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The Effect of Combined Septal and Turbinate Injection of Botulinum Toxin Type A in Allergic Rhinitis
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  • Mostafa Ismail,
  • Alaa Nabil,
  • Mostafa Nasr,
  • balegh abdel hak,
  • Osama Awad,
  • khalaf Hamead
Mostafa Ismail
Minia University Faculty of Medicine
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Alaa Nabil
Minia University
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Mostafa Nasr
Minia University
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balegh abdel hak
El Minia University hospital
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Osama Awad
Minia University Faculty of Medicine
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khalaf Hamead
Minia University Faculty of Medicine
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Abstract

Objectives: Allergic rhinitis ( AR) has been recently increasing in prevalence, and traditional treatment strategies sometimes show limited effectiveness for patients with intractable AR. Botulinum toxin type A (BTX-A) is among the increasingly used alternative treatment options. This study was conducted aiming at clinical assessment of the effect of combined septal and turbinate injection of BTX-A for management of uncontrolled AR. Design and setting: A single-arm pilot study enrolled 40 patients having moderate to severe uncontrolled AR were recruited in between October 2018 and August 2019. Each patient received 45 units of BTX-A injected in 3 fixed points of each side of the nose: inferior turbinate (15IU), middle turbinate (15IU) and nasal septum (15IU). All patients were evaluated in terms of nasal hypersecretions, congestion and sneezing with visual analogue scale prior to treatment and at weeks 1, 2, 4, 8 and 12 during the follow-up period. Results: Throughout the 12 weeks follow-up period, a significant difference in the degree of nasal hypersecretions could be identified before and after BTX-A injection. Sneezing differed significantly only in the first 4 weeks while nasal congestion did not differ significantly, before and after BTX-A injection. BTX-A was well tolerated by the patients, with no serious adverse or systemic effects. Conclusion: Combined septal and turbinate injection of BTX-A, in patients with uncontrolled AR, may be a long-lasting therapeutic option for the treatment of nasal hypersecretions, but not as effective as for sneezing and nasal congestion.