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Indian Journal of Otolaryngology and Head & Neck Surgery

Published in:

01-11-2019 | Original Article

Nasal Irrigation as Treatment in Sinonasal Symptoms Relief: A Review of Its Efficacy and Clinical Applications

Authors: Baharudin Abdullah, Chenthilnathan Periasamy, Rushdan Ismail

Published in: Indian Journal of Otolaryngology and Head & Neck Surgery | Special Issue 3/2019

Abstract

Nasal irrigations have been used for centuries without any scientific data to determine its efficacy. Despite their widespread use, much confusion exist about the mechanism of action, preparation, indications and therapeutic advantage of nasal irrigations. Anecdotal evidence and poorly controlled studies add to the confusion. Recent evidence provides strong scientific justification of the benefits and advantages of using nasal irrigations in sinonasal symptoms relief. The present review of the evidence based literature highlights its efficacy and clinical applications.

Benninger MS, Anon J, Mabry RL (1997) The medical management of rhinosinusitis. Otolaryngol Head Neck Surg 117(3):S41–S49PubMed

Barham HP, Harvey RJ (2015) Nasal saline irrigation: therapeutic or homeopathic. Braz J Otorhinolaryngol 81(5):457–458PubMed

Taccariello M, Parikh A, Darby Y, Scadding G (1999) Nasal douching as a valuable adjunct in the management of chronic rhinosinusitis. Rhinology 37(1):29–32PubMed

Tomooka LT, Murphy C, Davidson TM (2000) Clinical study and literature review of nasal irrigation. Laryngoscope 110(7):1189–1193PubMed

Parikh A, Scadding GK (1997) Fortnightly review: seasonal allergic rhinitis. BMJ 314(7091):1392–1395PubMedPubMedCentral

Harvey R, Hannan SA, Badia L, Scadding G (2007) Nasal saline irrigations for the symptoms of chronic rhinosinusitis. Cochrane Database Syst Rev 3:CD006394

Cole P (1998) Physiology of the nose and paranasal sinuses. Clin Rev Allergy Immunol 16(1):25–54PubMed

Osguthorpe JD, Hadley JA (1999) Rhinosinusitis: current concepts in evaluation and management. Med Clin North Am 83(1):27–41PubMed

Papsin B, McTavish A (2003) Saline nasal irrigation: its role as an adjunct treatment. Can Fam Physician 49:168–173PubMedPubMedCentral

10.

Brown CL, Graham SM (2004) Nasal irrigations: Good or bad? Curr Opin Otolaryngol Head Neck Surg 12(1):9–13PubMed

11.

Boek WM, Graamans K, Natzijl H, van Rijk PP, Huizing EH (2002) Nasal mucociliary transport: new evidence for a key role of ciliary beat frequency. Laryngoscope 112(3):570–573PubMed

12.

Talbot AR, Herr TM, Parsons DS (1997) Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 107(4):500–503PubMed

13.

Seppey M, Schweri T, Hausler R (1996) Comparative randomised clinical study of tolerability and efficacy of Rhinomer Force 3 versus a reference product in post-operative care of the nasal fossae after endonasal surgery. ORL J Otorhinolaryngol Relat Spec 58(2):87–92PubMed

14.

Georgitis JW (1994) Nasal hyperthermia and simple irrigation for perennial rhinitis. Chest 106(5):1487–1492PubMed

15.

Olson DE, Rasgon BM, Hilsinger RL Jr (2002) Radiographic comparison of three methods for nasal saline irrigation. Laryngoscope 112(8):1394–1398PubMed

16.

Wormald PJ, Cain T, Oates L, Hawke L, Wong I (2004) A comparative study of three methods of nasal irrigation. Laryngoscope 114(12):2224–2227PubMed

17.

van den Berg JW, de Nier LM, Kaper NM, Schilder AG, Venekamp RP, Grolman W, van der Heijden GJ (2014) Limited evidence: higher efficacy of nasal saline irrigation over nasal saline spray in chronic rhinosinusitis-an update and reanalysis of the evidence base. Otolaryngol Head Neck Surg 150(1):16–21PubMed

18.

Dunn JD, Dion GR, McMains KC (2013) Efficacy of nasal irrigations and nebulizations for nasal symptom relief. Curr Opin Otolaryngol Head Neck Surg 21(3):248–251PubMed

19.

Elmiyeh B, Heywood RL, Prasad VM, Chatrath P, Bassett P, Quiney R (2014) A prospective, single-blind, randomised, crossover study comparing three nasal hygiene systems and corresponding patient preference for such devices. J Laryngol Otol 128(1):73–77PubMed

20.

