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The Get Healthy Tampa Bay Podcast
Bringing all things health and wellness to Tampa Bay, FL from your very own family and obesity medicine physician, Dr. Kerry Reller, MD, MS. We will discuss general medical topics, weight management, and local spots and events focusing on health, wellness, and nutrition in an interview and solo-cast format. Published weekly.
The Get Healthy Tampa Bay Podcast
E126: Chronic Sinus Relief w/ Dr. Mariah Pate—Allergies, CRS & Balloon Sinuplasty Explained
Welcome to the Get Healthy Tampa Bay Podcast with Dr. Kerry Reller! This week, I’m joined by Dr. Mariah Pate, a board-certified ENT specialist in St. Petersburg, Florida, who focuses on sinus and allergy care using minimally invasive techniques.
In this episode, we dive into chronic rhinosinusitis (CRS)—what it is, how it’s diagnosed, and why so many patients are misdiagnosed or undertreated. Dr. Pate explains the role of inflammation, allergies, and even post-COVID changes in persistent sinus issues, and walks us through modern treatment options including balloon sinuplasty, turbinate reduction, allergy immunotherapy, and biologics for nasal polyps.
You’ll learn how CRS can affect your energy, sleep, and overall well-being—and how ENT specialists like Dr. Pate can help you finally breathe easier.
Mariah Pate, MD is a Board Certified Otolaryngologist, I am expertly trained in all areas of the Ear, Nose, and Throat specialty. She treats patient with an unique set of skills using minimally invasive office interventions for chronic breathing and sinus problems.
She is a native of Florida, attended the University of Florida for undergraduate and was awarded Magna Cum Laude honors. She attended medical school at East Tennessee State University and was in the top 5% of her medical class. She then completed her Otolaryngology residency at the Medical College of Georgia, where she was chief resident and won the resident research award. She is married and is the mom to two boys. She loves to be outdoors, enjoy the water, do pilates and cook for her family.
00:43 – Meet Dr. Mariah Pate: Florida native and ENT surgeon
03:00 – Acute vs. Chronic Rhinosinusitis: What’s the difference?
06:15 – Common symptoms & why antibiotics aren’t always the answer
10:20 – Causes of CRS: Infections, anatomy, allergies, and COVID
14:10 – Diagnosing CRS: The role of endoscopy and low-radiation CT scans
19:22 – Allergies + CRS: Why testing is crucial for long-term relief
23:05 – Allergy immunotherapy: Shots vs. sublingual and who benefits
27:45 – Minimally invasive sinus treatments: Balloon sinuplasty & more
34:10 – How CRS affects sleep, brain fog, fatigue, and even exercise
39:18 – Biologics for nasal polyps: A game-changer in ENT treatment
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Dr. Kerry Reller: Hi everybody, welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller, and today we have a very special guest, Dr. Mariah Pate. Welcome to the podcast!
Dr. Mariah Pate: Thank you for having me.
Dr. Reller: I’m so excited you're local to the St. Pete area and that you're an expert in ENT. Tell us a little about how you got into this field and what you do.
Dr. Pate: Sure! I'm a Florida native, born and raised in Orlando. I went to the University of Florida, worked a few years, then went to medical school. I loved surgery and procedures, so ENT was a great fit. After training, I moved back to Tampa Bay and have been practicing here for eight years. I’m a general ENT but focus on sinus and allergy treatments, especially minimally invasive procedures to help people breathe better.
Dr. Reller: That's awesome. We have similar paths—I also went away, worked a bit, then came back. But I didn’t like surgery!
Dr. Pate: Yeah, you either love it or you don’t!
Dr. Reller: Let’s talk about something we both see a lot: chronic rhinosinusitis, or CRS. Can you explain what that is?
Dr. Pate: Definitely. CRS is when sinus symptoms like facial pain, congestion, pressure, and drainage last 12 weeks or more. It’s different from acute sinusitis, which is short-term and often caused by bacterial infections. CRS often stems from chronic inflammation and can include recurrent infections. If you have multiple sinus infections a year, that also qualifies as CRS.
Dr. Reller: That makes sense. I see patients who think they need antibiotics early, but it’s not always the case. How do you guide patients before things become chronic?
Dr. Pate: I encourage people to track symptoms and see a provider if things don’t improve after a week or so. Overuse of antibiotics can lead to resistance and gut issues. A physical exam is key because symptoms can overlap with allergies or chronic conditions.
Dr. Reller: What are the common causes of CRS?
Dr. Pate: Common causes include recurrent infections, anatomical blockages like a deviated septum or enlarged turbinates, and allergies. COVID has also played a role—it can trigger inflammation and change how patients recover from infections.
