A Comparative Study in the Management of Chronic Rhinosinusitis by Nasal Douching with Hypertonic Saline vs Isotonic Saline

Muthubabu, K; Srinivasan, M K; Alagammai, S.; Nivasini, S. Thushita; Shravanthi, P.; Vinayak, R; Gayathri, C

doi:10.1007/s12070-020-01811-2

Cited by 3 publications

(5 citation statements)

References 12 publications

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“…The data from 1 RCT could not be used 46 . Hypertonic saline was more effective than isotonic saline in improving symptoms (nasal congestion 48,49,54,56,57 and nasal discharge), 48,49,54,56,57 the Lund‐Mackay computed tomography score, 56 and STT 4 . In contrast, 1 RCT reported similar effectiveness between hypertonic and isotonic saline 44 …”

Section: Resultsmentioning

confidence: 98%

“…Sixteen articles (13 RCTs and 3 meta-analyses) assessed adult CRS or mixed adults and children with CRS. 4 , 42 - 57 One RCT was conducted in children. 58 …”

Section: Resultsmentioning

confidence: 99%

“…There were 17 studies that assessed the effects of nasal saline treatment. Sixteen articles (13 RCTs and 3 meta‐analyses) assessed adult CRS or mixed adults and children with CRS 4,42–57 . One RCT was conducted in children 58 …”

Section: Resultsmentioning

confidence: 99%

“…58 Tonicity. Nine studies (8 RCTs 4,44,46,48,49,54,56,57 and 1 meta-analysis 55 ) assessed different tonicities of nasal saline treatment in adult CRS. The data from 1 RCT could not be used.…”

Section: Rhinosinusitismentioning

confidence: 99%

“…Sixteen articles (13 RCTs and 3 meta-analyses) assessed adult CRS or mixed adults and children with CRS. 4,[42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] One RCT was conducted in children. 58 Four RCTs compared the effects of nasal saline with nosaline treatment.…”

Section: Rhinosinusitismentioning

confidence: 99%

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Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review

et al. 2022

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Objective This review aimed to systematically determine the optimal nasal saline regimen for different types of sinonasal diseases. Data Sources PubMed, Embase, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov. The last search was on December 6, 2021. Review Methods Study selection was done by 2 independent authors. Randomized controlled trials and meta-analyses were included. The effects of nasal saline treatment through various devices, saline tonicities, and buffer statuses were evaluated in patients with allergic and nonallergic rhinitis, acute and chronic rhinosinusitis (CRS), CRS with cystic fibrosis, and postoperative care, including septoplasty/turbinoplasty and endoscopic sinus surgery. Results Sixty-nine studies were included: 10 meta-analyses and 59 randomized controlled trials. For allergic rhinitis, large-volume devices (≥60 mL) were effective for treating adults, while low-volume devices (5-59 mL) were effective for children. Isotonic saline was preferred over hypertonic saline due to fewer adverse events. For acute rhinosinusitis, saline irrigation was beneficial in children, but it was an option for adults. Large-volume devices were more effective, especially in the common cold subgroup. For CRS, large-volume devices were effective for adults, but saline drop was the only regimen that had available data in children. Buffered isotonic saline was more tolerable than nonbuffered or hypertonic saline. The data for CRS with cystic fibrosis and nonallergic rhinitis were limited. For postoperative care, buffered isotonic saline delivered by large-volume devices was effective. Conclusion Nasal saline treatment is recommended for treating most sinonasal diseases. Optimal delivery methods for each condition should be considered to achieve therapeutic effects of saline treatment.

