Efficacy of buffered hypertonic seawater in different phenotypes of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: a randomized double-blind study

Wang, Jun; Shen, Li; Huang, Zhi-Qun; Luo, Qing; Li, Mengyue; Tu, Junhao; Han, Mei; Ye, Jing

doi:10.1016/j.amjoto.2020.102554

Cited by 10 publications

(20 citation statements)

References 33 publications

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“…85 Finally, a recent study compared NI with buffered HS to physiological seawater in patients with CRSwNP post-FESS but further characterized them as eosinophilic (ECRSwNP) and noneosinophilic (NECRSwNP) phenotypes. 86 They found that as a group, there were substantial subjective and objective improvements with NI irrespective of the solution used; however, when patients were stratified based on ECRSwNP and NECRSwNP, the latter group treated with buffered HS experienced a greater improvement in mucosal edema and crusting immediately postoperatively and substantial objective improvement in Lund-Kennedy endoscopic scores and saccharine clearance times. 86…”

Section: Meta-analyses and Systematic Reviewsmentioning

confidence: 99%

“…86 They found that as a group, there were substantial subjective and objective improvements with NI irrespective of the solution used; however, when patients were stratified based on ECRSwNP and NECRSwNP, the latter group treated with buffered HS experienced a greater improvement in mucosal edema and crusting immediately postoperatively and substantial objective improvement in Lund-Kennedy endoscopic scores and saccharine clearance times. 86…”

Section: Meta-analyses and Systematic Reviewsmentioning

confidence: 99%

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Yardstick for the medical management of chronic rhinosinusitis

Borish

Baroody

Kim

et al. 2022

Annals of Allergy, Asthma & Immunology

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Section: Meta-analyses and Systematic Reviewsmentioning

confidence: 99%

Section: Meta-analyses and Systematic Reviewsmentioning

confidence: 99%

Yardstick for the medical management of chronic rhinosinusitis

Borish

Baroody

Kim

et al. 2022

Annals of Allergy, Asthma & Immunology

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“…However, in in vivo studies of patients with CRS, the difference in the improvement of patient symptoms according to tonicity is unclear. Three RCTs reported that isotonic saline was more helpful in improving the symptoms of patients with CRS [52][53][54], and two studies reported no differences between isotonic and hypertonic saline [51,55]. On the contrary, two RCTs and one systematic review showed that hypertonic saline helped improve symptoms compared to isotonic saline [56][57][58].…”

Section: Supporting Textmentioning

confidence: 99%

“…In vitro studies have reported that hypertonic saline reduces nasal mucosal edema and increases the ciliary beat frequency [ 51 ]. However, in in vivo studies of patients with CRS, the difference in the improvement of patient symptoms according to tonicity is unclear.…”

Section: Key Action Statementsmentioning

confidence: 99%

Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults

Park

Choi

Kim

et al. 2022

Clin Exp Otorhinolaryngol

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The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

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“…Furthermore, an in vitro study comparing non-diluted seawater and normal saline using airway epithelial cells suggested that non-diluted seawater improved ciliary beat frequency and wound repair speed [18]. Recently, clinical studies using hypertonic seawater irrigation identified that hypertonic seawater was effective for reducing the symptom score and endoscopic score in aspirin-induced CRS as well as CRS with nasal polyps [19,20].…”

Section: Salinementioning

confidence: 99%

Current Perspective on Nasal Delivery Systems for Chronic Rhinosinusitis

2021

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Chronic rhinosinusitis is an upper respiratory disease during which topical drug treatment via the nasal cavity is the most actively utilized therapeutic strategy. In addition to steroids, antibiotics, and antifungal agents, which are widely used in clinical practice, research on novel topical agents to improve the bacterial biofilm or mucociliary clearance remains ongoing. Moreover, owing to the complex structure of the nasal cavity, the effects of nasal drug delivery vary depending on factors related to delivery fluid dynamics, including device, volume, and compounds. In this article, we review methods and compounds that have been applied to chronic rhinosinusitis management and introduce recent advances and future perspectives in nasal drug delivery for upper respiratory diseases.

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Efficacy of buffered hypertonic seawater in different phenotypes of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: a randomized double-blind study

Cited by 10 publications

References 33 publications

Yardstick for the medical management of chronic rhinosinusitis

Yardstick for the medical management of chronic rhinosinusitis

Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults

Current Perspective on Nasal Delivery Systems for Chronic Rhinosinusitis

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