Syringe with Nasal Applicator versus Syringe Alone for Nasal Irrigation in Acute Rhinosinusitis: A Matched-Pair Randomized Controlled Trial (2025)

Squeeze bottle versus syringe nasal saline irrigation for persistent allergic rhinitis - a randomized controlled trial

2020

BACKGROUND Nasal irrigation is widely used as an adjunctive treatment for allergic rhinitis. There is little evidence regarding the efficacy of the devices used in this procedure. The objective of this study was to evaluate the efficacy of the squeeze bottle nasal saline irrigation in persistent allergic rhinitis patients compared with a syringe. METHODOLOGY We included patients between 18- and 60-years old presenting with persistent allergic rhinitis. All patients were instructed to perform nasal irrigation twice daily for four weeks. The patients were randomly assigned to use either the squeeze bottle nasal irrigation or a syringe for nasal irrigation. Symptoms score, physical examination results, satisfaction scores and adverse events were collected. RESULTS There were 116 patients enrolled in the study, 58 of whom used the squeeze bottle nasal irrigation system and 58 of whom used a syringe. During a four-week follow-up, improvements in patients' nasal symptom scores for rhi...

A randomized-controlled study comparing the efficacy of positive pressure nasal saline irrigation device versus syringe use in children with acute rhinosinusitis

Asian Pacific Journal of Allergy and Immunology, 2016

Objective: To evaluate the efficacy of positive-pressure nasal irrigation devices in children with acute sinusitis, in addition to bacterial colonization of the irrigation device. Method: We performed a randomized, prospective, controlled study of 80 children with acute sinusitis, aged between 3 and 15 years. Participants were randomly separated into two groups, where one group was treated using a squeezable bottle and the other group treated using a syringe. All patients were instructed to use a 1.25% buffered hypertonic solution for nasal irrigation twice daily for 2 weeks, in addition to amoxicillin-clavulanic acid. During this period, all participants recorded a 5S score, satisfaction score, any side effects and use of antihistamines. Parents were instructed to clean the device with soap after each use. After this period, the nasal irrigation devices were sent to a microbiological laboratory for bacterial identification. Results: At the 2-week follow-up, improvement in both 5S and satisfaction scores were observed in both groups compared to baseline, which were significantly higher in the group treated with the squeezable bottle compared to the syringe. Few complaints were reported, and side effects were equal in both groups. The overall rate of bacterial contamination for both treatments was approximately 80%, but this did not translate into higher rates of infection amongst patients. Conclusions: The use of a squeezable bottle for nasal irrigation in children with acute sinusitis was associated with further improvements in 5S and satisfaction scores compared to syringe use, and there were no significant differences in bacterial contamination between methods.

Qualitative aspects of nasal irrigation use by patients with chronic sinus disease in a multimethod study

Annals of family medicine

PURPOSE We qualitatively assessed attitudes regarding use of hypertonic saline nasal irrigation (HSNI) for frequent rhinosinusitis and chronic sinonasal symptoms in a 3-part, multimethod study.

Effects of self-prepared hypertonic nasal saline irrigation in allergic rhinitis: A randomized controlled trial

Asian Pacific Journal of Allergy and Immunology

Background: Nasal saline irrigation has been reported to be effective as an adjunctive therapy for allergic rhinitis (AR), but concerns about adverse events, supply problems, and high costs have limited its widespread clinical use. Aqueous 1.8% sodium chloride solution prepared by patients using drinking water (1.8% self-prepared hypertonic nasal saline irrigation; 1.8% SPHNSI) could solve some of these problems, but its clinical efficacy and safety need to be determined. Objective: We aimed to compare the efficacy and safety of 1.8% SPHNSI and 0.9% commercial isotonic nasal saline irrigation (0.9% CINSI) in patients with AR. Methods: A randomised, single-blinded, placebo-controlled trial was performed as a pilot study. Seventy-eight patients with AR were included. Each patient was randomised to nasal irrigation with 80 mL of either 1.8% SPHNSI or 0.9% CINSI twice-daily for 4 weeks. Randomised codes were generated using a computer and a block of 4 procedure. The primary outcome was improvement of quality of life scores in Thai patients with allergic rhinoconjunctivitis (Rcq-36). Secondary outcomes were clinical symptoms using total nasal symptom scores (TNSS) and adverse events. All outcomes were assessed by blinded assessors at baseline, week 2, and week 4. Results: At week 4, nasal irrigation with 1.8% SPHNSI had significantly improved the Rcq-36 score (54% versus 50%; p < 0.032) and congestion symptom score (96% versus 84%; p < 0.018) compared to nasal irrigation with 0.9% CINSI. Adverse events were comparable for both groups at week 4. Conclusion: This pilot study indicates that regular use of 1.8% SPHNSI in AR patients for 4 weeks is safe and has superior efficacy to 0.9% CINSI for alleviating congestion and improving quality of life scores.

