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Published on: April 25, 2025
A randomized, double-blind, within-person trial of hot saline at 42 °C for endoscopic sinus surgery
Aiko Shimizu1, Seiichiro Makihara1, Kensuke Uraguchi2,3
1Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Background:
The efficacy and safety of 42 °C hot saline irrigation in haemostasis remain unclear.
Aims/Objectives:
This study aimed to investigate the effects of hot saline irrigation at 42 °C during endoscopic sinus surgery (ESS) to assess its efficacy in reducing intraoperative bleeding.
Material And Methods:
In this randomized, double-blind, within-person trial, 13 patients with bilateral chronic rhinosinusitis with nasal polyps undergoing ESS were randomly assigned to receive 42 °C hot saline irrigation on one side and room-temperature saline irrigation as a control on the contralateral side. The primary outcome was the Boezaart surgical field score, while secondary outcomes included operative time, histopathological changes, and postoperative complications. The Wilcoxon signed-rank test was used for statistical analyses.
Results:
The Boezaart surgical field score significantly improved with hot saline irrigation compared with the control during anterior ethmoid surgery (p = 0.046); however, no significant difference was observed during posterior ethmoid and sphenoid surgeries. Operative times were comparable between groups. No adverse tissue changes or postoperative complications were observed.
Conclusions And Significance:
Hot saline irrigation at 42 °C improved surgical field visibility during ESS without adverse effects, demonstrating its potential as a haemostatic adjunct. This cost-effective and safe technique warrants further investigation for broader clinical application.
Trial Registration:
UMIN Clinical Trials Registry: UMIN000052864.
