Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review

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Wirach Chitsuthipakorn¹  Dichapong Kanjanawasee³  Minh P. Hoang⁵  Kachorn Seresirikachorn⁶  Kornkiat Snidvongs⁶ 

[1] Center of Excellence in Otolaryngology–Head and Neck Surgery, Rajavithi Hospital;College of Medicine, Rangsit University;Center of Research Excellence in Allergy and Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University;Biodesign Innovation Center, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University;Department of Otolaryngology, Hue University of Medicine and Pharmacy, Hue University;Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University;Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital

关键词: irrigation;    nose;    recommendation;    saline;    sinusitis;   

DOI  :  10.1177/2473974X221105277

学科分类：社会科学、人文和艺术（综合）

来源: Sage Journals

【 摘 要 】

Objective. This review aimed to systematically determine theoptimal nasal saline regimen for different types of sinonasaldiseases.Data Sources. PubMed, Embase, SCOPUS, Cochrane Library,Web of Science, ClinicalTrials.gov. The last search was onDecember 6, 2021.Review Methods. Study selection was done by 2 independentauthors. Randomized controlled trials and meta-analyseswere included. The effects of nasal saline treatment throughvarious devices, saline tonicities, and buffer statuses wereevaluated in patients with allergic and nonallergic rhinitis,acute and chronic rhinosinusitis (CRS), CRS with cysticfibrosis, and postoperative care, including septoplasty/turbinoplasty and endoscopic sinus surgery.Results. Sixty-nine studies were included: 10 meta-analysesand 59 randomized controlled trials. For allergic rhinitis,large-volume devices (60 mL) were effective for treatingadults, while low-volume devices (5-59 mL) were effective forchildren. Isotonic saline was preferred over hypertonic salinedue to fewer adverse events. For acute rhinosinusitis, salineirrigation was beneficial in children, but it was an option foradults. Large-volume devices were more effective, especially inthe common cold subgroup. For CRS, large-volume deviceswere effective for adults, but saline drop was the only regimenthat had available data in children. Buffered isotonic saline wasmore tolerable than nonbuffered or hypertonic saline. Thedata for CRS with cystic fibrosis and nonallergic rhinitis werelimited. For postoperative care, buffered isotonic saline delivered by large-volume devices was effective.Conclusion. Nasal saline treatment is recommended for treating most sinonasal diseases. Optimal delivery methods foreach condition should be considered to achieve therapeuticeffects of saline treatment.

【 授权许可】

CC BY|CC BY-NC