Andrew Blitzer, Dan Novakovic, Scott M Rickert and Lesley F Childs
A Pilot Study of Quantitative Measurements of Nasal Function in Rhinitis and the Therapeutic Effects of Botulinum Toxin
Objective: Symptoms of rhinitis can be attributed to the stimulation of cholinergic nerve endings, which leads to mucosal hypersecretion and an increase in nasal blood flow. As botulinum toxin is a powerful cholinergic blocker, the application of this toxin intranasally may help to decrease the symptom complex associated with rhinitis. A pilot study was designed to evaluate the use of hot wire airflow, measurement of stimulated secretions, and the effect of botulinum toxin on both. A quantitative assessment of this use in humans has never been performed.
Study Design: Double-blind, placebo controlled randomized control trial.
Methods: Botulinum toxin was injected into the inferior turbinates of 8 human subjects. Patients were their own controls, with each side randomized to receive onabotulinumtoxinA (BTX-A) (four 2.5 unit aliquots) or equivalent volume of normal saline.. Airflow was measured at baseline and each visit using hot-wire airflow device. Baseline and stimulated nasal secretions were collected on filter paper then weighed. The patients were followed monthly for a total of 4 months.
Results: There was a statistically significantly greater airflow on the BTX-A treated sides compared with control sides at 4 months. There was also a statistically significant decrease in stimulated secretions at 3 months. There was a notable trend toward reduction of resting secretions and stimulated secretions in the BTX-A treated sides during the treatment period. There was also a trend toward greater airflow in the BTX-A treated sides during the treatment period.
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