Bastier PL, Lechot A, Bordenave L, Durand M, de Gabory L (2015) Nasal irrigation: from empiricism to evidence-based medicine. A review. Eur Ann Otorhinolaryngol Head Neck Dis 132(5):281–285PubMed

21.

Heatley DG, McConnell KE, Kille TL, Leverson GE (2001) Nasal irrigation for the alleviation of sinonasal symptoms. Otolaryngol Head Neck Surg 125(1):44–48PubMed

22.

Rabago D, Zgierska A (2009) Saline nasal irrigation for upper respiratory conditions. Am Fam Physician 80(10):1117–1119PubMed

23.

Lin SY, Baugher KM, Brown DJ, Ishman SL (2015) Effects of nasal saline lavage on pediatric sinusitis symptoms and disease-specific quality of life: a case series of 10 patients. Ear Nose Throat J 94(2):E13–E18PubMed

24.

Pham V, Sykes K, Wei J (2014) Long-term outcome of once daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis. Laryngoscope 124(4):1000–1007PubMed

25.

Shargorodsky J, Lane AP (2015) What is the best modality to minimize bacterial contamination of nasal saline irrigation bottles? Laryngoscope 125(7):1515–1516PubMed

26.

Shoseyov D, Bibi H, Shai P, Shoseyov N, Shazberg G, Hurvitz H (1998) Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis. J Allergy Clin Immunol 101(5):602–605PubMed

27.

Luk C, Dulfano M (1983) Effect of pH, viscosity and ionic-strength changes on ciliary beating frequency of human bronchial explants. Clin Sci (Lond) 64(4):449–451

28.

Ponikau JU, Sherris DA, Kita H, Kern EB (2002) Intranasal antifungal treatment in 51 patients with chronic rhinosinusitis. J Allergy Clin Immunol 110(6):862–866PubMed

29.

Jiang RS, Hsu SH, Liang KL (2015) Amphotericin B nasal irrigation as an adjuvant therapy after functional endoscopic sinus surgery. Am J Rhinol Allergy 29(6):435–440PubMed

30.

Suslu N, Bajin MD, Suslu AE, Ogretmenoglu O (2009) Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty. Eur Arch Otorhinolaryngol 266(5):685–689PubMed

31.

Keojampa BK, Nguyen MH, Ryan MW (2004) Effects of buffered saline solution on nasal mucociliary clearance and nasal airway patency. Otolaryngol Head Neck Surg 131(5):679–682PubMed

32.

Hauptman G, Ryan MW (2007) The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients. Otolaryngol Head Neck Surg 137(5):815–821PubMed

33.

Satdhabudha A, Poachanukoon O (2012) Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study. Int J Pediatr Otorhinolaryngol 76(4):583–588PubMed

34.

Michel O (2006) Nasal irrigation in case of rhinosinusitis. Laryngo-Rhino-Otol 85(6):448–458

35.

Levine HL, Cordray S, Miner LA (2006) Use of Dead Sea salt solution for chronic rhinitis and rhinosinusitis. Oper Tech Otolaryngol-Head Neck Surg 17(2):147–150

36.

Cordray S, Harjo JB, Miner L (2005) Comparison of intranasal hypertonic dead sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis. Ear Nose Throat J 84(7):426–430PubMed

37.

Chen JR, Jin L, Li XY (2014) The effectiveness of nasal saline irrigation (seawater) in treatment of allergic rhinitis in children. Int J Pediatr Otorhinolaryngol 78(7):1115–1118PubMed

38.

Friedman M, Hamilton C, Samuelson CG, Maley A, Wilson MN, Venkatesan TK, Joseph NJ (2012) Dead Sea salt irrigations versus saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study. Int Forum Allergy Rhinol 2(3):252–257PubMed

39.

Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD (2015) Clinical practice guideline (update): adult sinusitis. Otolaryngol Head Neck Surg 152(2 Suppl):S1–S39PubMed

40.

Zeiger RS, Schatz M (1982) Chronic rhinitis: a practical approach to diagnosis and treatment. Immunol Allergy Pract 4(4):26–35

41.

Garavello W, Di Berardino F, Romagnoli M, Sambataro G, Gaini RM (2005) Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis. Int Arch Allergy Immunol 137(4):310–314PubMed

42.

Nguyen SA, Psaltis AJ, Schlosser RJ (2014) Isotonic saline nasal irrigation is an effective adjunctive therapy to intranasal corticosteroid spray in allergic rhinitis. Am J Rhinol Allergy 28(4):308–311PubMed

43.

Gliklich RE, Metson R (1995) The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg 113(1):104–109PubMed

44.

Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R (2002) Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial. J Fam Pract 51(12):1049–1055PubMed

45.

