gms | German Medical Science

Background: Botulinum toxin A (BTA) is a promising substance in the treatment of idiopathic rhinitis (IR), a disease characterized by nasal obstruction and hydrous rhinorrhea. In IR, BTA is conventionally injected into the nasal turbinates. In our own clinical experience, the submucoperichondrial injection of BTA into the nasal septum is an alternative both easy to perform by the physician and well tolerated by the patients.

Methods: Five patients received an injection of 80 mouse units Dysport® (Ipsen Pharma, Ettlingen, Germany) in total into the nasal septum. Patients rated the unpleasentness of the injection by a visual analogue scale (VAS). Over 14 days, nasal symptoms (rhinorrhea, nasal obstruction, urge to sneeze, nasal itching), the number of daily used facial tissues and possible complications were evaluated.

Results: The injection of BTA into the nasal septum was rated to be only marginally unpleasant (VAS, mean 0.76). A good symptom control was achieved in three patients concerning rhinorrhea and in all patients concerning nasal obstruction. The number of daily used facial tissued decreased in four patients and from a mean of 21.0 before the injection of BTA to 5.8 after 14 days. No patient reported any side effects caused by the injection of BTA.

Conclusions: This pilot study shows that septal injection of BTA in patients with IR can achieve good symptom control with a high patient comfort. The presented technique should be compared in further studies with the conventional injection technique into the nasal turbinates.