Abstract
Abstract
Background
Refractory chronic rhinitis often persists despite standard medical therapy. Botulinum toxin type A (BTX-A) injection into the inferior turbinates offers a minimally invasive alternative, but the influence of the injection site within the turbinate is unknown. This study compared the efficacy and safety of anterior versus posterior inferior turbinate BTX-A injections in refractory chronic rhinitis.
Methods
In this randomized, single-blinded clinical trial conducted from 2023 to 2025, 50 adults with refractory chronic rhinitis were randomized to receive 30 units of BTX-A injected submucosally under endoscopic guidance into either the anterior (
n
= 25) or posterior (
n
= 25) inferior turbinate bilaterally. The primary outcome was change in Sino-Nasal Outcome Test-22 score from baseline to 1 and 3 months post-injection. Secondary outcomes included rhinorrhea severity (0–5 Likert scale), nasal discharge on endoscopy, and adverse events. Data were analyzed using independent and paired t-tests in SPSS version 25.
Results
Groups were balanced at baseline (mean age 39.4–40.6 years, 48–56% female). Mean SNOT-22 scores decreased significantly from baseline (24.8 ± 4.8 anterior; 24.4 ± 4.7 posterior) to 1 month (10.5 ± 3.1 anterior; 9.8 ± 2.4 posterior) and remained stable at 3 months (10.4 ± 3.5 anterior; 10.9 ± 3.4 posterior), with no between-group differences (
P
= 0.745, 0.393, 0.656, respectively). Within-group reductions were highly significant (
P
P
> 0.05).
Conclusions
Anterior and posterior inferior turbinate BTX-A injections provide equivalent, rapid, and sustained symptom relief in refractory chronic rhinitis with excellent safety. Injection site does not affect efficacy, supporting a flexible technique. Larger trials with extended follow-up are needed.
Clinical trial number
Not applicable.