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.
"Clinicians frequently recommend nasal douching before and after surgery , although the method of instillation, quantity, frequency, and concentration are based on anecdotal evidence. Notwithstanding this variability, at least four RCTs have shown improvement in symptoms, quality of life and endoscopy and imaging findings    . "
[Show abstract][Hide abstract] ABSTRACT: Chronic rhinosinusitis (CRS) is widely recognized as one of the most common, if not the most common, chronic disease entities. This article discusses CRS without nasal polyposis. The discussion of maximal medical therapy concentrates on the best available evidence from published clinical trials.
Otolaryngologic Clinics of North America 01/2006; 38(6):1301-10, x. DOI:10.1016/j.otc.2005.07.003 · 1.49 Impact Factor
"Considering the composition, there are no clear guidelines regarding tonicity of the solution, though acidity is to be avoided (Bachmann et al., 2000). Medications (steroids and/or antibiotics) may be added, certainly when using the Rinoflow ® or a nose can, but clinical superiority over classical use of drops or sprays has never been demonstrated. "
[Show abstract][Hide abstract] ABSTRACT: Postoperative care is very important in the global management of the patient undergoing ESS. Postoperative tamponnade, packing, splinting or stenting is advocated by many surgeons, but its clinical beneficial effects have not clearly been demonstrated. Postoperative rinsing/washing of the surgical cavity offers advantages in healing: high volume, low pressure is to be preferred. Suction cleaning is advocated on a weekly basis starting one week after ESS and continues until secretions, blood, crusts have disappeared. Topical medications have not been the subject of randomized clinical trials. Of the various classes of systemic (oral) medications, only steroids resulted in better short term outcome when using higher doses compared to lower doses. Antibiotics have not shown clinical effects and should not routinely be given.
"In addition to the use of steroids there are still other therapeutic approaches to restoration of olfactory loss. They include the use of antileukotrienes (Parnes and Chuma, 2000), saline lavage (Bachmann et al., 2000) or approaches which have received less vigorous scientific investigation, e.g. diet changes (Rundles, 1946), anti-allergy immunotherapy (Stevenson et al., 1996) and herbal treatments. "
[Show abstract][Hide abstract] ABSTRACT: Olfactory loss may be caused by mechanical obstruction or inflammation of the olfactory epithelium due to allergic/non-allergic rhinitis and chronic sinusitis with or without polyps. Treatment of olfactory loss related to sino-nasal disease is possible. Apart from surgical approaches and/or treatment with antibiotics, both systemic and topical steroids are effectively used in the therapy of olfactory loss related to sino-nasal disease. In most cases improvement of olfactory function appears to relate to the anti-inflammatory actions of the steroids used. While some details of therapeutic effect and dose regimen are not clear, systemic steroids are often helpful even in patients without nasal obstruction due to polyps or obvious inflammatory changes.
Chemical Senses 10/2002; 27(7):617-22. DOI:10.1093/chemse/27.7.617 · 3.16 Impact Factor
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