Comparative Study between Intranasal Injection of Botulinum Toxin-A and Combined Intranasal Medical Treatment for Allergic Rhinitis

Background: Allergic rhinitis is one of the most common diseases, with no consensus on its ideal treatment. Botulinum Toxin-A was proposed to be an effective treatment.  Aim of the work: To estimate the outcome of intranasal injection of Botulinum Toxin-A [BTX-A] as a sole therapy for allergic rhinitis. Patients and Methods:Ninty patients with classic symptoms of allergic rhinitis were clinically evaluated and asked to complete the score for allergic rhinitis [SFAR] questionnaire using cutoff at >8 as diagnostic AR. Two blood samples [venous] and nasal smears were obtained at the beginning of the study and at the end of 12-weeks after initiation of therapy for estimation of human immunoglobulin E [IgE] and eosinophilia grading. Control group included patients who chose to receive combined medical treatment. BTX-A, 2.5 units were injected intranasally, under 0o rigid telescope guidance. Study outcome was the treatment success rate at the end of 12-w follow-up period. Results: Intranasal BTX-A injection provided significantly maintained relieve of allergic rhinitis manifestations especially for running nose than combination therapy. The treatment success rate of 1.9 versus 0.7 item/patient in study versus control group with significant difference in favor of BTX-A injection. Serum IgE levels and eosinophilia grades were significantly lower in control patients. Patients' satisfaction grading was significantly more with BTX-A injection. Conclusion: Intranasal BTX injection could be a safe and effective sole therapeutic modality for patients with long-lasting AR