A Novel Technique for the Topical Application of Botulinum Neurotoxin A to the Nasal Mucosa in Reducing Rhinitis Symptoms.

[INTRODUCTION] To date, no investigations have been published regarding the concentration, dose, and technique for a mucosal spray application of botulinum toxin A (BTA) to alleviate hypersecretory symptoms of rhinitis in humans. It is a promising option for reducing common symptoms of seasonal allergic rhinitis (AR) and idiopathic non-AR. It is safer and less painful than intranasal injections, with high reported satisfaction in reducing clinical symptoms.

[MATERIALS AND METHODS] Seventeen patients with idiopathic rhinitis who presented to a private clinic in Australia were given 25 units of BTA (Letybo®, Hugel, South Korea) at a concentration of 50 U/mL in normal saline in each nostril via a mucosal atomizer device. At 4 and 12 weeks, a survey of symptom relief, satisfaction with treatment, and willingness to get a repeat treatment was collected.

[RESULTS] Patients were otherwise healthy, and the mean age was 40.1 ± 19.4 years. The majority (15 of 17) of subjects at 4 and 12 weeks reported significant symptom relief and high satisfaction, and were willing to get a repeat treatment. No adverse effects were reported.

[CONCLUSION] Topical application of BTA on the nasal mucosa can be considered an effective therapeutic option in patients with persistent AR and idiopathic rhinitis. In comparison with injection techniques, BTA mucosal spray is effective at reducing persistent symptoms while minimizing the risk of pain and inadvertent systemic injection, and is able to promote contact with a wider mucosal area. Furthermore, it is easy to perform and is more tolerable for the patient. The authors present recommended concentrations, doses, and techniques.