Résumé
This thesis evaluates the efficacy of botulinum toxin, administered via injections into the nasal mucosa, for the treatment of refractory chronic rhinorrhea. Methods: thirteen patients received 80 U of botulinum toxin (abobotulinum toxin A, Dysport®) distributed between the two nasal cavities (anterior septum, head of the inferior turbinate, head of the middle turbinate, and the sphenopalatine region). The symptoms were evaluated using the TNSS (Total Nasal Symptom Score) and DyNaChron scores, completed before and after injection with monthly follow-up for 3 months, as well as a visual analog scale (VAS) created for the study, with an evaluation at 3 months. The MCID (Minimal Clinically Important Difference) and the mean score variation were used to assess effectiveness. Results: an improvement in rhinorrhea symptoms was observed in some patients, with 38% of patients reaching the MCID for anterior rhinorrhea according to DyNaChron, and 53% of patients reaching the MCID for TNSS. No serious adverse events were reported. Conclusion: botulinum toxin could represent a safe therapeutic alternative for patients suffering from refractory chronic rhinorrhea, although the response to treatment is variable. Further studies, with a standardized protocol and a larger sample size, are needed to better define its role in the therapeutic arsenal.