Last reviewed as up-to-date 9.3.2017 • Latest change 9.3.2017
Nasal saline irrigation may relief symptoms in chronic rhinosinusitis.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment)
and imprecise results (limited study size for each comparison).
A Cochrane review «»1 «Chong LY, Head K, Hopkins C et al. Saline irrigat...»1 included 2 studies with a total of 116 adults. One study compared large-volume (150
ml) hypertonic (2%) saline irrigation with usual treatment over a 6-month period at
the primary care setting; the other compared 5 ml nebulised saline twice a day with
intranasal corticosteroids for 3 months and evaluating them on completion of treatment
and 3 months later in a secondary care setting.
- Large-volume, hypertonic nasal saline vs. usual care (one trial, n=76):
The patients were with or without polyps. Disease-specific HRQL was reported using
the Rhinosinusitis Disability Index (RSDI). At the end of 3 months' treatment, patients
in the saline group were better than those in the placebo group (MD 6.3 points, 95%
CI 0.89 to 11.71) and at 6 months there was a greater effect (MD 13.5 points, 95%
CI 9.63 to 17.37). No adverse effects data were collected in the control group but
23% of participants in the saline group experienced side effects including epistaxis.
General HRQL was measured using SF-12, no difference was found after 3 months of treatment,
but at 6 months there was a small difference favouring the saline group, which may
not be of clinical significance (MD 10.5 points, 95% CI 0.66 to 20.34).
- Low-volume, nebulised saline vs. intranasal corticosteroids (one trial, n=40):
All patients had polyps. The primary outcome of disease-specific HRQL was not reported.
At the end of treatment (3 months) the patients who had intranasal corticosteroids
had less severe symptoms (MD -13.50, 95% CI -14.44 to -12.56); this corresponds to
a large effect size.
This document is linked to the following articles:
- Chong LY, Head K, Hopkins C et al. Saline irrigation for chronic rhinosinusitis.
Cochrane Database Syst Rev 2016;4():CD011995. «PMID: 27115216»PubMed