Saline Nasal Irrigation Reduces Symptoms, Severity of Sinusitis

October 13, 2003

Martha Kerr

Oct. 13, 2003 (New Orleans) — Daily nasal irrigation with a hypertonic saline solution reduces not only the severity of symptoms in sinusitis, but the occurrence of acute exacerbations and the need for antibiotic therapy, researchers announced here at this year's scientific assembly of the American Academy of Family Physicians.

David Rabago, MD, from the Department of Family Medicine at the University of Wisconsin, Madison, and colleagues presented results of a study of 76 patients with chronic sinusitis randomized to a regimen of daily nasal lavage with 135 cc of hypertonic saline solution (52 patients) or to a control group that managed symptoms as usual (24 patients). The study lasted for six months.

Patients in the intervention arm reported a significant improvement in quality of life, reduction in symptoms of sinusitis, reduction in antibiotic use, and a reduction in use of nasal sprays compared with control patients, Dr. Rabago told meeting attendees.

"Pouring water in your nose is not what you normally gravitate towards," Dr. Rabago commented, "but it seems to work for these patients."

After the initial phase of the study was completed, 54 patients, including control patients from phase 1 of the study, continued to use nasal lavage and were followed at 4, 8, and 12 months. There was no patient dropout, Dr. Rabago reported, and quality-of-life improvements were maintained throughout follow-up.

In phase 2, 65% of patients used nasal lavage when symptomatic and 35% used it on a daily basis. Approximately 10% of patients reported mild nasal burning, but 96% of subjects reported satisfaction with the technique and said they will continue to use it. Dr. Rabago described the patients as "enthusiastic."

Patients reported a 72% reduction in sinus infections, a 58% decrease in medication use, a 69% improvement in ability to breathe, and a 52% improvement in quality of life.

"Almost everyone you treat can benefit from this," Dr. Rabago said.

Bruce Gardner, MD, FAAFP, from Queen Anne Family Medicine and the University of Washington in Seattle, concurs. He told Medscape that he considers nasal saline lavage "an integral part of treating sinusitis, especially chronic sinusitis."

But he said that some patients are unable to integrate the technique into their healthcare regimen. "What you need is a positive result" when using a technique like saline irrigation of the nasal passages, Dr. Gardner said. "It is a technique that involves a learning curve and sometimes you just can't get past that...but it really does cut down on the need for other medications."

AAFP 2003 Scientific Assembly: Family Practice Research Presentations. Presented Oct. 4, 2003.

Reviewed by Gary D. Vogin, MD

Martha Kerr is a freelance writer for Medscape.