Saline Irrigation Improves Chronic Sinonasal Symptoms

Sinusitis is an inflammation of the lining in the paranasal cavities (sinuses). This can lead to swelling and blockage, making breathing through the nose difficult. It can also cause frequent headaches, tenderness in the face and pain behind the eyes.

Sinusitis usually occurs during infections of the upper respiratory tract (nose, pharynx, sinuses and throat) but can also be caused by allergies or anatomical irregularities. A deviated nasal septum for instance, may block the sinuses, which allows bacteria and viruses to multiply in the retained mucus. Pain is commonly present directly above affected sinuses.

Sinusitis can be either chronic or acute. Acute sinusitis usually resolves within four weeks. However if the condition persists for more than 12 consecutive weeks or if inflammation reoccurs frequently, then sinusitis is considered to be chronic.

Saline irrigation and saline spray are both non-pharmacological therapies, which can improve the drainage of mucus by rinsing the nasal passageways. This helps prevent the build up of secretions in nasal corridors and reduce tissue swelling. The study was an 8 week randomized, open trial, conducted on 127 adults with chronic nasal and sinus symptoms. Saline irrigation was performed with large volume and delivered with low positive pressure, while saline spray was employed to instill a fine mist of saline into the nostrils. The study aim was to find out if these two methods are indeed equivalent as is often believed.

Results were obtained using a Sino-Nasal Outcome Test (SNOT-20), where participants evaluated changes in severity and frequency of symptoms and changes in medication use. Participants in both groups reported symptom improvements, with the saline irrigation group consistently achieving lower symptom scores. 60% of patients using saline irrigation reported significant improvements of their symptoms, compared to only 39% of patients reporting the same in the spray group. Nasal drainage after treatment was the most common adverse effect in both groups (25% in the spray and 43% in the irrigation group), however it was mild and didn't lead to any treatment discontinuations. The use of other medications for sinusitis, which was permitted during the study, decreased in both groups throughout the duration of the study.

The researchers concluded that saline irrigation was a good adjunctive therapy for reducing the severity and frequency of nasal and sinus-related symptoms. Saline irrigation method was however associated with poorer compliance than saline spray. In order to improve it, it's important that its usefulness and benefits are properly explained by primary health care providers to their patients in the community.

This study was supported by NeilMed Pharmaceuticals, the makers of Sinus Rinse, which was the saline irrigation used in the study.

Source: Nasal Saline Irrigation May Relieve Chronic Sinonasal Symptoms (Medscape) [1]