Effect of combined septal and turbinate injection of botulinum toxin type A in allergic rhinitis

Mostafa Ismail, Alaa Nabil, Mostafa Nasr, Balegh Abdelhak, Osama G. Awad, Khalaf Hamead

Department of Otorhinolaryngology, Minia University Hospital, Minia University, Minia, Egypt

Allergic rhinitis (AR) has increased in prevalence recently, 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 carried out with the aim of performing a clinical assessment of the effect of combined septal and turbinate injection of BTX‑A for the management of uncontrolled AR.
Materials and methods
A single‑arm pilot study enrolled 40 patients with moderate to severe uncontrolled AR recruited between October 2018 and August 2019. Each patient received 45 units of BTX‑A injected into three fixed points of each side of the nose: inferior turbinate (15 IU), middle turbinate (15 IU),
and nasal septum (15 IU). All patients were evaluated in terms of nasal hypersecretions, congestion, and sneezing with a visual analog scale before treatment and at weeks 1, 2, 4, 8, and 12 during the follow‑up period.
Throughout the 12‑week 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.
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.
allergic rhinitis, botulinum toxin, intranasal injection, nasal congestion, nasal hypersecretions, sneezing.

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