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鼻内注射A型肉毒杆菌毒素对特发性鼻炎症状的影响。

The Effect of Turbinate Injection of Botulinum Toxin A on the Symptoms of Idiopathic Rhinitis.

作者信息

Carvalho Thiago, Salgado Daniel Calduro, Mion Olavo de Godoy, de Mello João Ferreira, Voegels Richard Louis

机构信息

Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, Brazil.

出版信息

Int Arch Otorhinolaryngol. 2021 Aug 13;26(2):e191-e198. doi: 10.1055/s-0041-1730307. eCollection 2022 Apr.

Abstract

Idiopathic rhinitis is a nonallergic and noninfectious rhinitis characterized mainly by nasal obstruction and rhinorrhea, resulting from an autonomic imbalance. Botulinum toxin type A (BTX-A) demonstrated its action in reducing rhinorrhea and nasal obstruction when injected into the nasal turbinates or septum.  To analyze the effects of intranasal BTX-A injection to control the symptoms of idiopathic rhinitis and its possible adverse effects.  Patients with idiopathic rhinitis were divided into two groups. Group A had 15 participants (8 female and 6 male), of ages from 47 to 84 years (mean 66.57 years), and these received 60 U of Dysport (Ipsen Ltd, Maidenhead, Berkshire, UK) in each inferior nasal turbinate; group B had 12 participants (1 male and 11 female), of ages from 50 to 76 years (mean 60 years), and they received 1 ml of 0.9% saline. The individuals were reevaluated in the 1 , 2 , 4 , 8 , and 12 weeks after injection by a questionnaire, accompanied by nasal inspiratory peak flow and acoustic rhinometry.  Group A showed significant improvement, mainly regarding the symptoms of sneezing/itching and nasal obstruction, over time and when compared to group B. Acoustic rhinometry confirmed the improvement in nasal obstruction. There was no relationship between the nasal peak flow data and the nasal obstruction score. No major adverse effects have been reported.  The injection of botulinum toxin in the inferior nasal turbinates of patients with idiopathic rhinitis reduces the symptoms of sneezing, itching, nasal obstruction, and runny nose without significant adverse effects, suggesting that it is an option in the treatment of these patients.

摘要

特发性鼻炎是一种非过敏性、非感染性鼻炎,主要特征为鼻塞和流涕,由自主神经失调引起。A型肉毒杆菌毒素(BTX-A)注射到鼻甲或鼻中隔时,可减轻流涕和鼻塞症状。

分析鼻内注射BTX-A对控制特发性鼻炎症状及其可能的不良反应的效果。

将特发性鼻炎患者分为两组。A组有15名参与者(8名女性和6名男性),年龄在47至84岁之间(平均66.57岁),在下鼻甲各注射60 U的Dysport(益普生有限公司,英国伯克郡梅登黑德);B组有12名参与者(1名男性和11名女性),年龄在50至76岁之间(平均60岁),接受1毫升0.9%的生理盐水。在注射后的第1、2、4、8和12周,通过问卷调查对个体进行重新评估,并测量鼻吸气峰流量和声反射鼻测量。

与B组相比,随着时间推移,A组在打喷嚏/瘙痒和鼻塞症状方面有显著改善。声反射鼻测量证实了鼻塞的改善。鼻峰流量数据与鼻塞评分之间没有关联。未报告重大不良反应。

在特发性鼻炎患者的下鼻甲注射肉毒杆菌毒素可减轻打喷嚏、瘙痒、鼻塞和流涕症状,且无明显不良反应,表明这是治疗这些患者的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de0c/9122764/57f94d1eb35e/10-1055-s-0041-1730307-i200256-1.jpg

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