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Related Concept Videos

Suctioning the Nasopharyngeal Airway01:29

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Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
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Upper respiratory tract disorders, including viral infections and allergic rhinitis, cause significant discomfort and disrupt daily life. Managing these conditions involves a variety of drugs, such as antihistamines, intranasal steroids, decongestants, antitussives, expectorants, and mucolytics. Specific examples of drugs in each category are provided.
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Related Experiment Video

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Intranasal Administration of CNS Therapeutics to Awake Mice
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Saline irrigation for chronic rhinosinusitis.

Lee Yee Chong1, Karen Head, Claire Hopkins

  • 1UK Cochrane Centre, Oxford, UK.

The Cochrane Database of Systematic Reviews
|April 27, 2016
PubMed
Summary

Nasal saline irrigation offers some benefits for chronic rhinosinusitis symptom relief compared to placebo. However, evidence quality is low to very low, and nebulized saline shows no advantage over intranasal steroids.

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Area of Science:

  • Otolaryngology
  • Respiratory Medicine

Background:

  • Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition of the nasal and sinus lining.
  • Symptoms include nasal blockage, discharge, facial pain, and reduced sense of smell, with or without nasal polyps.
  • Nasal saline irrigation is a common self-management strategy for CRS symptoms.

Purpose of the Study:

  • To evaluate the efficacy of saline irrigation in managing chronic rhinosinusitis.
  • To compare saline irrigation with placebo, no treatment, or other pharmacological interventions.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) with at least three months follow-up.
  • Searched multiple databases including CENTRAL, MEDLINE, EMBASE, and ClinicalTrials.gov.
  • Primary outcomes: disease-specific quality of life, symptom severity, and epistaxis. Secondary outcomes included general quality of life and endoscopic scores.

Main Results:

  • Two RCTs involving 116 adults were included.
  • Large-volume (150 ml) hypertonic saline irrigation showed improvement in quality of life compared to placebo, but evidence quality was low to very low.
  • Low-volume (5 ml) nebulized saline did not demonstrate benefits over intranasal corticosteroids for symptom severity.

Conclusions:

  • Difficult to draw definitive conclusions due to heterogeneity in study populations and interventions.
  • Large-volume hypertonic saline irrigation may offer some benefit over placebo for CRS.
  • Low-volume nebulized saline is not superior to intranasal steroids for CRS management.