Nasal irrigation has been used as an adjunctive therapy of sinonasal disease including
acute/chronic sinusitis and allergic rhinitis. Several published articles reported
it also improves clinical sinus symptoms.
To evaluate the effectiveness of normal saline nasal irrigation in the management
of acute sinusitis in children.
This was a randomized, prospective placebo-controlled study.
We included 69 participants with acute sinusitis. 30 of 69 participants underwent
normal saline nasal irrigation. 39 of 69 participants were not receiving nasal irrigation.
All participants performed nasal peak expiratory flow rate (nPEFR) test, nasal smear
examination, radiography (Water's projection) and requested to complete the Pediatric
Rhinoconjunctivitis Quality of Life Questionnaires (PRQLQ) at the baseline visit.
All participants were requested to record the symptom diary card every day and were
followed-up every 1 week during this period. A physical examination, nasal smear and
nPEFR were performed at each visit, and all daily diary cards collected. At the final
visit, the symptoms diaries were reviewed and participants were requested to complete
the PRQLQ again. The nPEFR, radiography (Water's projection) and nasal smear were
also repeated.
Normal saline irrigation group significantly improved mean PRQLQ values and nPEFR
values at medium (T=2.816, P<0.05) and final period (T=2.767, P<0.05) compared with
the other group. Although there were no statically significant improving rate of radiography
(Water's projection) in among two groups (T=0.545, P>0.05), but normal saline irrigation
group was better than the other group. The improval rate of mean TSS in the irrigation
group significantly improved all symptoms compared with the placebo group, in which
rhinorrhea, nasal congestion, throat itching, cough and sleep quality improved. 27
of 66 (40.9%) participants with atopy, 16 of 27 (53.33%) participants underwent normal
saline irrigation. Normal saline irrigation atopy group significantly improved rhinorrhea,
nasal congestion, throat itching and sleep quality symptoms compared with non-irrigation
atopy group. Normal saline irrigation atopy group significantly improved nPEFR values
at final period (Z=2.53, P<0.05).
This study evidence that normal saline nasal irrigation improves Pediatric Rhinoconjunctivitis
Quality of Life and decreases acute sinusitis symptoms. Nasal irrigation is an effective
adjunctive treatment for pediatric acute sinusitis. Normal saline nasal irrigation
in atopy children also improves allergic-related symptoms. We may need larger, longer
and extended study to assess the conclusion.