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Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study
Werner Garavello1, Marco Romagnoli, Lorenza Sordo
1Department of Otorhinolaryngology, D.N.T.B., University of Milano Bicocca, Milano, Italy. wer_g@yahoo.it
Insights
Nasal irrigation with hypertonic saline effectively reduced seasonal allergic rhinitis symptoms in children. This safe and inexpensive treatment also decreased the need for antihistamines during the pollen season.
Area of Science:
- Pediatric Allergy and Immunology
- Rhinology
- Otolaryngology
Background:
- Nasal irrigation with hypertonic saline shows promise for sinonasal disease management.
- Efficacy in pediatric seasonal allergic rhinitis prevention remains uninvestigated.
Purpose of the Study:
- To evaluate hypertonic saline nasal irrigation for preventing seasonal allergic rhinitis symptoms in children.
- To assess its impact on antihistamine use.
Main Methods:
- Twenty children with Parietaria allergy were enrolled.
- Ten received daily hypertonic saline nasal irrigation for 6 weeks; ten served as controls.
- Rhinitis symptom scores and antihistamine use were recorded weekly.
Main Results:
- Nasal irrigation significantly reduced daily rhinitis scores for 5 weeks.
- Antihistamine consumption decreased significantly after the second week, with notable differences in weeks 3, 4, and 6.
- The treatment was well-tolerated.
Conclusions:
- Hypertonic saline nasal irrigation is an effective, inexpensive, and tolerable adjunctive treatment for pediatric seasonal allergic rhinitis.
- It can reduce symptom severity and medication requirements during pollen season.
Abstract:
Recent evidence suggests that nasal irrigation with hypertonic saline may be useful as an adjunctive treatment modality in the management of many sinonasal diseases. However, no previous studies have investigated the efficacy of this regimen in the prevention of seasonal allergic rhinitis-related symptoms in the pediatric patient. Twenty children with seasonal allergic rhinitis to Parietaria were enrolled in the study. Ten children were randomized to receive three-times daily nasal irrigation with hypertonic saline for the entire pollen season, which had lasted 6 weeks. Ten patients were allocated to receive no nasal irrigation and were used as controls. A mean daily rhinitis score based on the presence of nasal itching, rhinorrea, nasal obstruction and sneezing was calculated for each week of the pollen season. Moreover, patients were allowed to use oral antihistamines when required and the mean number of drug assumption per week was also calculated. In patients allocated to nasal irrigation, the mean daily rhinitis score was reduced during 5 weeks of the study period. This reduction was statistically significantly different in the 3th, 4th and 5th week of therapy. Moreover, a decreased consumption of oral antihistamines was observed in these patients. This effect became evident after the second week of treatment and resulted in statistically significant differences during the 3th, 4th and 6th week. This study supports the use of nasal irrigation with hypertonic saline in the pediatric patient with seasonal allergic rhinitis during the pollen season. This treatment was tolerable, inexpensive and effective.