrtec medication the night before. In the past, if that happened I would wake up feeling ‘stuffy’ and not quite right. But on this morning I was completely free of any allergy symptoms. It was perhaps a small thing, but it was a clear indicator to me that SLIT was working.

“Since then, I’ve noticed a decrease in the number of times I get sick and the severity of my illness. So much so—and I really think this is the biggest indicator of the success of SLIT for me—that this past summer when I went to Mann ENT for a checkup, I realized it had been nearly a year since I had been prescribed an antibiotic. Previously, I was on an antibiotic for a sinus infection from three to five times a year. So this was a great change!

“SLIT has absolutely, without a doubt, improved my quality of life. I can tell that there is an improvement in my overall health. I don’t spend nearly as many days sick or trying to push through as I have in the past. I am not completely miserable if I forget my allergy pill and, most importantly, I have fewer sinus issues.

“So I am a huge fan of SLIT, and of the allergy department at Mann ENT and Dr. Spector and Matt Butala in particular. They have both done an amazing job explaining how SLIT works, making the process—even the allergy testing—as easy as possible, and I am very grateful that they discussed this option with me. It has had a huge positive impact on my well-being.”