Effect of irrigation of the nose with isotonic salt solution on adult patients with chronic paranasal sinus disease.

Otorhinolaryngological Clinic, Cologne University, Germany.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde (Impact Factor: 1.46). 01/2001; 257(10):537-41. DOI: 10.1007/s004050000271
Source: PubMed

ABSTRACT In a prospective, randomized, controlled, double-blind trial we compared the effectiveness of endonasal irrigations with Ems salt solution to that with sodium chloride solution in the treatment of adult patients with chronic paranasal sinus disease. Subjects (n = 40) were randomly allocated to treatment either with isotonic Ems salt solution or with isotonic sodium chloride solution. The treatment consisted of endonasal irrigation twice daily and additional nasal spray as required. Nasal endoscopy, plain radiography of the paranasal sinuses, olfactometry, anterior rhinomanometry, and a saccharin-clearance test were carried out on days 1 and 7. Patients recorded rating scales of general discomfort, nasal airway obstruction, agreeableness of the irrigation, duration of improved nasal resistance after each irrigation, and the amount of additional nasal spray in a diary. Nasal air flow was not improved significantly. Subjective complaints, endonasal endoscopy, and radiography results revealed a significant improvement in both groups (P = 0.0001). In comparison, the two groups were not significantly different in outcome. Endonasal irrigations with salt solutions are effective in the treatment of chronic sinusitis, and a significant difference between Ems salt and sodium chloride was not observed.

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    ABSTRACT: Introduction Many otolaryngologists use nasal saline irrigations and sprays for patients with chronic rhinitis and rhinosinusitis as a mainstay to treat and irrigate purulent secretions from the nasal cavity. The Dead Sea is the world’s most saline lake. Its 30% salt composition has proportionately more calcium, magnesium, bromine, and potassium, and less sodium sulfate and carbonate than any other ocean. The dominant cation, magnesium, has been effective in the treatment of inflammatory cutaneous lesions, inhibits histamine effects, and stabilizes eosinophils. This article examines the value of a nasal irrigating solution and spray from the Dead Sea. Purpose To determine the effectiveness of Dead Sea salt solution (Oasis nasal spray/irrigation; Master Solutions, Tulsa, OK) on the symptomatic treatment of purulent rhinitis and rhinosinusitis by measuring the quality of life and sinus-specific symptoms. Methods A total of 31 patients were selected because of refractive purulent rhinosinusitis that persisted after medical or surgical treatment. A relatively new irrigating solution and nasal wash containing Dead Sea salt as their major components (Oasis) were used as an irrigation in the morning, and spray midday and evening. The Medical Outcomes Short Form 36 (SF-36) and Chronic Sinusitis Survey were used to measure quality of life. Of the 31 patients, 26 returned the survey instruments. Data were analyzed using STATISTICA (StatSoft, Inc, Tulsa, OK). Results The means before treatment were 20.08 for chronic sinusitis and 75.88 for quality of life, and after treatment significantly reduced to 13.37 and 45.65, respectively. Conclusions Dead Sea Salt is an effective irrigation and spray in the treatment of purulent rhinosinusitis, improving quality of life and rhinosinusitis symptoms. It may have its effectiveness because of the different cation composition from normal or hypertonic saline.
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    ABSTRACT: The use of saline nasal irrigation (SNI) in the treatment of nasal and sinus disorders has its roots in the yoga tradition and homeopathic medicine. In recent years, SNI has been increasingly observed as concomitant therapy for acute (ARS) and chronic rhinosinusitis (CRS). Various devices are employed, such as nasal douches, neti pots or sprays. The saline solutions used vary in composition and concentration. This article gives a current overview of literature on the clinical efficacy of SNI in the treatment of ARS and CRS. It then answers frequent questions that arise in daily clinical routine (nasal spray vs. nasal irrigation, saline solution composition and concentration, possible risks for patients). SNI has been an established option in CRS treatment for many years. All large medical associations and the authors of systematic reviews consistently conclude that SNI is a useful addition for treating CRS symptoms. SNI use in ARS therapy, however, is controversial. The results of systematic reviews and medical associations’ recommendations show the existing but limited efficacy of SNI in ARS. For clinical practice, nasal douches are recommended—whatever the form of rhinosinusitis—along with isotonic and hypertonic saline solutions in CRS (in ARS to a limited extent). To prevent infections, it is essential to clean the nasal douche thoroughly and use the proper salt concentration (2−3.5 %). Conclusive proof of the efficacy of SNI in the treatment of ARS is still pending. In CRS, SNI is one of the cornerstones of treatment.
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