Efficacy of Sterile Water Compared with Normal Saline Solution for Nasal Irrigation on the Sinonasal Symptoms in Chronic Sinusitis Patients

Abstract

Efficacy of Sterile Water Compared with Normal Saline Solution for Nasal Irrigation on the Sinonasal Symptoms in Chronic Sinusitis Patients

Girapong Ungkhara MD, MPA*

Thanyunuch Athakris MD**

* Department of Otolaryngology, BMA Medical College and Vajira Hospital

** Department of Defensive Medicine, Police General Hospital

Objective: To compare the efficacy of nasal irrigation using sterile water versus normal saline solution to relieve sinonasal symptoms of chronic sinusitis patients.

Study design: Randomized double-blind controlled trial.

Subjects: A total of 42 chronic sinusitis patients who were treated at the Department of Otolaryngology, BMA Medical College and Vajira Hospital during December 2004 were enrolled. The inclusion criteria were those who were older than 15 years old, had symptoms of chronic sinusitis for more than 3 months and had been treated with conventional therapy.

Methods: The enrolled patients were randomized into 2 groups; 21 patients in normal saline solution group and 21 patients in sterile water group. The investigators and the patients were blinded to the solution each patient received. The patients were asked to answer the questionnaire to evaluate the sinonasal symptoms before irrigation. After being educated about the correct technique of nasal irrigation, the patients had self nasal irrigation at home for 1 week. Then, they were asked to follow up and answered the questionaires to reassess their sinonasal symptoms.

Main outcome measures: Sinonasal symptoms score including cough, presence and characteristics of nasal discharge. The highest score was 7.

Results: After nasal irrigation for 1 week, sinonasal symptoms were significantly improved in both groups. The median sinonasal symptom score decrease from 6 to 3 in patients of normal saline group and from 5 to 3 in sterile water group. The improvement of sinonasal symptoms score was not significant different between the two groups.

Conclusion: In chronic sinusitis patients, nasal irrigation with either normal saline or sterile water was effective and significantly improved the sinonasal symptoms. The improvement of sinonasal symptoms was not significant different between the two solutions.

Vajira Med J 2008 ; 52 : 193-199