Turbinate Injection of Botulinum Toxin in the Treatment of the Chronic Rhinitis

Objectives: This systemic review with meta-analysis evaluated the effect of intranasal BTX-A turbinate injection on chronic rhinitis-related symptoms.

Data sources: PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases.

Review methods: We reviewed studies retrieved from databases up to Aug 2024. The studies evaluating the degree of change of rhinitis-related symptom scores and quality of life before and after BTX-A injection were analyzed. Standard mean differences were used to calculate effect sizes.

Results: A total of 269 patients from 7 studies were analyzed. BTX-A injection showed a significant improvement in rhinitis-related symptoms (congestion: 2.5416, 95% CI 1.0927-3.9905, I² = 94.4%, itching: 1.2553, 95% CI 0.6660-1.8446; I² = 70.8%, rhinorrhea: 1.8451, 95% CI 1.0468-2.6435, I² = 89.7%, and sneezing: 1.3580, 95% CI 0.5194-2.1967; I² = 90.7%), total nasal symptom score (2.4020, 95% CI 1.4161-3.3879, I² = 86.1%), and quality of life (1.5256, 95% CI 1.0760-1.9752; I² = 0.0%) throughout the follow-up period (4 months). However, 3 months after injection, although symptom improvement remained, there was no statistical significance. Allergic rhinitis (AR) patients showed a significant improvement in rhinitis-related symptoms compared with nonallergic rhinitis (NAR) patients.

Conclusions: Nasal symptoms and quality of life scores related to rhinitis were decreased after BTX-A injection. In particular, this treatment showed better efficacy in AR and could be more beneficial for the symptoms of nasal congestion and rhinorrhea at the early periods of treatment. However, the effects lasted for a relatively short period of only 2-3 months. Laryngoscope, 2024.