The Effect of Gelfoam Impregnated With Botulinum Toxin on Allergic Rhinitis Symptoms

Document Type : Original

Authors

1 Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

2 Department of Allergy and Clinical Immunology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Introduction:
This study evaluated the effect of gelfoam impregnated with botulinum toxin on the symptoms induced by allergic rhinitis.
Materials and Methods:
In total, 30 patients with allergic rhinitis who did not respond to common therapies were included in this clinical trial study. All patients were treated with intranasal gelfoam impregnated with botulinum toxin type a (40 unit in each side) placed in the middle meatus of each nostril. The main symptoms of allergic rhinitis were scored from zero to three by the patients. Symptoms recorded and compared before and two months after the treatment.
Result:
The mean age of patients was 31.03±6.9 years. The mean score for sneezing was 2.23 before the treatment which significantly decreased to 1.06 after the treatment (P<0.05). The mean scores of rhinorrhea, nasal congestion, and nasal itching were 2.53, 2.03, and 1.93, respectively, before the treatment which significantly decreased to 0.93, 1, and 0.8 after the treatment (P<0.05). No reported side effects was observed in this study.
Conclusion:
According to the results, treatment with gelfoam impregnated with botulinum toxin is an effective and safe method in patients who have not responded to common therapies for allergic rhinitis. Accordingly, it is recommended to relieve symptoms in patients with seasonal allergic rhinitis in order to maintain the effectiveness of this treatment at least 8 weeks.

Keywords

Main Subjects

References

1. Bauchau V, Durham S. Prevalence and rate of diagnosis of allergic rhinitis in Europe. European Respiratory Journal. 2004;24(5): 758-64.
2. Crystal-Peters J, Crown WH, Goetzel RZ, Schutt DC. The cost of productivity losses associated with allergic rhinitis. Am J Manag Care. 2000;6(3):
373-8.
3. Okubo K, Kurono Y, Fujieda S, Ogino S, Uchio E, Odajima H, et al. Japanese guideline for allergic rhinitis. Allergology International. 2011;60(2):171-89.
4. Price D, Bond C, Bouchard J, Costa R, Keenan J, Levy ML, et al. International Primary Care Respiratory Group (IPCRG) guidelines: management of allergic rhinitis. Primary care respiratory journal. 2006;15(1): 58-70.
5. Sardana N, Craig TJ. Congestion and sleep impairment in allergic rhinitis. Asian Pacific journal of allergy and immunology. 2011; 29(4):297.
6. Bousquet J, Van Cauwenberge P, Khaltaev N, Organization WH. Allergic rhinitis and its impact on asthma. Journal of allergy and clinical immunology. 2001;108(5):S147-S334.
7. Bousquet J, Bullinger M, Fayol C, Marquis P, Valentin B, Burtin B. Assessment of quality of life in patients with perennial allergic rhinitis with the French version of the SF-36 Health Status Questionnaire. Journal of allergy and clinical immunology. 1994; 94(2): 182-8.
8. Tripathi A, Patterson R. Impact of allergic rhinitis treatment on quality of life. Pharmacoeconomics. 2001;19(9):891-9.
9. Bousquet J, Van Cauwenberge P, Ait Khaled N, Bachert C, Baena‐Cagnani C, Bouchard J, et al. Pharmacologic and anti‐IgE treatment of allergic rhinitis ARIA update (in collaboration with GA2LEN). Allergy. 2006;61(9):1086-96.
10. Leynaert B, Neukirch C, Liard R, Bousquet J, Neukirch F. Quality of life in allergic rhinitis and asthma: a population-based study of young adults. American journal of respiratory and critical care medicine. 2000;162(4):1391-6.
11. Rohrbach S, Laskawi R. Minimally invasive application of botulinum toxin type A in nasal hypersecretion. ORL. 2001;63(6):382-4.
12. Simpson LL. Identification of the major steps in botulinum toxin action. Annu Rev Pharmacol Toxicol. 2004;44:167-93.
13. Kim K-S, Kim S-S, Yoon J-H, Han JW. The effect of botulinum toxin type A injection for intrinsic rhinitis. The Journal of Laryngology & Otology. 1998; 112(3): 248-51.
14. Schantz EJ, Johnson EA. Properties and use of botulinum toxin and other microbial neurotoxins in medicine. Microbiology and Molecular Biology Reviews. 1992;56(1):80-99.
15. Ünal M, Sevim S, Doğu O, Vayisoğlu Y, Kanik A. Effect of botulinum toxin type A on nasal symptoms in patients with allergic rhinitis: a double-blind, placebo-controlled clinical trial. Acta oto-laryngologica. 2003;123(9):1060-3.
16. Rohrbach S, Olthoff A, Giefer B, Laskawi R, Götz W. Botulinum toxin type A induces apoptosis in nasal glands of guinea pigs. Annals of Otology, Rhinology & Laryngology. 2001;110(11):1045-50.
17. Wang J, Chen F, Meng M, Zhang X, Chen Y, Huang W, et al. The influence of botulinum toxin type A on vasomotor rhinitis and morphological study. Lin chuang er bi yan hou ke za zhi= Journal of clinical otorhinolaryngology.2003;17(11):
643-5.
18. Shaari CM, Sanders I, Wu B-L, Biller HF. Rhinorrhea is decreased in dogs after nasal application of botulinum toxin. Otolaryngology—Head and Neck Surgery. 1995;112(4):566-71.
19. Bousquet J, Khaltaev N, Cruz AA, Denburg J, Fokkens W, Togias A, et al. Allergic rhinitis and its impact on asthma (ARIA) 2008. Allergy. 2008; 63: 8-160.
20. Okuda M. Grading the severity of allergic rhinitis for treatment strategy and drug study purposes. Current allergy and asthma reports. 2001; 1(3):235-41.
21. Özcan C, Vayisoglu Y, Doğu O, Görür K. The effect of intranasal injection of botulinum toxin A on the symptoms of vasomotor rhinitis. American journal of otolaryngology. 2006;27(5):314-8.
22. Rohrbach S, Junghans K, Köhler S, Laskawi R. Minimally invasive application of botulinum toxin A in patients with idiopathic rhinitis. Head & face medicine. 2009;5(1):18.
23. Yang TY, Jung YG, Kim YH, Jang TY. A comparison of the effects of botulinum toxin A and steroid injection on nasal allergy. Otolaryngology–Head and Neck Surgery. 2008;139(3):367-71.
24. Hashemi SM, Okhovat A, Amini S, Pourghasemian M. Comparing the effects of botulinum toxin-A and cetirizine on the treatment of allergic rhinitis. Allergology International. 2013; 62(2):245-9.
25. Abtahi SM, Hashemi SM, Abtahi SH, Bastani B. Septal injection in comparison with inferior turbinates injection of botulinum toxin A in patients with allergic rhinitis. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2013;18(5):400.
Iranian Journal of Otorhinolaryngology
Volume 31, Issue 4 - Serial Number 105
July and August 2019
Pages 203-208

Files

Share

How to cite

Statistics