A multicenter survey on the effectiveness of nasal irrigation devices in rhinosinusitis patients

Abstract

Background: Nasal irrigation is widely used as an adjunctive treatment for rhinosinusitis. However, there is little information available regarding the efficacy of the devices used in this procedure. The objective of this study was thus to evaluate the effectiveness of nasal irrigation devices based on the experiences of patients with rhinosinusitis. Methods: We conducted a multicenter survey study between November 2017 and December 2019. The questionnaire was developed based on the available literature and expert opinion and submitted to the otolaryngology residents and staff of each center as well as those in their networks. Results: Four hundred eighteen patients were enrolled in this study: 76 with acute viral rhinosinusitis (18%), 53 with acute bacterial rhinosinusitis (13%), 156 with chronic rhinosinusitis without nasal polyps (37%), and 133 with chronic rhinosinusitis with nasal polyps (32%). We found that high-volume devices were most effective in helping to clear secretion in patients with acute viral rhinosinusitis, chronic rhinosinusitis without nasal polyps, and acute bacterial rhinosinusitis (P = .017, .009, .002, respectively) and in reducing post-nasal drip in those with acute bacterial rhinosinusitis (P = .040). There were no statistically significant differences among devices in patients with chronic rhinosinusitis with nasal polyps. Conclusions: Nasal irrigation with high-volume devices was an effective treatment for rhinosinusitis and was more effective at clearing nasal secretion and reducing post-nasal drip than that with other types of devices.

Effects of large volume, isotonic nasal saline irrigation for acute rhinosinusitis: a randomized controlled study

“…21 In a recent survey of 129 acute rhinosinusitis patients, the patients reported that large-volume, positivepressure devices help clear secretion more effectively than low-volume devices. 5 The present study was designed to assess patients with ARS which included all ARS subtypes (common cold, postviral rhinosinusitis, and ABRS). These subtypes are different in pathogenesis, clinical symptoms, disease onset, and duration.…”

“…The aim of large volume, positive pressure saline irrigation is to mechanically wash nasal discharge out of the nasal cavity 21 . In a recent survey of 129 acute rhinosinusitis patients, the patients reported that large‐volume, positive‐pressure devices help clear secretion more effectively than low‐volume devices 5 . The present study was designed to assess patients with ARS which included all ARS subtypes (common cold, postviral rhinosinusitis, and ABRS).…”

“…2 It has been recommended as an adjunctive treatment for ARS. 1,[3][4][5] However, evidence shows that the benefits of nasal saline irrigation for treating ARS are limited. The International Consensus Statement on Rhinology and Allergy: Rhinosinusitis (2021) 3 recommended nasal saline irrigation as an "option" for ARS treatment, whereas the European Position Paper on Rhinosinusitis and Nasal Polyps 2020 (EPOS 2020) 1 stated that "no advice can be given".…”

“…Nasal saline irrigation is utilized for mechanical lavage of mucus, debris, and inflammatory cytokines and enhancing mucociliary function 2 . It has been recommended as an adjunctive treatment for ARS 1,3–5 . However, evidence shows that the benefits of nasal saline irrigation for treating ARS are limited.…”

Current Perspective on Nasal Delivery Systems for Chronic Rhinosinusitis

“…In the international consensus statement of allergy and rhinology: rhinosinusitis in 2016, it is strongly recommended that large volume (>200 mL) nasal saline irrigation be used as an auxiliary means for other drug treatment of CRS [ 86 ]. A recent study involving 418 patients with rhinosinusitis showed that large-volume nasal irrigators were more effective than other types of irrigators in removing nasal secretions and reducing postnasal drip [ 87 ]. Kanjanawasee et al [ 88 ] compared the effects of nasal irrigation using hypertonic saline (HS) and isotonic saline (IS) in treating sinonasal diseases.…”