Nasal irrigation with hypertonic saline is a more effective treatment than traditional saline for chronic rhinosinusitis, improving nasal symptoms and ciliary movement with mild side effects, but more research is needed to determine the exact manner and concentration of nasal irrigation.
- Nasal irrigation with hypertonic saline is more effective than traditional saline in treating chronic rhinosinusitis. - Hypertonic saline is significantly more effective than isotonic saline in improving nasal symptoms and ciliary movement. - There is no significant difference in imaging findings and smell improvement between hypertonic and isotonic saline. - Hypertonic saline has mild side effects and is worthy of widespread use in clinical practice. - It is still necessary to further study the exact manner and concentration of nasal irrigation.
This is from Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial in 2020 at https://pubmed.ncbi.nlm.nih.gov/32534983/.
Top five keywords: chronic rhinosinusitis, hypertonic saline, nasal irrigation, meta-analysis, treatment.
Introduction: Currently, several different concentrations of saline are recommended for use in nasal irrigation. Increasing studies show that nasal irrigation with hypertonic saline is more effective than traditional saline in the treatment of rhinosinusitis, but there have been few systematic analyses of the effect of nasal irrigation with hypertonic saline on chronic rhinosinusitis.
Objective: We sought to compare the effects of hypertonic saline and isotonic saline in the treatment of rhinosinusitis in order to provide a reference for clinical nasal irrigation for chronic rhinosinusitis treatment.
Methods: Medline, cochrane library, EMBASE, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database, and other databases were searched, and the searching was supplemented by manual searches for relevant references to treatment of rhinosinusitis by saline nasal irrigation. The last retrieval date was March 2018. The included studies were evaluated for quality, and data were extracted for meta-analysis using RevMan 5.3.
Results: Seven studies were included. Effects favoring hypertonic saline on nasal symptoms were greater in 4 subgroups. These were (1) patients with nasal secretion (SMD=1.52; 95% CI: 1.04, 2.00; p<0.01), (2) patients with congestion (SMD=1.52; 95% CI: 1.04, 2.00; p<0.01), (3) patients with headache (SMD=0.82; 95% CI: 0.38, 1.26; p<0.01), (4) patients with overall symptomatic relief (SMD=1.63; 95% CI: 0.83, 2.44; p<0.01). However, no difference was shown in smell improvement (SMD=0.47; 95% CI: -0.65, 1.59; p=0.41) and radiologic scores improvement (SMD=2.44; 95% CI: -3.14, 8.02; p<0.01). Besides, hypertonic saline showed greater improvement in mucociliary clearance time scores than did the isotonic saline group (SMD=1.19; 95% CI: 0.78, 1.60; p<0.01). Hypertonic saline brought greater minor adverse effects.
Conclusion: Compared with isotonic saline, hypertonic saline nasal irrigation for the treatment of chronic rhinosinusitis is significantly more effective and has mild side effects in improving nasal symptoms and ciliary movement, but there is no significant difference in imaging findings and smell improvement. Although hypertonic saline is worthy of widespread use in clinical practice, it is still necessary to further study the exact manner and concentration of nasal irrigation.
Keywords: Chronic rhinosinusitis; Hypertonic saline; Irrigação nasal; Meta-analysis; Metanálise; Nasal irrigation; Rinossinusite crônica; Solução salina hipertônica; Tratamento; Treatment.
Copyright © 2020 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.
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Figure 2
Quality of the included studies,…
Figure 2
Quality of the included studies, assessed by risk of bias.
Figure 2 Quality of the included studies, assessed by risk of bias.
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