The effect of botulinum toxin type A injection for intrinsic rhinitis

Botulinum toxin type A (BTA) is known to inhibit the release of acetylcholine from cholinergic nerve endings. Owing to the characteristics of BTA, we thought that it could be used for the treatment of intrinsic rhinitis acting as an anticholinergic drug. In a double-blind placebo-controlled study four units of BTA were injected into the middle turbinate (two units) and inferior turbinate (two units) in each nasal cavity. Rhinorrhoea, nasal obstruction, and sneezing were recorded in a symptom diary on the basis of a scale of 5 and the number of paper tissues used per day was also recorded for 24 weeks. Rhinorrhoea was significantly diminished in severity (24.1-41.5 per cent reduction) and paper tissue use (54.3 per cent reduction) in the BTA group compared with the placebo group. This effect could be maintained for four weeks. Sneezing and nasal stuffiness were not affected by BTA. These results suggest that BTA can be used to treat rhinorrhoea in intrinsic rhinitis patients, however, the effective period is short.