Abstract:LR is an isotonic solution that has no effect on CBF. Therefore it is probable that this solution is more appropriate than saline for nasal irrigation and nebulization or antral lavage. Moreover, the results of this study suggest that mucolytic effects induced by hyperosmolarity should be attained preferably with hypertonic saline 7% in patients with cystic fibrosis or asthma. At this concentration, the ciliostatic effect is reversible, whereas irreversible changes are to be expected at higher concentrations.
“…They concluded that 0.9% NaCI had moderate and temporary ciliostatic, that 7% NaCI exhibited complete but reversible effect and that 14.4% had a complete and irreversible effect, but that Ringer's solution had no such effect effects. They also emphasized that Ringer's solution closely approximates to extracellular fluid and has no adverse effect on ciliary beat frequency, for which reason it is more suitable that saline for antral lavage, nebulization and nasal irrigation [14].…”
Mucociliary clearance (MC) is one of the main defense mechanisms of the nasal respiratory mucosa. The purpose of this study was to determine changes occurring nasal MC in patients with sinusitis, and how medical treatment affects changes in MC, and to identify an appropriate topical solution with positive effects on MC for use in the treatment of sinusitis by examining the effects of various topical solutions on MC. 60 patients diagnosed with rhinosinusitis at the ear, nose and throat clinic were included in this prospective study. Patients were randomly assigned into groups. Group 1 (n:10) received no topical treatment. Group 2 (n:10) was administered with fluticasone propionate, Group 3 (n:10) received mometasone furoate and Group 4 (n:10) received oxymetazoline. Group 5 (n:10) received isotonic sea water for nasal irrigation, while Group 6 (n:10) received isotonic Ringer's solution for nasal irrigation. Group 7 represented the control group (non-sinusitis). The saccharin test was used to determine nasal mucociliary clearance times. The saccharin test was performed before and on the 2nd week of treatment in all groups. Basal MCT and 2nd week MCT values were compared in all groups. When measurements performed 20 min and 14 days after administration of topical agents were compared with basal values, mean MCT values at 20 min. and 14 days were shorter in all groups compared to mean basal MCT values. However, the difference between 20-min, 14th day and basal MCT values was only statistically significant in the oxymetazoline and isotonic Ringer's solution groups (p<0.05). We think that oxymetazoline and isotonic Ringer's solution can be used as supportive therapy in the treatment of sinusitis since these produce a significant shortening of MCT.
“…They concluded that 0.9% NaCI had moderate and temporary ciliostatic, that 7% NaCI exhibited complete but reversible effect and that 14.4% had a complete and irreversible effect, but that Ringer's solution had no such effect effects. They also emphasized that Ringer's solution closely approximates to extracellular fluid and has no adverse effect on ciliary beat frequency, for which reason it is more suitable that saline for antral lavage, nebulization and nasal irrigation [14].…”
Mucociliary clearance (MC) is one of the main defense mechanisms of the nasal respiratory mucosa. The purpose of this study was to determine changes occurring nasal MC in patients with sinusitis, and how medical treatment affects changes in MC, and to identify an appropriate topical solution with positive effects on MC for use in the treatment of sinusitis by examining the effects of various topical solutions on MC. 60 patients diagnosed with rhinosinusitis at the ear, nose and throat clinic were included in this prospective study. Patients were randomly assigned into groups. Group 1 (n:10) received no topical treatment. Group 2 (n:10) was administered with fluticasone propionate, Group 3 (n:10) received mometasone furoate and Group 4 (n:10) received oxymetazoline. Group 5 (n:10) received isotonic sea water for nasal irrigation, while Group 6 (n:10) received isotonic Ringer's solution for nasal irrigation. Group 7 represented the control group (non-sinusitis). The saccharin test was used to determine nasal mucociliary clearance times. The saccharin test was performed before and on the 2nd week of treatment in all groups. Basal MCT and 2nd week MCT values were compared in all groups. When measurements performed 20 min and 14 days after administration of topical agents were compared with basal values, mean MCT values at 20 min. and 14 days were shorter in all groups compared to mean basal MCT values. However, the difference between 20-min, 14th day and basal MCT values was only statistically significant in the oxymetazoline and isotonic Ringer's solution groups (p<0.05). We think that oxymetazoline and isotonic Ringer's solution can be used as supportive therapy in the treatment of sinusitis since these produce a significant shortening of MCT.
“…The best mucociliary clearance is attained with the inhalation of HSS at concentrations of between 3% and 12% with the effect dependent on the dose [9,10]. The tolerance limit is 12% as higher concentrations may cause pharyngeal irritation and at a concentration of 14.4% the ciliostatic effect is irreversible [10].…”
“…Entretanto verifica-se que, apesar da hipertonicidade ser um fator que aparentemente atue de forma positiva, ela não deve ser muito acentuada, uma vez que alguns trabalhos publicados já demonstraram que soluções com alta hipertonicidade podem causar efeitos locais indesejáveis, como cilioestase reversível em mucosa de seio esfenóide após 5 min de exposição a solução salina a 7%, e cilioestase irreversível após exposição a solução a 14,4% 26 . Além da diminuição do batimento ciliar, também foi observada disjunção das células epiteliais in vitro, em fragmento submetidos a soluções salinas hipertônicas, a 3% e a 7% 28 .…”
Section: Discussionunclassified
“…Soluções contendo potássio, como a solução de Ringer com Lactato (que contém 0,030g de cloreto de potássio em 100ml de solução) e a solução de Locke Ringer (com 0,042g em 100ml) foram usadas em estudos envolvendo mucosa nasal e apresentaram resultados favoráveis 12,26,29 . Os resultados deste estudo sugerem que a presença deste íon não foi determinante de nenhuma das alterações encontradas na mucosa.…”
A irrrigação intranasal tem grande importância como terapia adjuvante de doenças nasossinusais. Entretanto, faltam estudos que avaliem as alterações histológicas que as diferentes soluções utilizadas podem causar na mucosa do nariz. Objetivo: Analisar os aspectos histológicos da mucosa nasal de ratos após irrigação local com diferentes soluções hidroeletrolíticas. Forma de estudo: Experimental. Material e Método: 120 ratos Wistar foram divididos igualmente em 4 grupos. O grupo número 1 recebeu solução salina a 0,9%. Os grupos 2 e 3 receberam soluções contendo Cloreto de Sódio associado a Cloreto de Potássio e Glicose, em diferentes concentrações. O grupo 4 foi o grupo controle. Duas vezes ao dia, 0,1ml (2 gotas) das soluções foram aplicados na narina esquerda dos ratos, através de uma seringa. Metade dos animais de cada grupo foi sacrificado após a primeira semana e a metade restante após a quarta semana de tratamento. Os fragmentos de mucosa obtidos foram processados e estudados em microscopia óptica, utilizando a hematoxilina e eosina. Resultados: Pôde-se observar que a infiltração de células inflamatórias foi estatisticamente mais intensa no grupo 2, em 1 e 4 semanas de administração das soluções (p≤0,05), quando comparada ao grupo controle. A formação de glândulas intraepiteliais foi estatisticamente mais evidente no grupo 1, quando comparada aos grupos 3 e 4 (p≤0,05). Conclusão: A solução salina hipertônica testada causou a menor reação tecidual na mucosa nasal de ratos quando comparada ao grupo controle. Não foram encontradas vantagens na utilização da solução salina a 0,9% em comparação com o uso das demais soluções em estudo.
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