The purpose of this study was to compare the efficacy of a mineral-rich solution vs normal saline solution (0.9% NaCl) following endoscopic complete bilateral ethmoidectomy.
This was a prospective, multicenter, randomized, controlled, open-label trial in subjects suffering from steroid-resistant sinonasal polyposis. Adults performed 4 nasal irrigations of mineral or saline solutions daily for 28 days. Evaluations included subject-reported RHINO quality of life (QoL) and NOSE scores, tolerability, and satisfaction, the Lund–Kennedy endoscopic score and assessments of crusting, secretions and mucociliary clearance (rhinoscintigraphy).
A total of 189 subjects were randomized. Clinically relevant improvements (> 20 points) in RhinoQOL and NOSE scores were measured in both groups without any significant inter-group difference. Among the subjects with impaired RhinoQOL at pre-inclusion, the change in Impact-RhinoQOL score was significantly superior in mineral-rich vs saline solution at day 21 (p = 0.028) and day 28 (p = 0.027). The Lund–Kennedy score continuously improved in both groups earlier with the mineral-rich solution. Crusts were significantly fewer in number and less severe/obstructive in patients receiving mineral-rich vs saline solution at day 7 (p = 0.026) and day 14 (p = 0.016). Furthermore, secretions disappeared significantly more quickly and were less thick/purulent with mineral-rich solution at day 14 (p = 0.002) and day 21 (p = 0.043). Less epistaxis was reported in the mineral vs saline solution (p = 0.008 at day 21).
Our findings indicate that the composition of a nasal irrigation solution influences endoscopic scores and QoL after sinus surgery for patients over 60, those with an initially poor QoL and higher symptom score, and smokers.
Desrosiers M, Evans GA, Keith PK et al (2011) Canadian clinical practice guidelines for acute and chronic rhinosinusitis. J Otolaryngol Head Neck Surg 40(Suppl 2):S99–S193 PubMed
Fokkens WJ, Lund VJ, Mullol J et al (2012) European Position Paper on Rhinosinusitis and Nasal Polyps 2012. Rhinol Suppl 23:3 (p preceding table of contents, 1–298) PubMed
SFORL (2001) Les thérapeutiques peropératoires en chirurgie endonasale. Cachan: LOb Conseil. https://www.orlfrance.org/wp-content/uploads/2017/06/RPC1_chir_endonasal_long-1.pdf. Accessed Feb 2018
Chong LY, Head K, Hopkins C et al (2016) Saline irrigation for chronic rhinosinusitis. Cochrane Database Syst Rev 4:CD011995 PubMed
Cordray S, Harjo JB, Miner L (2005) Comparison of intranasal hypertonic dead-sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis. Ear Nose Throat J 84:426–430 PubMed
Strnad P, Skoupa J, Cimrova H, Hornik P (2016) Efficacy of hypertonic seawater saline in the treatment of persistent rhinitis/rhinosinusitis. Rev Laryngol Otol Rhinol 137(1):3–10
- Prospective, randomized, controlled, open-label study to compare efficacy of a mineral-rich solution vs normal saline after complete ethmoidectomy
Ludovic de Gabory
Guillaume de Bonnecaze
- Springer Berlin Heidelberg
Neu im Fachgebiet HNO
Mail Icon II