Effect of adjunctive sodium hyaluronate versus surfactant nasal irrigation on mucociliary clearance in allergic rhinitis: a single-blind, randomised, controlled study

Abstract

Objective To investigate the effects of nasal irrigation with sodium hyaluronate and surfactant solutions on mucociliary clearance time in patients with mild persistent allergic rhinitis. Methods A total of 120 patients diagnosed with mild persistent allergic rhinitis were enrolled in this prospective study. The patients were allocated randomly to the surfactant, sodium hyaluronate or isotonic saline (as a control) nasal irrigation group. The mucociliary clearance times and improvements in mucociliary clearance times were compared. Results Improvements in mean mucociliary clearance time were significantly greater in the surfactant and sodium hyaluronate groups than in the control group (p < 0.01). The mean post-treatment mucociliary clearance time of the surfactant group was significantly lower than that of the control (p < 0.001) and sodium hyaluronate groups (p = 0.03). Conclusion Surfactant and sodium hyaluronate nasal irrigation solutions may both be used as adjunctive treatments for allergic rhinitis. Surfactant nasal irrigation resulted in better mucociliary clearance times.

Efficacy of hyaluronic acid in the treatment of nasal inflammatory diseases: a systematic review and meta-analysis

“…The initial search identified 129 relevant studies: 38 from PubMed, 26 from Embase, 29 from the Web of Science, 33 from the Cochrane Library, and three articles from other sources. After excluding duplicate articles and further evaluating the full text of the remaining articles, 11 articles ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Favilli et al, 2019 ; Savietto et al, 2020 ; Thieme et al, 2020 ; Ocak et al, 2021 ; Ercan et al, 2022 ) were finally included in this meta-analysis. Ercan et al (2022 ) and Cassandro et al (2015 ) had two treatment groups, which were identified as Ercan a and Ercan b and Cassandro a and Cassandro b, respectively.…”

“…A total of 11 studies ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Favilli et al, 2019 ; Savietto et al, 2020 ; Thieme et al, 2020 ; Ocak et al, 2021 ; Ercan et al, 2022 ) and 825 participants met the inclusion criteria. Four studies ( Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Savietto et al, 2020 ) were CRS, one study ( Ciofalo et al, 2017 ) was ARS, two studies ( Ocak et al, 2021 ; Ercan et al, 2022 ) were AR, one study ( Favilli et al, 2019 ) was pregnancy rhinitis (PR), one study ( Thieme et al, 2020 ) was rhinitis sicca, and two studies ( Gelardi et al, 2013b ; Gelardi et al, 2016 ) included multiple rhinitis. Eight studies ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Favilli et al, 2019 ; Savietto et al, 2020 ) were from Italy, two studies ( Ocak et al, 2021 ; Ercan et al, 2022 ) were from Turkey, and one study ( Thieme et al, 2020 ) was from Germany.…”

“…Four studies ( Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Savietto et al, 2020 ) were CRS, one study ( Ciofalo et al, 2017 ) was ARS, two studies ( Ocak et al, 2021 ; Ercan et al, 2022 ) were AR, one study ( Favilli et al, 2019 ) was pregnancy rhinitis (PR), one study ( Thieme et al, 2020 ) was rhinitis sicca, and two studies ( Gelardi et al, 2013b ; Gelardi et al, 2016 ) included multiple rhinitis. Eight studies ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Favilli et al, 2019 ; Savietto et al, 2020 ) were from Italy, two studies ( Ocak et al, 2021 ; Ercan et al, 2022 ) were from Turkey, and one study ( Thieme et al, 2020 ) was from Germany. The duration of the intervention administration varied between studies and ranged from 4 weeks to 3 months ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Savietto et al, 2020 ; Thieme et al, 2020 ; Ocak et al, 2021 ; Ercan et al, 2022 ).…”

“…Eight studies ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Favilli et al, 2019 ; Savietto et al, 2020 ) were from Italy, two studies ( Ocak et al, 2021 ; Ercan et al, 2022 ) were from Turkey, and one study ( Thieme et al, 2020 ) was from Germany. The duration of the intervention administration varied between studies and ranged from 4 weeks to 3 months ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Gelardi et al, 2016 ; Ciofalo et al, 2017 ; Savietto et al, 2020 ; Thieme et al, 2020 ; Ocak et al, 2021 ; Ercan et al, 2022 ). Due to the particularity of pregnant patients ( Favilli et al, 2019 ), the end time of medication was determined according to the time of delivery.…”

“…The dosage of HA was different in different studies. There were six trials ( Gelardi et al, 2013b ; Casale et al, 2014 ; Cassandro et al, 2015 ; Cantone and Iengo, 2016 ; Favilli et al, 2019 ; Ocak et al, 2021 ) with a dose of 9 mg, one trial ( Ciofalo et al, 2017 ) with a dose of 6 ml, one trial ( Savietto et al, 2020 ) with a dose of 5 mg, one trial ( Thieme et al, 2020 ) with a dose of 1–2 sprays/nostril, and one trial ( Gelardi et al, 2016 ) with a 1 cm dose of intranasal cream in each nostril, and one trial ( Ercan et al, 2022 ) did not mention the dose.…”