Role of Botulinum Toxin Injection in Non Allergic Non Infectious Chronic Rhinosinusitis (A Systematic Review)

Botulinum toxin is derived from clostridium botulinum, in the recent era it has been used in many aspects of medicine such as sialorrhea, aesthetic surgery and most recently in rhinosinusitis. Rhinosinusitis is defined as an inflammation of the membranes lining the nose and paranasal sinuses, characterized by nasal symptoms including itching, rhinorrhea and nasal obstruction. Rhinosinusitis represents a global health problem affecting between 10% and 25% of the world population. Aim of the Work Systematic review of the clinical trials, to detect the efficacy of using botulinum toxin locally in cases of non-allergic non-infectious rhinosinusitis and allergic rhinosinusitis. Methodology This is a meta-analysis study. The study included published medical articles about botulinum toxin injection for patients suffering from non-allergic non-infectious rhinosinusitis (NANIR) and patients complaining of allergic rhinosinusitis through searching the Medline data base. Results 172 patients were included in our systematic review, where botulinum toxin was used locally in the nasal cavity, a clear symptomatologic benefit of BTX on both (NANIR) and allergic rhinosinusitis in terms of rhinorrhea, pruritis, sneezing, nasal obstruction. No systemic effects were reported, and 6 cases only reported epistaxis for 1week after BTX injection. Conclusion The available data favors the efficacy of usage of botulinum toxin for cases of (NANIR) and allergic rhinosinusitis, further randomized controlled studies must be conducted in the future.