Thursday 01 November 2007, 12:00AM
PEARLS 33, November 2007, written by Brian R
McAvoy
Clinical question
Are nasal saline irrigations effective for chronic rhinosinusitis
symptoms?
Bottom line
Nasal saline irrigations relieve symptoms, help as an adjunct to
treatment and are well tolerated by the majority of patients. While
there is no evidence saline is a replacement for standard
therapies, addition of topical nasal saline is likely to improve
symptom control in patients with persistent sino-nasal disease.
Caveat
All of the studies reviewed were small. Numbers of participants in
the 8 studies varied from 14 to 120. A wide range of delivery
techniques and solutions were used in the studies, and duration of
treatment ranged from 7 days to 6 months. No recommendations can be
made regarding specific solutions, dosage or delivery.
Context
Chronic sinusitis is thought to affect between 5 and 15 per cent
of the population.1 It is the principal Diagnosis in 2 per cent of
all patient visits to primary care.2
Cochrane Systematic Review
Harvey R et al. Nasal saline irrigations for the symptom
of chronic rhinosinusitis. Cochrane Reviews 2007. Issue 3. Article
No. CD006394. DOI: 10.1002/14651858.CD006394.pub.2. Note: This
review contains 8 studies involving a total of 389
participants.
Further references
1. Melen I. Chronic sinusitis: clinical and
pathophysiological aspects. Acta Otolaryngologica 1994;
515:45-48.
2. Schappert SM. National ambulatory medical care survey. 1991
Summary.National Centre for Health Statistics, 1992.