The Effect of Combined Septal and Turbinate Injection of Botulinum Toxin
Type A in Allergic Rhinitis
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.