Rhinorrhea is decreased in dogs after nasal application of botulinum toxin
CHRISTOPHER M.SHAARI, MD, IRA SANDERS, MD, BEI - LIAN WU, MD, and HUGI - I F.BILLER, MD, New York, New York At
this time no effective long-term therapy exists for the excessive secretion of vasomotor rhinitis.
Because rhinorrhea is under parasympathetic control, it was theorized that botuiinum toxin - A
powerful and Iong - acfing cholinergic blocker that has been successful in the treatment of dystonia
- might be useful in blocking the cholinergic control of rhinorrhea. Four
male mongrel dogs were studied. Fifty A units of botulinum toxin type was soaked into sterile gauze,
which was then packed into the left nasal cavity of each dog for I hour. Saline-soaked gauze was similarly
introduced into the right nasal cavity to serve as control. Six days later, rhinorrhea
was produced by inserting a bipolar needle electrode into the sphenopalatine gangUon and electrically stimulating
for 10 minutes. [o mA, 50 Hz . Nasal secretions were collected with a suction catheter
placed in the nasal vestibule. Three of four dogs exposed to the toxin showed a 41% average
decrease in rhinorrhea [specifically 53 %, 41 %, 30 %, and 1. One dog showed a 10% increase in
secretion after exposure to the toxin. We conclude that topically applied botulinum toxin reduced
rhinorrhea neurally evoked by an average of 41 per cent. Because
some secretion is mediated by noncholinergic neurotransmitters such as vasoactive intestinal peptide, topical
Application of an anticholinergic substance has limitations. However, because all the
nasal parasympathetic nerves appear to originate from cholinergic synapses in the sphenopalatine ganglion
, direct injections of toxin into this ganglion may possibly allow complete blockade of all
cholinergically mediated rhinorrhea.
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