title: Investigation of the effects of intranasal botulinum toxin type A and ipratropium bromide nasal spray on nasal hypersecretion in idiopathic rhinitis without eosinophilia.
abstract: Idiopathic rhinitis without eosinophilia is a group of frequently observed diseases, the aetiopathogenesis of which is not yet well known. One of the most disturbing symptoms for patients within this disease group is nasal hypersecretion. Although many different treatments have been tried for hypersecretion, nasal topical drugs form the basis of any such therapy today. Ipratropium bromide (IB) is a drug offirst choice in nasal hypersecretion therapy. It displays a parasympatholytic effect in topical use and antagonizes acetylcholine transport in efferent parasympathetic nerves, thus decreasing submucosal gland secretion, which is the cause of hypersecretion. Botulinum toxin type A (BTX-A) is among the alternative treatment choices that is increasingly used in symptomatic treatment of nasal hypersecretion. Our study was planned with the aim of comparing the effect of these two groups of drugs on nasal hypersecretion. Thirty-eight patients who were diagnosed with idiopathic rhinitis without eosinophilia were included in the study and were divided in 3 different groups: In the first group, a total of 10 units of BTX-A were injected into both nasal cavities. In the second group, 3x2 IB was injected into both nasal cavities for 4 weeks. The third group received intranasal physiologic saline as placebo. The patients were evaluated in terms of nasal hypersecretion with visual analogue scale prior to the treatment and at weeks 1, 2, 4, 8, and 12 during the follow-up period. Throughout the 8 weeks follow-up period, the patient complaints displayed a 41.2% decrease in the group that received BTX-A and a 61.4% decrease in the group which received IB, while no change was observed in the control group. Both drug groups were well tolerated by the patients, with no serious adverse or systemic effects. As a result, while IB and BTX-A differ in terms of method of application, they display a similar degree and duration of efficiency in hypersecretion therapy.
authors.affiliation: Department of Otorhinolaryngology, Medical Faculty, Istanbul Bilim University, Istanbul, Turkey.
authors.forename: Tarik
authors.initials: T
authors.lastname: Sapci
authors.forename: Sara
authors.initials: S
authors.lastname: Yazici
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Evcimik
authors.forename: Ziya
authors.initials: Z
authors.lastname: Bozkurt
authors.forename: Ahmet
authors.initials: A
authors.lastname: Karavus
authors.forename: Bayram
authors.initials: B
authors.lastname: Ugurlu
authors.forename: Emre
authors.initials: E
authors.lastname: Ozkurt
mesh_terms: D000281:Administration, Intranasal; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009093:Mucus / Q000378:metabolism; D009297:Nasal Mucosa / Q000378:metabolism* / Q000503:physiopathology; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D011446:Prospective Studies; D012220:Rhinitis / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; D009241:Ipratropium