Clinical Citations: Using saline nasal irrigation to manage sinonasal symptoms

The annoying symptoms of rhinosinusitis are often refractory to treatment, and their impact on patients' quality of life has been well established. However, some encouraging news comes from a study by Rabago and associates, who found that hypertonic saline nasal irrigation (HSNI) improves quality of life in patients with chronic sinonasal symptoms.

These researchers conducted a 2-phase study. Phase 1 was a 6-month, structured, intensive, randomized, controlled trial of 76 participants who had had 2 episodes of acute rhinosinusitis or 1 episode of chronic rhinosinusitis per year for 2 consecutive years and whose quality of life was impaired by their symptoms. During this phase, 52 participants used HSNI a mean of 87% of days, concurrent with their established standard-of-care treatment; 24 participants practiced standard-of-care treatment only.

Participants completed the Rhinosinusitis Disability Index and a single-item sinus-symptom severity assessment. In phase 2, 54 of the phase 1 participants were assessed over 12 months in an uncontrolled setting. The Sino-Nasal Outcomes Test was added.

Results of both phases indicated that HSNI was associated with improved quality of life, reduced symptoms, and decreased use of antibiotics and nasal sprays.