Background: Chronic rhinosinusitis is a very common disorder caused by chronic inflammation or irritation of nasal
mucosa.
Objectives: The purpose of this study was to evaluate the efficacy and safety of topical application of botulinum toxin
type A (BTX-A) compared with intraturbinate injection for the treatment of noninfectious chronic rhinosinusitis.
Patients and methods: This prospective comparative study was carried out on 30 patients with noninfectious chronic rhinosinusitis.
Patients were divided randomly into two groups. BTX-soakedmerocel was applied topically in group A (topical
group),which included 15 patients. Intraturbinate BTX injectionwas applied in group B (injected group),which included 15
patients. The total nasal-symptomscore (TNSS)was applied initially and after the procedure for 8weeks of follow-up period.
Results: Both groups showed significant improvement of the TNSS all over the period of the study compared with the
baseline, except at the eighth week in group A (topical group). At the eighth week, the TNSS was significantly higher in
group A than group B, median (range) of 8 (4e11) compared with 5 (3e6), P value was less than 0.001. No one complained
from epistaxis and only three patients in group B reported nasal-dryness sensation at the fourth and sixth weeks and
improved by the eighth week.
Conclusion: BTX-A topical application using soaked merocel could be a safe and a very successful way for managing
the symptoms of chronic noninfectious rhinosinusitis. However, injections had a longer duration of impact than topical
application. |
