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.
Keywords: Allergic rhinitis, Botulinum toxin, Nasal
hypersecretions, Sneezing, Nasal congestion, Intranasal injection.