[Use of isotonic NaCl solution in patients with acute rhinosinusitis]

The mucous membrane of the nose and paranasal sinuses has several important physiological functions. Inflammation of the nose and paranasal sinuses impairs filtration, humidification and warming of the inhaled air. It also affects the beating of cilia and the mucociliary clearance within the nose and lumen of the sinuses. The result is impairment of the mechanism by which the removal of the stagnant pathological discharge from the paranasal sinuses and of foreign matter (environmental pollutants) from the nasal mucosa would be otherwise effected. The use of special products to cleanse the nasal mucosa may considerably improve its function. Day-to-day ENT practice offers evidence of beneficial effects of nasal douching with isotonic sea water solutions. Products which cleanse nasal mucosa are now used as an adjunct to treatment of rhinosinusitis and rhinitis co-existing with nasal polyps.

was a retrospective assessment of symptoms in patients with acute rhinosinusitis depending on the therapeutic modality used, especially in a group of patients using an isotonic solution (0.9% NaCl) in addition to standard treatment.

Medical records of 80 patients, males and females with symptoms of acute rhinosinusitis were included in the final evaluation. The following medical records including fully documented medical history and physical findings in compliance with the EP3OS were randomly selected from the medical records at the ENT Outpatient Clinic: 40 patients with acute rhinosinusitis treated symptom-relieving medication (Group A) and symptom-relieving medication with topical nasal corticosteroids (Group C); 40 patients with acute rhinosinusitis treated symptom-relieving medication plus isotonic NaCl solution twice a day (Group B) and symptom-relieving medication with topical nasal corticosteroids plus isotonic NaCl solution twice a day (Group D).

Seven-days-treatment resulted in the decreasing of severity of the disease by 39.59% in control group and by 73.62% in patients using isotonic solution NaCl. The use of isotonic NaCl solutions as an adjunct to the treatment of acute rhinosinusitis results in highly statistically significant improvement of nasal patency (by 45.1% in control group and by 72.0% in patients using isotonic solutions) due to decreased swelling of the mucosa of the nasal turbinate. The use of isotonic NaCl solutions as an adjunct to the treatment of acute rhinosinusitis results in a highly statistically significant improvement in function of smell. Treatment with local nasal corticosteroids in combination with isotonic NaCl solutions produces a significant reduction in the severity of symptoms in patients with rhinosinusitis. The therapeutic effect in these patients is statistically significantly better than in patients treated with local nasal corticosteroids alone.

The findings of the present study support the investigators' opinion that the isotonic solution (0.9% NaCl) should be recommended for nasal douching may be a valuable adjunct to the standard medical treatment of acute rhinosinusitis.