الفهرس | Only 14 pages are availabe for public view |
Abstract Rhinitis is defined as inflammation of the membranes lining the nose, characterized by nasal symptoms including itching, rhinorrhea and nasal congestion. Rhinitis represents a global health problem affecting between 10% and 25% of the world population. Rhinitis can be classified into Allergic, infective and NANIR. The most common form of nonallergic rhinitis is the idiopathic condition also known as vasomotor rhinitis. Individuals categorized as such are those who not only lack conventional evidence of allergic disease but are also devoid of any evidence of sinusitis/nasal polyposis, anatomic abnormalities, or a known infection. The first-line treatment for VMR is medical therapy in the form of topical corticosteroid and topical antihistamine sprays (which are indicated for NAR as well as AR). Ipratropium bromide (0.03%) is the only topical anticholinergic approved for treatment of NAR with no systemic side effects except for occasional dryness and epistaxis. Topical capsaicin has been shown to be an efficacious treatment for NAR based on its modulating effects on C-fibers, but because of its irritant qualities, its use is often limited by patient intolerance, there are no oral antihistamines or anticholinergics currently approved for NAR. BTX is a new postulated modality of treatment for NANIR, It provides the parasympathetic blockade in intrinsic rhinitis when injected into the nose. The current body of literature shows a clear symptomatologic benefit of BTX on both intrinsic and allergic rhinitis. Use of BTX in the nose has proven to be well tolerated, with no significant morbidity. |