Effectiveness of nasal irrigation devices: a Thai multicentre survey

PeerJ

Background Nasal irrigation is widely used as an adjunctive treatment for nasal diseases. There is little evidence regarding the efficacy of the devices used in this procedure. The objective of this survey was to evaluate the effectiveness of nasal irrigation devices based on the experiences of patients and physicians. Methods We conducted a multicentre survey study between November 2017 and October 2018. Physician and patient questionnaires were developed based on the available literature and expert opinion. The physician questionnaire was submitted to the Otolaryngology residents and staff of each centre and their network. The physicians were also asked to distribute the patient questionnaire to their patients. Results Information regarding 331 devices used by the patients was collected. The mean age of the patients was 45.46 ± 17.19 years (from 5 to 81). Roughly half were male, and half were female (48.6%: 51.4%). Among the high-pressure devices, we found that the high-pressure l...

Real-World Data on the Use of Hypertonic Saline Nasal Spray in ENT Practice

SN Comprehensive Clinical Medicine, 2019

Hypertonic saline solutions are in broad medicinal use for treatment of various disorders of nose and paranasal sinuses. This trial aimed at the evaluation of safety and efficacy of a hypertonic saline nasal spray within the scope of routine care in an otorhinolaryngological outpatient setting. One hundred and thirty-six patients were included into this uncontrolled clinical trial and received 2.7% saline solution nasal spray. Symptoms and clinical signs were documented on an ordinal scale of 0-4 during initial and final examination, and both individual symptoms and the sum of symptom scores (clinical sum score) were assessed. Participating patients and physicians furthermore evaluated the clinical benefit of the therapy. Clinical sum score decreased from 13.63 ± 6.65 to 7.85 ± 6.79 (p < 0.001) between initial and final examination, and significant improvements were observed for 10 out of 12 individual symptoms. A clinical benefit was attributed to hypertonic saline treatment by both patients and physicians in more than 50% of the documented cases. Seventy percent of the patients noticed improvement of nasal breathing, and 50% of the patients considered hypertonic saline an alternative to the use of α-sympathomimetics. One adverse event (epistaxis) was reported, whereas 95% of the patients rated the treatment as flawless. Eleven pregnant women and one nursing mother participated in the trial without the occurrence of any negative effect on mother and child. This study substantiates the safe and efficacious use of hypertonic saline nasal spray. Reduction in use of classical decongestants constitutes a valuable and safe therapeutic option for patients for whom use of these drugs is contraindicated. Clinical Trial Register: DRKS-ID: DRKS00010825

Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis: a hypothesis generating study

WMJ : official publication of the State Medical Society of Wisconsin, 2008

Rhinosinusitis is a common, expensive disorder with a significant impact on patients&#39; quality of life. Chronic sinus symptoms are associated with allergic rhinitis, asthma, and nasal polyposis. Saline nasal irrigation is an adjunctive therapy for rhinosinusitis and sinus symptoms. Prior studies suggest that hypertonic saline nasal irrigation (HSNI) may be effective for symptoms associated with allergy, asthma, and nasal polyposis. To assess the degree to which subjects using nasal irrigation for chronic sinus symptoms also reported improvements in symptoms related to allergy, asthma, or nasal polyposis. Qualitative study using in-depth long interviews of 28 participants in a prior qualitative nasal irrigation study. All participants were receiving daily nasal irrigation. Transcripts of interviews were systematically examined. Twelve of 21 subjects with allergic rhinitis spontaneously reported that HSNI improved symptoms. Two of 7 subjects with asthma and 1 of 2 subjects with nas...

Limited Evidence: Higher Efficacy of Nasal Saline Irrigation over Nasal Saline Spray in Chronic Rhinosinusitis--An Update and Reanalysis of the Evidence Base

Otolaryngology -- Head and Neck Surgery, 2014

Objective. To assess the effectiveness of nasal saline irrigation in adult patients with chronic rhinosinusitis.

Nasal Irrigation in the Control of Nasal Symptoms in Pediatrics - Systematic Review of the Literature

International Journal of Health Science, 2022

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Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial

The Journal of family practice, 2002

To test whether daily hypertonic saline nasal irrigation improves sinus symptoms and quality of life and decreases medication use in adult subjects with a history of sinusitis. Randomized controlled trial. Experimental subjects used nasal irrigation daily for 6 months. Seventy-six subjects from primary care (n=70) and otolaryngology (n=6) clinics with histories of frequent sinusitis were randomized to experimental (n=52) and control (n=24) groups. Primary outcome measures included the Medical Outcomes Survey Short Form (SF-12), the Rhinosinusitis Disability Index (RSDI), and a Single-Item Sinus-Symptom Severity Assessment (SIA); all 3 were completed at baseline, 1.5, 3, and 6 months. Secondary outcomes included daily assessment of compliance and biweekly assessment of symptoms and medication use. At 6 months, subjects reported on side effects, satisfaction with nasal irrigation, and the percentage of change in their sinus-related quality of life. No significant baseline differences ...