Saline irrigation for chronic rhinosinusitis

Chong, Lee Yee; Head, Karen; Hopkins, Claire; Philpott, Carl; Schilder, Anne

doi:10.1002/14651858.cd011995

Cited by 30 publications

(49 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The study suggested that saline irrigation using a hypertonic solution is beneficial in the short‐term treatment of CRS when used in large volumes (150 mL). However, the quality of the evidence was low . Similarly, there is moderate‐quality evidence that topical corticosteroids improve nasal blockage and high‐quality evidence that they increase the risk of epistaxis …”

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of steroid‐soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery

Hwang¹,

Sharhan

Kim

et al. 2017

The Laryngoscope

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Randomized controlled trial of steroid‐soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery

Hwang¹,

Sharhan

Kim

et al. 2017

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…Treatment of CRS is aimed at reducing airway inflammation, and nasal steroids are the first‐line treatment, which may be combined with nasal lavage . However, other medical interventions such as montelukast and low‐dose macrolides may also have some effect, although at present there remains the need for large, randomized trials of these treatments.…”

Section: Crs and Nasal Polypsmentioning

confidence: 99%

Co‐morbidities in severe asthma: Clinical impact and management

2017

View full text Add to dashboard Cite

Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD), bronchiectasis, allergic bronchopulmonary aspergillosis (ABPA) and eosinophilic granulomatous with polyangiitis (EGPA). Furthermore, the review offers a summary of recommended diagnostic and management approaches for each co-morbidity. Finally, the review links co-morbid conditions to specific phenotypes of severe asthma, in order to guide the clinician on which co-morbidities to look for in specific patients.

show abstract

“…Medical management is a crucial component in the treatment of CRS, both as a first‐line treatment and as a means for maintaining disease improvement after endoscopic sinus surgery. Medical management of CRS primarily consists of intranasal saline irrigations and intranasal corticosteroids as supported by level‐1 evidence . Using a multifaceted approach that includes both saline irrigations and topical intranasal corticosteroids, the sinonasal inflammation associated with CRS is decreased with a reciprocal improvement in patient outcomes …”

Section: Introductionmentioning

confidence: 99%

Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients

et al. 2019

View full text Add to dashboard Cite

Objective Intranasal saline irrigations and intranasal corticosteroids are supported by level‐1 evidence for medical management of chronic rhinosinusitis (CRS). We sought to study adherence with these medications. Methods Prospective study of 174 patients with CRS. Patients reported their usage of intranasal saline irrigation and intranasal corticosteroid over the preceding 3 months, at presentation, and a subsequent follow‐up visit 3 to 12 months later. Adherence was defined as reported medication usage for ≥6 days per week. Results At the time of presentation, 44.3% of patients were using an intranasal corticosteroid spray or irrigation ≥6 days/week, whereas only 24.1% were using saline irrigation ≥6 days per week. At follow‐up, 60.3% of patients were using either an intranasal corticosteroid spray or irrigation ≥6 days per week, whereas 35.6% were using saline irrigation ≥6 days per week. Adherence with intranasal corticosteroids was associated with comorbid asthma (adjusted odds ratio [OR] = 2.68, 95% confidence interval [CI]: 1.10–6.50, P = 0.029), allergy (OR = 2.22, 95% CI: 1.05–4.71, P = 0.037), and change in 22‐item Sinonasal Outcome Test score (OR = 0.98, 95% CI: 0.96–0.99, P = 0.027). Use of intranasal corticosteroid sprays versus irrigations (OR = 2.56, 95% CI: 0.84–7.83, P = 0.099) was suggestive of association with improved adherence. Adherence with intranasal saline irrigation was associated with age (OR = 1.02, 95% CI: 1.01–1.05, P = 0.034). Conclusion Usage and adherence with intranasal steroids and saline may be low in CRS patients even with management in a tertiary level, subspecialty rhinology clinic. Adherence with medications represents a major opportunity for improving patient care and outcomes, specifically by targeting patients with lower disease burden and improving convenience of medications. Level of Evidence 2C Laryngoscope, 130:852–856, 2020

show abstract

Saline irrigation for chronic rhinosinusitis

Abstract: Analysis 2.2. Comparison 2 Intranasal steroids versus nasal saline (nebulised, small-volume), Outcome 2 Adverse events. Analysis 2.3. Comparison 2 Intranasal steroids versus nasal saline (nebulised, small-volume), Outcome 3 Endoscopy scoremeasured using modified Lund-Mackay (range unknown

Cited by 30 publications

References 17 publications

Randomized controlled trial of steroid‐soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery

Randomized controlled trial of steroid‐soaked absorbable calcium alginate nasal packing following endoscopic sinus surgery

Co‐morbidities in severe asthma: Clinical impact and management

Intranasal corticosteroids and saline: Usage and adherence in chronic rhinosinusitis patients

Contact Info

Product

Resources

About