Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery

• Published in: Acta oto-laryngologica Vol. 139; no. 6; pp. 529 - 535
• Main Authors: Perić, Aleksandar, Kovačević, Sandra Vezmar, Barać, Aleksandra, Gaćeša, Dejan, Perić, Aneta V., Jožin, Svjetlana Matković
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 03-06-2019
• Subjects: Adult; Aspirin; Aspirin - administration & dosage; Aspirin - adverse effects; China; Chronic Disease; Double-Blind Method; Endoscopy - methods; Female; Humans; Male; Middle Aged; Nasal Lavage - methods; nasal polyps; nasal surgical procedures; postoperative care; Postoperative Care - methods; Prognosis; Prospective Studies; Rhinitis - chemically induced; Rhinitis - diagnostic imaging; Rhinitis - surgery; Risk Assessment; Saline Solution, Hypertonic - administration & dosage; Seawater; sinusitis; Sinusitis - chemically induced; Sinusitis - diagnostic imaging; Sinusitis - surgery; Tomography, X-Ray Computed - methods; Treatment Outcome; China; nasal polyps; sinusitis; postoperative care; Aspirin; nasal surgical procedures
• ISSN: 0001-6489; 1651-2251
• DOI: 10.1080/00016489.2019.1605454

Background: Aspirin-induced chronic rhinosinusitis (CRS) is a severe progressive persistent disease, usually associated with nasal polyps (NPs).
Aim/objective: To compare effect of hypertonic (2.3% NaCl) sea water and isotonic 0.9% NaCl on symptoms and endoscopic findings in those patients in the period of 1 month after endoscopic sinus surgery (ESS).
Material and methods: This prospective, randomized study included 30 patients with aspirin-induced CRS undergoing ESS. Patients were divided into two groups of 15 subjects and one of the two nasal irrigation solutions was administered in each group. Intensity of 5 symptoms (nasal obstruction, nasal discharge/postnasal drip, facial pain/pressure, headache and trouble sleeping) and endoscopic findings were assessed during the 1st, 7th, 14th, 21st and 28th days after the nasal packs removal.
Results: We found significantly lower total symptom score (TSS) during the 7th (p = .009), 14th (p = .003), 21st (p < .001) and the 28th day (p = .001), lower total endoscopic score (TES) on the 21st (p = .002) and 28th day (p = .001), lower nasal obstruction, facial pain/pressure, headache and trouble sleeping, and lower nasal mucosal edema, nasal secretion and nasal crusting in patients treated by hypertonic sea water.
Conclusion and significance: Hypertonic sea water should be recommended douching solution in the early postoperative care of patients with aspirin-induced CRS.