Clinical Study and Literature Review of Nasal Irrigation

Abstract

Objectives/Hypothesis Nasal disease, including chronic rhinosinusitis and allergic rhinitis, is a significant source of morbidity. Nasal irrigation has been used as an adjunctive treatment of sinonasal disease. However, despite an abundance of anecdotal reports, there has been little statistical evidence to support its efficacy. The objective of this study was to determine the efficacy of the use of pulsatile hypertonic saline nasal irrigation in the treatment of sinonasal disease. Study Design A prospective controlled clinical study. Methods Two hundred eleven patients from the University of California, San Diego (San Diego, CA) Nasal Dysfunction Clinic with sinonasal disease (including allergic rhinitis, aging rhinitis, atrophic rhinitis, and postnasal drip) and 20 disease‐free control subjects were enrolled. Patients irrigated their nasal cavities using hypertonic saline delivered by a Water Pik device using a commercially available nasal adapter twice daily for 3 to 6 weeks. Patients rated nasal disease–specific symptoms and completed a self‐administered quality of well‐being questionnaire before intervention and at follow‐up. Results Patients who used nasal irrigation for the treatment of sinonasal disease experienced statistically significant improvements in 23 of the 30 nasal symptoms queried. Improvement was also measured in the global assessment of health status using the Quality of Well‐Being scale. Conclusions Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease.

Non-diluted seawater enhances nasal ciliary beat frequency and wound repair speed compared to diluted seawater and normal saline

“…Nasal irrigation with saline solutions is commonly used as adjunctive treatment in upper respiratory conditions as well as in postsurgical follow‐up 18. A 2012 systematic review and meta‐analysis by Hermelingmeier et al 19.…”

Irrigação intranasal: avaliação dos efeitos do uso de soluções hidroeletrolíticas na mucosa de ratos

“…Esta solução era hipertônica em relação aos componentes do muco, apresentando osmolaridade de 474mOsm/l. Assim como resultados de trabalhos recentes 4,11,14,16,21 , os dados deste estudo sugerem que a hipertonicidade seja uma característica desejável para as soluções a serem usadas para irrigação intranasal.…”

“…Deste modo, diversas terapias adjuvantes vêm sendo utilizadas com o objetivo de auxiliar na obtenção de um tratamento eficaz com diminuição dos custos. Entre elas está a irrigação, a humidificação e a hipertermia nasal 3,4 .…”

“…O sucesso consistente obtido nesta época, em pacientes com doenças infecciosas como a sífilis e a tuberculose, acabou prolongando sua utilização durante o século XX 5 . Desde então, médicos do mundo todo têm indicado a irrigação nasal como terapia auxiliar no tratamento de rinosinusites virais e bacterianas agudas [1][2][3][4]6 , crônicas 2,6,7 , rinite alérgica 4,8,9 , rinite atrófica e ozena [8][9][10] , rinite induzida por drogas 8 , outras doenças nasosinusais 9,11 e no período pós-operatório de cirurgias do nariz e seios paranasais 2,4,12 .…”

Treatment of Allergic Rhinitis: ARIA Document, Nasal Lavage, Antihistamines, Cromones and Vasoconstrictors

“…According to Tomooka et al, patients who use nasal lavage twice a day for 3-6 week periods have statistically significant improvement (23 of the 30 symptoms on The Quality of Well Being scale questionnaires improve or disappear) (Tomooka et al, 2000).…”