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Section: Resultsmentioning

confidence: 98%

“…Sixteen articles (13 RCTs and 3 meta-analyses) assessed adult CRS or mixed adults and children with CRS. 4 , 42 - 57 One RCT was conducted in children. 58 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Rhinosinusitismentioning

confidence: 99%

Section: Rhinosinusitismentioning

confidence: 99%

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Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review

et al. 2022

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Medical Management of Headache and Facial Pain in CRS: A Systematic Review and Meta‐Analysis

Heiland,

Marrero‐Gonzalez,

Nguyen

et al. 2024

The Laryngoscope

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ObjectivesThis study aims to characterize the effect of medical therapy on headache and facial pain/pressure among patients with chronic rhinosinusitis (CRS).Data SourcesCINAHL, PubMed, and Scopus.MethodsCINAHL, PubMed, and Scopus were searched from inception through April 10th, 2024, for English language articles reporting headache or facial pain/pressure outcomes in CRS patients. Inclusion was restricted to studies reporting results of the medical treatment of CRS in nonsurgical cohorts. Primary outcome measures included the sino‐nasal outcome test (SNOT) and the visual analogue scale (VAS). Meta‐analyses of continuous measures (mean), mean difference (Δ), and proportions (%) were conducted.ResultsThe initial search yielded 2429 unique articles. After a full‐text review of 272 articles, 17 studies reporting outcomes for 2269 patients were included in the meta‐analysis. The mean patient age was 48.6 years (range 18.0–86.0; 95% CI: 46.5 to 50.6), among which 55.4% (95% CI: 51.5 to 59.4) were male and 82.9% (95% CI: 68.8 to 93.4) had nasal polyposis. SNOT facial pain/pressure scores improved by 1.1 points (95% CI: −1.7 to −0.5; relative reduction 40.4%) with non‐biologic therapies and 1.0 point (95% CI: −1.4 to −0.6; relative reduction 54.6%) with biologic therapies. On an 11‐point scale, VAS headaches scores improved by 1.8 units (95% CI: −3.3 to −0.3; 42.1% relative reduction) in CRSwNP patients and 1.0 unit (95% CI: −1.7 to −0.3; 54.0% relative reduction) in CRSsNP patients.ConclusionsOur findings suggest medical therapy significantly reduces facial pain and pressure in the CRS population. Laryngoscope, 2024

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Headache and Facial Pain/Pressure in the Chronic Rhinosinusitis Population: A Systematic Review and Meta‐analysis

Heiland,

Farmer,

Nguyen

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo evaluate the severity and prevalence of headache and facial pain/pressurere in the chronic rhinosinusitis (CRS) population.Data SourcesCINAHL, PubMed, Scopus.Review MethodsThe literature was searched from inception through June 2023 for English language articles documenting “headache” or “facial pain/pressure” and “chronic rhinosinusitis.” Data collected included Lund‐MacKay computed tomography score, Lund‐Kennedy endoscopy score, sinonasal outcome test, and visual analog scale. Meta‐analyses were performed on continuous measures (mean), proportions (%), and regression.ResultsA total of 69 studies were included with 8643 CRS patients and 703 control patients. The CRS group had a mean age of 44.1 (range: 16‐82; 95% confidence interval [CI]: 40.3‐48) and 86.1% [95% CI: 76.4‐93.5] with nasal polyposis. The control group had a mean age of 39.2 (range: 17‐88; 95% CI: 28.7‐49.8). All CRS subgroups had significantly more severe headache and facial pain/pressure when compared to the control (P < .0001). Patients without polyps had significantly more severe facial pain/pressure and headache when compared to patients with polyps (P < .0001). Facial pain/pressure is a moderate problem or worse in 29.8% of polypoid patients versus 56.4% of nonpolypoid patients; Δ26.6% [95% CI: 0.7‐50; P = .045].ConclusionsAcross all outcome metrics, CRS patients experience significantly more severe headache and facial pain/pressure when compared to a control population. Nonpolypoid patients experience significantly more severe facial pain/pressure and headache when compared to polypoid patients. The majority of nonpolypoid patients experience facial pain/pressure that is moderate in severity or worse.

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A Comparative Study in the Management of Chronic Rhinosinusitis by Nasal Douching with Hypertonic Saline vs Isotonic Saline

Cited by 3 publications

References 12 publications

Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review

Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review

Medical Management of Headache and Facial Pain in CRS: A Systematic Review and Meta‐Analysis

Headache and Facial Pain/Pressure in the Chronic Rhinosinusitis Population: A Systematic Review and Meta‐analysis

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