Impact of pulsatile nasal irrigation on the prognosis of functional endoscopic sinus surgery

Nasal irrigation is a popular adjunctive therapy after sinonasal surgery. The objective of this study was to determine the efficacy of nasal irrigation after functional endoscopic sinus surgery (FESS).

Patients with chronic rhinosinusitis (CRS) who underwent FESS were enrolled. The preoperative computed tomography (CT) Lund-Mackay staging, Lund symptom, and endoscopy scores were assessed. All patients received postoperative endoscopic débridement and medical treatment and were randomly allocated to receive nasal irrigation for 3 months or not. The symptom and endoscopy scores were repeatedly measured at 2 weeks and 1, 2, and 3 months postoperatively.

Seventy-seven subjects completed the study. When patients were classified as having either severe or mild CRS (CT score > 12 or < or = 12, respectively), the patients with mild CRS in the irrigation group had a significantly better endoscopy score and symptom score change rates than those in the nonirrigation group (p = .019 and .032, respectively), but there were no significant differences in those outcomes between irrigation and nonirrigation groups in patients with severe CRS.

Our results showed that nasal irrigation is an effective post-FESS management in patients with mild CRS. However, the efficacy of nasal irrigation in patients with severe CRS needs further investigation.