Minimally invasive application of botulinum toxin A in patients with idiopathic rhinitis

Abstract

BackgroundNasal hypersecretion due to idiopathic rhinitis can often not be treated sufficiently by conventional medication. Botulinum toxin A (BTA) has been injected into the nasal mucosa in patients with nasal hypersecretion with a reduction of rhinorrhea lasting for about 4 to 8 weeks. Since the nasal mucosa is well supplied with glands and vessels, the aim of this study was to find out if the distribution of BTA in the nasal mucosa and a reduction of nasal hypersecretion can also be reached by a minimally invasive application by sponges without an injection.MethodsPatients were randomly divided into two groups. The effect of BTA (group A, C, D) or saline as placebo (group B) was investigated in 20 patients with idiopathic rhinitis by applying it with a sponge soaked with BTA (40 units each nostril) or saline. Subgroups C and D contained these patients of group A and B who did not improve in symptoms one week after the original treatment (either BTA or saline) who then received the alternative medication. Changes of symptoms (rhinorrhea, nasal obstruction) were scored by the patients in a four point scale and counted (consumption of tissues, sneezing) in a diary. The patients were followed up weeks 1, 2, 4, 8 and 12.ResultsThere was a clear reduction of the amount of secretion in group A compared to group B, C and D. This did not correlate with the tissue consumption, which was comparably reduced in group A and B, but reduced less in group C and D. Sneezing was clearly reduced in group A but comparably unchanged in group B and C and increased in group D. Nasal congestion remained unchanged.ConclusionIn some patients with therapy-resistant idiopathic rhinitis BTA applied with a sponge is a long-lasting and minimal invasive therapy to reduce nasal hypersecretion.

A Novel Botulinum Neurotoxin Topical Gel: Treatment of Allergic Rhinitis in Rats and Comparative Safety Profile

“…[21][22][23] Treatment with RT001 but not control resulted in significant reduction in PSA score by day 3 after treatment when compared with control and with essentially full resolution to normal baseline levels by day 5. In accordance with previous studies using BoNTA in animals 15,18 and in humans, 25 these results indicate that the topical intranasal application of RT001 can relieve clinical signs in a rat model of allergic rhinitis.…”

An evidence-based review of botulinum toxin (Botox) applications in non-cosmetic head and neck conditions

“…79 In another RCT of 20 patients with idiopathic (vasomotor) rhinitis, topical application of Botox on a sponge significantly reduced rhinorrhoea compared with placebo (saline) but nasal congestion remained unchanged. 80 Furthermore, in a study of 38 patients with idiopathic rhinitis, Botox displayed a similar degree and duration of efficacy with regard to hypersecretion symptoms to ipratropium bromide. 81 Middle and inferior turbinate injections of Botox were shown to be a highly effective, safe and simple intervention in a RCT of 30 patients with vasomotor rhinitis [1b].…”

Evidencia y uso actual de toxina botulínica en patología otorrinolaringológica

“…Existen al menos 6 estudios clínicos randomizados [51][52][53][54][55][56] que comparan la inyección de toxina botulínica en los cornetes (sólo inferiores, sólo medios o ambos) utilizando distintas formulaciones de toxina botulínica (hubo un estudio que en vez de inyectar los cornetes aplicó la toxina de forma tópica).…”