title: Septal injection of botulinum neurotoxin A for idiopathic rhinitis: a pilot study.
abstract: OBJECTIVE
  Botulinum neurotoxin A (BTA) is a promising therapeutic option in the treatment of idiopathic rhinitis (IR), a disease characterized by nasal obstruction and hydrous rhinorrhea. The conventional localization for the injection of BTA in IR is the nasal turbinates. In our own clinical experience, submucoperichondrial injection of BTA in the nasal septum is an alternative that is easy to perform for the therapist and also well tolerated by the patient.
  
  
  METHODS
  Five patients received an injection of in total 80 mouse units Dysport (Ipsen Pharma, Ettlingen, Germany) in the nasal septum. The unpleasantness of the nasal injection of BTA was measured on a visual analogue scale. Over the course of 14 days, nasal symptoms (rhinorrhea, nasal obstruction, urge to sneeze, nasal pruritus), the number of facial tissues used daily, and possible complications were evaluated.
  
  
  RESULTS
  The unpleasantness of the injection of BTA into the nasal septum after local anesthesia was rated low (visual analogue scale, 0.76 on average). A good subjective symptom control was achieved in 3 patients concerning rhinorrhea and in all patients concerning nasal obstruction. The number of facial tissues used daily as a parameter for rhinorrhea was on average 21.0 before the injection of BTA, decreased in 4 patients over the course of time, and was on average 5.8 after 14 days. No patient reported any adverse effects after the injection of BTA.
  
  
  CONCLUSIONS
  This pilot study demonstrates that septal injection of BTA in patients with IR can achieve good symptom control and patient comfort and should be compared in further studies to the conventional turbinal injection technique.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilian University, Munich, Germany. thomas.braun@med.uni-muenchen.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Braun
authors.forename: Robert
authors.initials: R
authors.lastname: Gürkov
authors.forename: Matthias F
authors.initials: MF
authors.lastname: Kramer
authors.forename: Eike
authors.initials: E
authors.lastname: Krause
mesh_terms: D000772:Anesthesia, Local; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D009300:Nasal Septum; D009465:Neuromuscular Agents / Q000008:administration & dosage*; D010147:Pain Measurement; D010865:Pilot Projects; D012189:Retrospective Studies; D012220:Rhinitis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A