Department of Otolaryngology, Head and Neck Surgery, University of Göttingen, Germany.
Head Face Med. 2009 Oct 16;5:18. doi: 10.1186/1746-160X-5-18.
Nasal hypersecretion due to idiopathic rhinitis can often not be treated sufficiently by conventional medication. Botulinum toxin A (BTA) has been injected into the nasal mucosa in patients with nasal hypersecretion with a reduction of rhinorrhea lasting for about 4 to 8 weeks. Since the nasal mucosa is well supplied with glands and vessels, the aim of this study was to find out if the distribution of BTA in the nasal mucosa and a reduction of nasal hypersecretion can also be reached by a minimally invasive application by sponges without an injection.
Patients were randomly divided into two groups. The effect of BTA (group A, C, D) or saline as placebo (group B) was investigated in 20 patients with idiopathic rhinitis by applying it with a sponge soaked with BTA (40 units each nostril) or saline. Subgroups C and D contained these patients of group A and B who did not improve in symptoms one week after the original treatment (either BTA or saline) who then received the alternative medication. Changes of symptoms (rhinorrhea, nasal obstruction) were scored by the patients in a four point scale and counted (consumption of tissues, sneezing) in a diary. The patients were followed up weeks 1, 2, 4, 8 and 12.
There was a clear reduction of the amount of secretion in group A compared to group B, C and D. This did not correlate with the tissue consumption, which was comparably reduced in group A and B, but reduced less in group C and D. Sneezing was clearly reduced in group A but comparably unchanged in group B and C and increased in group D. Nasal congestion remained unchanged.
In some patients with therapy-resistant idiopathic rhinitis BTA applied with a sponge is a long-lasting and minimal invasive therapy to reduce nasal hypersecretion.
特发性鼻炎导致的鼻分泌物过多，通常无法通过常规药物治疗充分缓解。将肉毒杆菌毒素 A（BTA）注射到鼻黏膜中，可减少鼻分泌物，缓解时间约为 4 至 8 周。由于鼻黏膜有丰富的腺体和血管，因此本研究旨在确定是否可以通过使用海绵进行微创给药（而非注射）将 BTA 分布到鼻黏膜中，并减少鼻分泌物过多。
将患者随机分为两组。通过用 BTA 浸湿的海绵（每侧鼻孔 40 个单位）或盐水（作为安慰剂）将 BTA（组 A、C 和 D）或盐水（组 B）应用于 20 例特发性鼻炎患者，以评估 BTA 的效果。亚组 C 和 D 包含组 A 和 B 中那些在原始治疗（BTA 或盐水）一周后症状未改善的患者，然后给予替代药物。患者通过四点量表对症状（流涕、鼻塞）评分并记录日记（纸巾消耗、打喷嚏次数）。患者在第 1、2、4、8 和 12 周进行随访。
与组 B、C 和 D 相比，组 A 的分泌物量明显减少。但这种减少与纸巾消耗无关，组 A 和 B 的纸巾消耗都有减少，但组 C 和 D 的减少较少。组 A 的打喷嚏次数明显减少，但组 B 和 C 基本不变，而组 D 的打喷嚏次数增加。鼻塞没有变化。
对于一些治疗抵抗的特发性鼻炎患者，使用海绵给予 BTA 是一种持久且微创的治疗方法，可以减少鼻分泌物过多。