Dr. Reller: Interesting. I hadn’t thought about the long-term sinus effects of COVID. What about immune issues?
Dr. Pate: Definitely. Patients with frequent infections might have underlying immune deficiencies. That’s why we do thorough evaluations, including endoscopy and in-office CT scans, to assess anatomy and potential causes.
Dr. Reller: Do you think CRS is underdiagnosed?
Dr. Pate: Absolutely. Around 11% of the population has it, but it's often mistaken for allergies or recurrent colds. Getting an early diagnosis improves outcomes and quality of life significantly.
Dr. Reller: Speaking of quality of life, what are some of the impacts CRS has on daily living?
Dr. Pate: Besides congestion and drainage, patients often have brain fog, fatigue, poor sleep, and reduced productivity. It can affect exercise tolerance and overall energy. Many people don’t realize how bad they felt until they feel better.
Dr. Reller: What challenges do patients face in getting help?
Dr. Pate: Over-the-counter meds can be misleading. People try antihistamines, nasal sprays, or decongestants like Afrin without realizing they can worsen symptoms if used incorrectly. Lack of continuity in care also contributes—seeing multiple urgent care providers makes it hard to track patterns.
Dr. Reller: Let’s talk diagnosis. How do ENT specialists confirm CRS?
Dr. Pate: We start with a detailed history, physical exam, and endoscopy. Then we use a CT scan to see the sinuses. In-office scanners make this easier and safer now, with very low radiation. This gives us a full picture and guides treatment decisions.
Dr. Reller: What role does allergy and immune testing play?
Dr. Pate: It's huge. If someone has allergies and we don't treat them, even after fixing anatomical issues, the problems come back. Testing helps guide immunotherapy and timing for medications. It's also important for identifying patients who could benefit from allergy shots or drops.
Dr. Reller: Right—and immunotherapy can actually help patients get off medications. What are the different types?
Dr. Pate: The gold standard is allergy shots, but sublingual drops are another option, especially in Europe. Shots are usually more effective, but drops are more convenient. Insurance coverage can be an issue, especially with drops.
Dr. Reller: What are the other treatment options beyond meds and immunotherapy?
Dr. Pate: When meds aren’t enough, minimally invasive procedures can help. Balloon sinuplasty opens sinus passages using a balloon. It’s done under local anesthesia in the office. We can also reduce turbinate size and address mild septum issues without major surgery.
Dr. Reller: How long do those results last?
Dr. Pate: Most patients see long-term relief. About 85% have lasting improvement, but results vary based on severity and underlying causes. Diagnosing allergies or immune issues is key to preventing recurrence.
Dr. Reller: I have a patient with immune issues and a mild septal deviation. When do you consider surgery?
Dr. Pate: If someone has tried medications and immunotherapy and is still symptomatic, we consider procedures. Many times, addressing the turbinates and sinuses improves airflow enough that septoplasty isn’t needed. Sleep quality and energy often improve significantly afterward.
Dr. Reller: Speaking of sleep, do you see overlap with sleep apnea?
Dr. Pate: Yes. Nasal obstruction contributes to snoring and poor CPAP tolerance. Fixing the nose often helps patients use CPAP more effectively and feel better overall. Sleep studies are still important, but nasal surgery can be part of the solution.
Dr. Reller: What can people do daily to support sinus health?
Dr. Pate: Healthy lifestyle habits—good sleep, diet, exercise—make a difference. Nasal saline sprays or rinses help clear allergens. Products with xylitol can reduce congestion and viral adhesion. And don’t ignore persistent symptoms—get evaluated early.
Dr. Reller: I also see a link between obesity and CRS.
Dr. Pate: Yes, obesity is inflammatory and can worsen sinus disease. Sinus anatomy can also change with obesity, and the risk of polyps and chronic issues goes up. It’s all connected.
Dr. Reller: What about biologics for nasal polyps?
Dr. Pate: They’ve been a game-changer. For patients with asthma or recurring polyps, biologics help reduce inflammation and improve outcomes—sometimes even before surgery. They're expensive, but very effective.
Dr. Reller: It’s great to have that option. Any final thoughts?
Dr. Pate: Don’t wait 20 years to get help. There are effective, non-scary options that can dramatically improve your quality of life. We love helping people feel better.
Dr. Reller: Where can people find you?
Dr. Pate: Visit www.tampabaybreathefree.com or call 727-493-2479. We offer online scheduling and usually see new patients within a week.
Dr. Reller: Amazing. Thank you so much for joining us, Dr. Pate!
Dr. Pate: Thank you for having me!
Dr. Reller: Stay tuned for next week’s episode!