Rabago D, Pasic T, Zgierska A, Mundt M, Barrett B, Maberry R (2005) The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms. Otolaryngol Head Neck Surg 133(1):3–8PubMed

46.

Rabago D, Barrett B, Marchand L, Maberry R, Mundt M (2006) Qualitative aspects of nasal irrigation use by patients with chronic sinus disease in a multimethod study. Ann Fam Med 4(4):295–301PubMedPubMedCentral

47.

Rabago D, Guerard E, Bukstein D (2008) Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis. WMJ 107(2):69–75PubMedPubMedCentral

48.

Bachmann G, Hommel G, Michel O (2000) Effect of irrigation of the nose with isotonic salt solution on adult patients with chronic paranasal sinus disease. Eur Arch Otorhinolaryngol 257(10):537–541PubMed

49.

Scheid DC, Hamm RM (2004) Acute bacterial rhinosinusitis in adults: Part II. Treatment. Am Fam Physician 70:1697–1704PubMed

50.

Achilles N, Mösges R (2013) Nasal saline irrigations for the symptoms of acute and chronic rhinosinusitis. Curr Allergy Asthma Rep 13(2):229–235PubMed

51.

Slapak I, Skoupa J, Strnad P, Hornk P (2008) Efficacy of isotonic nasal wash (seawater) in the treatment and prevention of rhinitis in children. Arch Otolaryngol Head Neck Surg 134(1):67–74PubMed

52.

Tano L, Tano K (2004) A daily nasal spray with saline prevents symptoms of rhinitis. Acta Otolaryngol 124(9):1059–1062PubMed

53.

King D, Mitchell B, Williams CP, Spurling GK (2015) Saline nasal irrigation for acute upper respiratory tract infections. Cochrane Database Syst Rev 4:CD006821

54.

Keerl R, Weber R, Muller C, Schick B (1997) Effectiveness and tolerance of nasal irrigation following paranasal sinus surgery. Laryngorhinootologie 76(3):137PubMed

55.

Liang KL, Su MC, Tseng HC, Jiang RS (2008) Impact of pulsatile nasal irrigation on the prognosis of functional endoscopic sinus surgery. J Otolaryngol Head Neck Surg 37(2):148–153PubMed

56.

Low TH, Woods CM, Ullah S, Carney AS (2014) A double-blind randomized controlled trial of normal saline, lactated Ringer’s, and hypertonic saline nasal irrigation solution after endoscopic sinus surgery. Am J Rhinol Allergy 28(3):225–231PubMed

57.

Kim ST, Sung UH, Jung JH, Paik JY, Woo JH, Cha HE, Kang IG (2013) The effect of maxillary sinus irrigation on early prognostic factors after endoscopic sinus surgery: a preliminary study. Am J Rhinol Allergy 27(5):e158–e161PubMed

58.

Salib RJ, Talpallikar S, Uppal S, Nair SB (2013) A prospective randomised single-blinded clinical trial comparing the efficacy and tolerability of the nasal douching products Sterimar™ and Sinus Rinse™ following functional endoscopic sinus surgery. Clin Otolaryngol 38(4):297–305PubMed

59.

Liang KL, Kao TC, Lin JC, Tseng HC, Su MC, Hsin CH, Shiao JY, Jiang RS (2008) Nasal irrigation reduces postirradiation rhinosinusitis in patients with nasopharyngeal carcinoma. Am J Rhinol 22(3):258–262PubMed

60.

Rabone S, Saraswati S (1999) Acceptance and effects of nasal lavage in volunteer woodworkers. Occup Med (Lond) 49(6):365–369

61.

Castano R, Gautrin D, Theriault G, Trudeau C, Ghezzo H, Malo JL (2009) Occupational rhinitis in workers investigated for occupational asthma. Thorax 64(1):50–54PubMed

62.

Garavello W, Somigliana E, Acaia B, Gaini L, Pignataro L, Gaini RM (2010) Nasal lavage in pregnant women with seasonal allergic rhinitis: a randomized study. Int Arch Allergy Immunol 151(2):137–141PubMed

Title: Nasal Irrigation as Treatment in Sinonasal Symptoms Relief: A Review of Its Efficacy and Clinical Applications
Authors: Baharudin Abdullah
Chenthilnathan Periasamy
Rushdan Ismail
Publication date: 01-11-2019
Publisher: Springer India
Published in: Indian Journal of Otolaryngology and Head & Neck Surgery / Issue Special Issue 3/2019
Print ISSN: 2231-3796
Electronic ISSN: 0973-7707
DOI: https://doi.org/10.1007/s12070-017-1070-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nasal Irrigation as Treatment in Sinonasal Symptoms Relief: A Review of Its Efficacy and Clinical Applications

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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