Effectiveness of nasal irrigation devices: a Thai multicentre survey

Abstract

Background Nasal irrigation is widely used as an adjunctive treatment for nasal diseases. There is little evidence regarding the efficacy of the devices used in this procedure. The objective of this survey was to evaluate the effectiveness of nasal irrigation devices based on the experiences of patients and physicians. Methods We conducted a multicentre survey study between November 2017 and October 2018. Physician and patient questionnaires were developed based on the available literature and expert opinion. The physician questionnaire was submitted to the Otolaryngology residents and staff of each centre and their network. The physicians were also asked to distribute the patient questionnaire to their patients. Results Information regarding 331 devices used by the patients was collected. The mean age of the patients was 45.46 ± 17.19 years (from 5 to 81). Roughly half were male, and half were female (48.6%: 51.4%). Among the high-pressure devices, we found that the high-pressure large-volume nasal irrigation devices yielded significantly higher symptom scores in seven of 12 domains (p < 0.05). Among the large-volume devices, we found that the large-volume high-pressure nasal irrigation devices received significantly higher symptom scores in 4 of 12 domains (p < 0.05). However, a higher proportion of patients using the large-volume high-pressure devices had retained fluid in the sinuses compared to those using large-volume low-pressure devices (p < 0.001). Conclusions This survey supports the regular use of nasal irrigation, particularly with large-volume high-pressure devices, as an effective treatment for nasal disease. It may be effective at clearing nasal secretion, improve nasal congestion, decrease post-nasal drip, improve sinus pain or headache, improve taste and smell, and improve sleep quality. It could be used by patients with good compliance and minimal side effects.

Essentials in saline pharmacology for nasal or respiratory hygiene in times of COVID-19

“…(2) Neither is there evidence that nasal rinse would lead to worsening olfaction. Nasal saline irrigation has no effect on normal olfaction [151], and its use in nasal disease has not led to adverse outcome [152]. Its hydrating effect may possibly help to prevent and overcome dry nose during COVID-19 [153].…”

A multicenter survey on the effectiveness of nasal irrigation devices in rhinosinusitis patients

“…Previous studies found that the VAS score was correlated with the Sino‐nasal Outcome Test (SNOT‐22) 18,19 . The construct validity of this questionnaire was shown in our previous study 11 …”

“…12 We also found a trend toward significance favoring high-volume, high-pressure devices for rhinosinusitis from the subgroup analysis. 11 To confirm this trend, the current study expands upon our previous research by examining the comparative effectiveness of various nasal irrigation devices in rhinosinusitis based on patient experience.…”

“…In a previous study funded by the Thailand Research Fund, we evaluated the effectiveness of different nasal irrigation devices based on the experiences of patients and found that high‐volume, high‐pressure devices were able to clear nasal secretion, reduce nasal congestion, post‐nasal drip, sinus pain, and headache, and improve taste, smell, and sleep quality in patients with nasal symptoms 11 . As the effects were significantly found in the allergic rhinitis subgroup, a subsequent randomized controlled trial was conducted and confirmed that high‐volume, high‐pressure devices can improve patients' nasal symptom scores significantly greater than the control group of allergic rhinitis patients 12…”

The minimum effective dose of abobotulinum toxin A injection for allergic rhinitis: A dose‐escalation randomized controlled trial

“…In the Thai community screening program for ear nose and throat diseases, the prevalence of allergic rhinitis diagnosed by the otolaryngologists ranging from 3 to 5% 3‐7 . The main treatment options for allergic rhinitis include antihistamines, intranasal corticosteroids, and nasal irrigation 1,8 …”