Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults

Park, Do Yang; Choi, Ji-Ho; Kim, Chang Woo; Jung, Yong Gi; Mun, Sue Jean; Min, Hyun Jin; Park, Soo Kyung; Shin, Jae–Min; Yang, Hyung Chae; Hong, Seung No; Mo, Ji‐Hun

doi:10.21053/ceo.2021.00654

Cited by 19 publications

(9 citation statements)

References 134 publications

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“…A small proportion of ENT interviewees declared that in case of side effects such as dryness and bleeding or if the patient is intolerant to the use of nasal spray, they propose a nasal douche with diluted local corticosteroids. If, finally, side effects persist, discontinuation of treatment should be considered [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Corso

Pipolo²,

Cantone

et al. 2022

JPM

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Background: Local and systemic corticosteroids have long been the workhorse in management of chronic rhinosinusitis with nasal polyps (CRSwNP), although there is no universally accepted modality of prescription. We carried out a survey in Italy to capture current trends in the use of topical and systemic corticosteroids in patients with CRSwNP. Methods: A survey was set up on Survey Monkey®. Each author distributed the link to the survey in an ad hoc manner and a total of 437 participants filled out the survey. Results: Mometasone furoate (79.3%) was the most frequently prescribed, administered daily by 61.9% of participants; the remaining preferred to discontinue treatment for brief periods to reduce side effects or to modulate the therapy in mild cases. The majority believe that a short cycle of systemic steroids should be prescribed for re-exacerbation of symptoms and that the number of cycles in the previous year should be evaluated to define control of the disease even if international guidelines do not provide clear indications on this topic. A certain degree of divergence emerged from responses regarding how long and the maximal dose of systemic steroids which place patients at high risk for adverse events. Finally, systemic corticosteroids seem to offer only temporary benefit on recovery of smell without guaranteeing long-term control even if the patient is adherent to topical corticosteroids. Conclusions: Our results highlight the need for clear guidelines on oral steroids, which could help supporting the use of a precision medicine approach, including indications for new biological agents.

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Section: Discussionmentioning

confidence: 99%

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Corso

Pipolo²,

Cantone

et al. 2022

JPM

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“…The effectiveness of nasal irrigation is influenced by factors such as the position of the head during irrigation, the volume of irrigation, and any nasal surgery related to the nasal cavity ( 36 ). As such, further evidence is necessary to select suitable irrigation methods, and determine the frequency and duration of their use ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

“…Hypertonic saline may also trigger the release of histamine, increasing nasal reactivity and secretion, which can ultimately decrease nasal airway capacity ( 41 ). Previous research has shown that nasal irrigation solutions at temperatures between 20–40 ℃ is considered safe and effective ( 37 ). However, more research needs to be conducted to determine the correlation between the appropriate temperature and the efficacy of nasal irrigation ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Significance of saline nasalirrigation for COVID-19 infection: observations and reflections from nursing care of nasopharyngeal carcinoma

Yan,

Ding,

et al. 2024

Transl Cancer Res

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Background Coronavirus disease 2019 (COVID-19) has placed a tremendous burden on the world’s healthcare systems, prompting medical professionals worldwide to diligently research and experiment with treatment methods to prevent infection and alleviate symptoms. Previous studies have shown the potential of nasal irrigation in reducing viral clearance time and alleviating local symptoms of COVID-19. However, views differ regarding its efficacy in improving systemic symptoms. Thus, we sought to examine whether saline nasal irrigation might play a role in treatment and self-care after COVID-19 infection, but further validation is still necessary. Methods We conducted a retrospective analysis of 468 patients and 51 healthcare personnel concurrently. The participants were grouped based on whether they received saline nasal irrigation. We used χ 2 tests and Fisher’s exact tests to assess the differences in the rates of COVID-19 infection and the rates of developing a fever after COVID-19 infection among different groups. Additionally, we used independent samples t -tests and Mann-Whitney U tests to evaluate differences in the maximum fever temperature and fever duration among participants with fever in different groups. Results The rate of developing a fever after COVID-19 infection was lower (37.7%) in the patients who underwent saline nasal irrigation. Among all febrile patients, there was no difference in the highest fever temperature, but patients who underwent saline nasal irrigation had a shorter fever duration (1.72±1.05 days). Additionally, the rate of COVID-19 infection and the rate of developing a fever were higher, and fever symptoms were more severe in the healthcare worker group than in the patient group. Conclusions Saline nasal irrigation can alleviate symptoms caused by COVID-19 infection.

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“…Chronic rhinosinusitis (CRS) is characterized by persistent inflammation of the sinus mucosa, which results in nasal congestion, postnasal drip, facial pressure, and decreased olfactory function [ 1 , 2 ]. Furthermore, it leads to chronic pain, depression, and social dysfunction, which impair quality of life [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Steroid-Impregnated Spacers After Endoscopic Sinus Surgery in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

Hwang¹,

KIM²,

Basurrah³

et al. 2023

Clin Exp Otorhinolaryngol

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Objectives: To compare the effect of steroid-impregnated spacers to conventional management after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS). Methods: Six databases were searched from inception until November 2022. Sixteen studies were found that compared the improvement of chronic sinusitis-related symptoms and postoperative outcomes between a steroid-impregnated spacer group and control group (non-steroid impregnated spacers). The Cochrane risk of bias tool (randomized controlled studies) and Newcastle–Ottawa Scale (non-randomized controlled studies) were used to assess the quality of the works included.Results: Regarding the endoscopic findings, the degree of mucosal edema, ethmoid inflammation, crust formation at 2–3 months postoperatively, nasal discharge, polyposis, and scarring/synechia were significantly lower in the steroid-impregnated spacers group. Also, the steroid-impregnated spacer significantly reduced the Lund–Kennedy score and perioperative sinus endoscopy score compared with the control group at 2–3 weeks postoperatively. Also, the steroid-impregnated spacer group had lower rates of adhesions, middle turbinate lateralization, polypoid change, the need for oral steroid, the need for postoperative therapeutic intervention, and lysis of adhesions compared to controls. However, there were no significant group differences in the short-term (2–3 weeks postoperatively) endoscopic findings regarding nasal discharge, postoperative crusting, polyposis, or scarring/synechia.Conclusion: Steroid-impregnated nasal packing reduced the rates of postoperative intervention and recurrent polyposis and inflammation in CRS patients undergoing ESS.

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Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults

Cited by 19 publications

References 134 publications

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Survey on Use of Local and Systemic Corticosteroids in the Management of Chronic Rhinosinusitis with Nasal Polyps: Identification of Unmet Clinical Needs

Significance of saline nasalirrigation for COVID-19 infection: observations and reflections from nursing care of nasopharyngeal carcinoma

Efficacy of Steroid-Impregnated Spacers After Endoscopic Sinus Surgery in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis

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