Saline irrigation spells relief for sinusitis sufferers

Mari Egan, MD, MHPE; John Hickner, MD, MS. Department of Family Medicine, The University of Chicago

Otolaryngologists recommend saline irrigation after sinus surgery to clear secretions, debris, and crusts; reduce the risk of postoperative mucosal adhesions; and expedite mucosal healing. Saline irrigation is also gaining popularity as an alternative approach to chronic sinusitis symptom relief, and several randomized controlled trials (RCTs) have demonstrated both objective and subjective efficacy of this treatment for sinonasal disease.

Role of saline nasal irrigation in the treatment of chronic rhinosinusitis.

Author: Dr. Brindusa Petrutescu, MD, Allergology and Clinical Immunology, Bucharest, Romania

Use of saline nasal cleansing as non-drug treatment in many diseases of the nose and sinuses is not a novel concept. In yoga tradition and homeopathic medicine nasal lavage is a ritual, along with daily teeth-brushing.

Validation of the Sino-Nasal Outcome Test 20 (SNOT-20) domains in nonsurgical patients.

Melissa A. Pynnonen, M.D., H. Myra Kim, Sc.D. and Jeffrey E. Terrell, M.D.

Subscales identified differences in the impact of two medical interventions on chronic sinonasal symptoms. Reporting subscale scores might improve the precision of the SNOT-20 instrument, allowing discrimination between various treatments and their differential impact on sinonasal quality of life.

Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation.

Richard J. Harvey, MD, John C. Goddard, MD, Sarah K. Wise, MD, and Rodney J. Schlosser, MD, Charleston, SC; and Atlanta, GA

ESS greatly enhances the delivery of nasal solutions, regardless of delivery device. Pressurized spray solutions in un-operated sinuses provide little more than nasal cavity distribution. Use of squeeze bottle/neti pot post-ESS offers a greatly enhanced ability to deliver solutions to the paranasal sinuses.

Nasal Saline for Chronic Sinonasal Symptoms - A Randomized Controlled Trial.

Melissa A. Pynnonen, MD; Shraddha S. Mukerji, MD; H. Myra Kim, ScD; Meredith E. Adams, MD; Jeffrey E. Terrell, MD

Nasal irrigations performed with large volume and delivered with low positive pressure (NeilMed Sinus Rinse) are more effective than saline sprays for treatment of chronic nasal and sinus symptoms in a community based population.

Pre- and Postoperative Sinus Penetration of Nasal Irrigation

Alethea Grobler, MBBS; Erik K. Weitzel, MD; Achim Buele, MD; Camille Jardeleza, MD; Yew C. Cheong, MD; John Field, PhD, AStat; Peter-John Wormald, MD, FRACS

Unoperated sinuses or cases with gross sinus ostial obstruction will not be reliably penetrated by sinus irrigant. A 3.95-mm ostial diameter seems to be the minimum size to guarantee penetration in paranasal sinuses to maximize the potential for topical sinus treatment.

Nasal Lavage With Mupirocin for the Treatment of Surgically Recalcitrant Chronic Rhinosinusitis.

Brent Uren, FRACS; Alkis Psaltis, MBBS; Peter-John Wormald, MD

Nasal lavage with a mupirocin solution may represent an effective alternative to manage patients with recalcitrant CRS due to SA infection. It is well tolerated and involves reduced treatment related morbidity when compared with standard oral or systemic drug delivery. Further research is needed to better understand the pharmacodynamics of topical drug use in the sinonasal cavities.

Radiographic Comparison of Three Methods for Nasal Saline Irrigation.

David E. L. Olson, MD; Barry M. Rasgon, MD; Raymond L. Hilsinger, Jr., MD

Three different methods of nasal irrigations were compared; positive pressure (NeilMed Sinus Rinse), negative pressure and the nebulizer method. Study concluded that irrigations performed by positive pressure penetrated into the ethmoid and maxillary sinuses more consistently than other methods of irrigation.

Baby shampoo nasal irrigations for the symptomatic post–functional endoscopic sinus surgery patient.

Alexander G. Chiu, M.D., James N. Palmer, M.D., Bradford A. Woodworth, M.D., Laurel Doghramji, R.N., Michael B. Cohen, B.A., Anthony Prince, B.A., and Noam A. Cohen, M.D., Ph.D.

Baby shampoo nasal irrigation has promise as an inexpensive, tolerable adjuvant to conventional medical therapies for symptomatic patients after FESS. Its greatest benefit may be in improving symptoms of thickened nasal discharge and postnasal drainage.

Rhinitis and onset of asthma: a longitudinal population-based study.

Rafea Shaaban, Mahmoud Zureik, David Soussan, Catherine Neukirch, Joachim Heinrich, Jordi Sunyer, Matthias Wjst, Isa Cerveri, Isabelle Pin , Jean Bousquet, Deborah Jarvis, Peter G Burney, Françoise Neukirch, Bénédicte Leynaert

A close relation between asthma and allergic rhinitis has been reported by several epidemiological and clinical studies. However, the nature of this relation remains unclear. We used the follow-up data from the European Community Respiratory Health Survey to investigate the onset of asthma in patients with allergic and non-allergic rhinitis during an 8·8-year period.

Allergic rhinitis: new insights, new therapies.

Dr Paul Carson

Dr Paul Carson on how his investment in fibre optic technology has provided some new perspectives on allergic rhinitis and the importance of managing the condition. At the risk of boring you about a topic many dismiss as trivial, may I persuade you to re-think your notions on allergic rhinitis? Why?

General Medical Literature

Nasal irrigations are often mentioned as adjunctive measures in treating many sinonasal conditions. Despite their widespread use, much mystique and uncertainty exist about the indications and therapeutic mechanisms of nasal irrigations. Anecdotal evidence and poorly controlled studies add to the confusion. Recent evidence challenges some of the assumptions underlying the use of nasal irrigations.