Introduction: Chronic sinusitis affects all age groups
and is a cause for significant morbidity. Recent realization that noninfectious
inflammatory causes can predispose to infectious sinusitis has evoked renewed
interest in developing and documenting efficacious ancillary therapies that
could supplement antibiotic use. Hypertonic saline solution has been shown to
increase mucociliary clearance and ciliary beat frequency.Objectives: A double blinded randomized comparative study was
undertaken to evaluate the effect of hypertonic saline (3.5%) nasal drops and
normal saline (0.9%) nasal drops, to assess the tolerance of hypertonic saline
nasal drops and to know if hypertonic nasal drops improve the “quality of life”
in patients with chronic sinusitis.Methods: Fifty patients diagnosed as chronic
sinusitis in the age group of 18-45 years were randomized into two groups; Group
A was treated with normal saline and Group B with 3.5% hypertonic saline for a
period of 4 weeks. Pre and Post treatment x-rays of the
paranasal sinuses (Water’s view) were graded and radiological scores were given
accordingly. The symptoms were evaluated before and after treatment using
visual analogue score. Patients were queried about tolerance to the nasal solution
and scores were given. Conclusion:
References
[1]
O. Berg, H. Bergstedt, C. Carenfelt and M. G. Zind, “Discrimination of purulent from non-purulent maxillary sinusitis: Clinical and radiographic diagnosis,” The Annals of Otology, Rhinology, and Laryngology, Vol. 90, No. 3, 1981, pp. 272-275.
[2]
I. S. Mackay and V. J. Lund, “Surgical Management of Sinusitis: Scott-Brown’s Otolaryngology,” 6th Edition, Butterworth Heinemann Publishers, Oxford, 1997.
[3]
W. Wingrave, “The Nature of Discharges and Douches,” The Lancet, Vol. 17, 1902, pp. 1373-1375.
[4]
M. Grossan, “Irrigation of the Child’s Nose,” Clinical Pediatrics, Vol. 13, No. 3, 1974, pp. 229-231.
doi:10.1177/000992287401300306
[5]
R. S. Zeiger, “Prospects for Ancillary Treatment of Sinusitis in the 1990s,” Journal of Allergy and Clinical Immunology, Vol. 90, No. 3, 1992, pp. 478-495.
doi:10.1016/0091-6749(92)90173-Y
[6]
D. Shoseyov, H. Bibi, P. Shai, N. Shoseyov, G. Shazberg and H. Hurvitz, “Treatment with Hypertonic Saline versus Normal Saline Nasal Wash of Pediatric Chronic Sinusitis,” Journal of Allergy and Clinical Immunology, Vol. 101, No. 5, 1998, pp. 602-605.
doi:10.1016/S0091-6749(98)70166-6
[7]
“Instruction Manual and General Information on Yogic Saline Nasal Cleansing Technique. The Jala-neti Booklet,” 2005.
http://www.yogaage.com/asanas/jala.pdf
[8]
B. C. Band, A. L. Mukherjee and F. B. Bang, “Human Nasal Mucous Flow Rates,” The Johns Hopkins Medical Journal, Vol. 121, No. 1, 1967, pp. 38-48.
[9]
M. Grossan, “A Device for Nasal Irrigation,” ANL, Vol. 3, 1976, pp. 65-70.
[10]
Y. Majima, Y. Sakakura, T. Matsubara, S. Murai and Y. Miyoshi, “Mucociliary Clearance in Chronic Sinusitis: Related Human Nasal Clearance and in Vitro Bullfrog Palate Clearance,” Biorheology, Vol. 20, No. 2, 1983, pp. 251-262.
[11]
J. W. Georgitis, “Nasal Hyperthermia and Simple Irrigation for Perennial Rhinitis,” Chest, Vol. 106, No. 5, 1994, pp. 1487-1491. doi:10.1378/chest.106.5.1487
[12]
M. J. Dulfano, K. Adler and O. Wooten, “Primary Properties of Sputum. IV. Effects of 100 Percent Humidity and Water Mist,” American Review of Respiratory Disease, Vol. 107, No. 1, 1973, pp. 130-132.
[13]
C. M. Rossman, R. M. Lee, J. B. Forrest and M. T. Newhouse, “Nasal Ciliary Ultrastructure and Function in Patients with Primary Ciliary Dyskinesia Compared with That in Normal Subjects and in Subjects with Various Respiratory Diseases,” American Review of Respiratory Disease, Vol. 129, No. 1, 1984, pp. 161-170.
[14]
S. C. Manning, “Pediatric Sinusitis,” Otolaryngologic Clinics of North America, Vol. 26, No. 4, 1993, pp. 623-638.
[15]
E. D. O. Mangete, D. West and C. D. Blankson, “Hypertonic Saline Solution for Wound Dressing (Letter),” The Lancet, Vol. 340, No. 8831, 1992, p. 1351.
doi:10.1016/0140-6736(92)92533-L
[16]
H. G. Folkesson, F. Kheradmand and M. A. Matthay, “The Effect of Salt Water on Alveolar Epithelial Barrier Function,” American Journal of Respiratory and Critical Care Medicine, Vol. 150, No. 6, 1994, pp. 1555-1563.
doi:10.1164/ajrccm.150.6.7952614
[17]
N. T. Johnson, M. Villalon, F. H. Royce, R. Hard, P. Verdugo, “Autoregulation of Beat Frequency in Respiratory Ciliated Cells. Demonstrated by Viscous Loading,” American Review of Respiratory Disease, Vol. 144, No. 5, 1991, pp. 1091-1094. doi:10.1164/ajrccm/144.5.1091
[18]
K. Hirata, “Dynamic Viscoelasticity of Nasal Mucus from Children with Chronic Sinusitis,” Mie Medical Journal, Vol. 34, 1985, pp. 205-219.
[19]
L. T. Tomooka, “Claire Murphy and Terence M Davidson. Clinical Study and Literature Review of Nasal Irrigation,” Laryngoscope, Vol. 110, No. 7, 2000, pp. 1189-1193.
doi:10.1097/00005537-200007000-00023
[20]
D. G. Heatley, K. E. McConnell, T. L. Kille and G. E. Leverson, “Nasal Irrigation for the Alleviation of Sinonasal Symptoms,” Otolaryngology—Head and Neck Surgery, Vol. 125, No. 1, 2001, pp. 44-48.
doi:10.1067/mhn.2001.115909
[21]
D. Rabago, A. Zgierska, M. Mundt, B. Barrett, J. Bobula and R. Maberry, “Efficacy of Daily Hypertonic Saline Nasal Irrigation among Patients with Sinusitis,” The Journal of Family Practice, Vol. 51, No. 12, 2002, pp. 1049-1055.
[22]
M. Taccariello, A. Parikh, Y. Darby and G. Scadding, “Nasal Douching as a Valuable Adjunct in the Management of Chronic Rhinosinusitis,” Rhinology, Vol. 37, No. 1, 1999, pp. 29-32.