Nasal saline irrigations for the symptoms of chronic rhinosinusitis

Harvey, Richard J.; Hannan, Swarnali Ahmed; Badia, Lydia; Scadding, Glenis

doi:10.1002/14651858.cd006394.pub3

Cited by 12 publications

(12 citation statements)

References 44 publications

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“…Along with steroid/pharmacological treatment, EPOS [7] recommends nasal saline irrigation as additional first-line treatment in acute and chronic rhinosinusitis and after sinonasal surgery [7]. Some reviews also state nasal irrigation as adjunctive treatment for allergic rhinitis, acute upper respiratory tract infections, and rhinitis of pregnancy [11–13]. Data for nasal inhalation is limited; EPOS [7] mentions inhalation treatment only in acute rhinosinusitis without evidence.…”

Section: Introductionmentioning

confidence: 99%

Thermal Water Applications in the Treatment of Upper Respiratory Tract Diseases: A Systematic Review and Meta-Analysis

Keller¹,

König²,

Mösges³

2014

Journal of Allergy

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Background. Thermal water inhalations and irrigations have a long tradition in the treatment of airway diseases. Currently there exists no systematic review or meta-analysis on the effectiveness of thermal water treatment in upper respiratory tract diseases. Methods. A systematic search in the databases of MEDLINE, EMBASE, CENTRAL, ISI Web of Science, and MedPilot was accomplished. Results. Eight evaluable outcome parameters from 13 prospective clinical studies were identified for 840 patients. Mucociliary clearance time improves significantly (P < 0.01) for the pooled thermal water subgroup and the sulphurous subgroup after 2 weeks (−6.69/minutes) and after 90 days (−8.33/minutes), not for isotonic sodium chloride solution (ISCS). Nasal resistance improved significantly after 2 weeks (Radon, ISCS, and placebo), after 30 days (sulphur and ISCS), and after 90 days (sulphur). Nasal flow improved significantly with the pooled thermal water, radon alone, and ISCS subgroups. For the IgE parameter only sulphurous thermal water (P < 0.01) and ISCS (P > 0.01) were analyzable. Adverse events of minor character were only reported for sulphurous treatment (19/370). Conclusion. Thermal water applications with radon or sulphur can be recommended as additional nonpharmacological treatment in upper airway diseases. Also in comparison to isotonic saline solution it shows significant improvements and should be investigated further.

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Section: Introductionmentioning

confidence: 99%

Thermal Water Applications in the Treatment of Upper Respiratory Tract Diseases: A Systematic Review and Meta-Analysis

Keller¹,

König²,

Mösges³

2014

Journal of Allergy

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“…Remarks: Studies in allergic rhinitis during pregnancy find saline nasal lavage and nasal CCS sprays safe and effective (11,27) .…”

Section: Resultsmentioning

confidence: 99%

Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations

Lal

Jategaonkar

Borish

et al. 2016

Rhin

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Background Management of rhinosinusitis during pregnancy requires special considerations. Objectives 1. Conduct a systematic literature review for acute and chronic rhinosinusitis (CRS) management during pregnancy. 2. Make evidence-based recommendations. Methods The systematic review was conducted using MEDLINE and EMBASE databases and relevant search terms. Title, abstract and full manuscript review were conducted by two authors independently. A multispecialty panel with expertise in management of Rhinological disorders, Allergy-Immunology, and Obstetrics-Gynecology was invited to review the systematic review. Recommendations were sought on use of following for CRS management during pregnancy: oral corticosteroids; antibiotics; leukotrienes; topical corticosteroid spray/irrigations/drops; aspirin desensitization; elective surgery for CRS with polyps prior to planned pregnancy; vaginal birth versus planned Caesarian for skull base erosions/ prior CSF rhinorrhea. Results Eighty-eight manuscripts underwent full review after screening 3052 abstracts. No relevant level 1, 2, or 3 studies were found. Expert panel recommendations for rhinosinusitis management during pregnancy included continuing nasal corticosteroid sprays for CRS maintenance, using pregnancy-safe antibiotics for acute rhinosinusitis and CRS exacerbations, and discontinuing aspirin desensitization for aspirin exacerbated respiratory disease. The manuscript presents detailed recommendations. Conclusions The lack of evidence pertinent to managing rhinosinusitis during pregnancy warrants future trials. Expert recommendations constitute the current best available evidence.

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“…In 2015, a randomised clinical trial demonstrated that hypertonic saline irrigation and gargling for the common cold significantly reduce symptom duration and severity as well as over-the-counter medication use [39]. Furthermore, several Cochrane reviews summarise the evidence for the positive effects of hypertonic saline solution in the management of the symptoms of upper respiratory tract infections [40–42]. …”

Section: Discussionmentioning

confidence: 99%

Ectoine lozenges in the treatment of acute viral pharyngitis: a prospective, active-controlled clinical study

Dao¹,

Overhagen

Bilstein

et al. 2019

Eur Arch Otorhinolaryngol

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PurposeAcute pharyngitis is an uncomfortable disorder mostly caused by viruses and for which antibiotics are unwarranted. This study compared lozenges containing ectoine, a natural extremolyte, with hyaluronic acid lozenges and hypertonic saline gargle for symptomatic treatment of acute viral pharyngitis.MethodsThis prospective, controlled clinical study, recruited 90 patients with moderate-to-severe pharyngitis symptoms who chose to use either ectoine (n = 35), hyaluronic acid (n = 35), or saline gargle (n = 20). Patients applied their 7-day treatment from the inclusion visit (V1) until the end-of-study visit (V2). Patients’ pharyngitis symptoms, general health, general treatment effectiveness and tolerability, and patient compliance were assessed by investigators and patients.ResultsThe sum score for three primary symptoms (pain on swallowing, urge to cough, and hoarseness) decreased by 79.5% (ectoine), 72.2% (hyaluronic acid), and 44.8% (saline gargle). Both lozenges were significantly superior to saline gargle (P < 0.05). Regarding general health improvement, ectoine was significantly superior to saline gargle (72.5% vs. 45.2%, P < 0.05), but hyaluronic acid (63.3%) was not. At V2, 65.7% of patients receiving ectoine reported “very good” general health vs. 48.6% of those receiving hyaluronic acid and 20.0% using saline gargle. Ectoine was significantly superior (P < 0.05) to both hyaluronic acid and saline gargle in terms of tolerability and patient compliance. No patients taking ectoine reported unpleasant sensations while applying their treatment, whereas almost half of patients using hyaluronic acid lozenges and saline gargle did.ConclusionTreatment with ectoine lozenges significantly relieves moderate-to-severe symptoms of acute viral pharyngitis and is more effective and tolerable than treatments with hyaluronic acid lozenges and hypertonic saline gargle.Electronic supplementary materialThe online version of this article (10.1007/s00405-019-05324-9) contains supplementary material, which is available to authorized users.

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Nasal saline irrigations for the symptoms of chronic rhinosinusitis

Cited by 12 publications

References 44 publications

Thermal Water Applications in the Treatment of Upper Respiratory Tract Diseases: A Systematic Review and Meta-Analysis

Thermal Water Applications in the Treatment of Upper Respiratory Tract Diseases: A Systematic Review and Meta-Analysis

Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations

Ectoine lozenges in the treatment of acute viral pharyngitis: a prospective, active-controlled clinical study

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