Efficacy of Nasal Saline Sprays to Relieve Symptoms of Chronic Sinusitis

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Darwin Yeung


(1) sinusitis (2) sodium chloride (3) rhinitis (4) saline solution, hypertonic


Background: Chronic sinusitis is a common condition that significantly reduces quality of life. Nasal saline irrigation is a simple and effective way to reduce symptoms. However, few studies have investigated the efficacy of low-volume nasal saline sprays in symptom relief. Objective: To determine whether nasal saline sprays are effective in reducing symptoms of chronic sinusitis. Methodology: An Ovid MEDLINE search (1948 to 2010) was conducted using the MeSH headings listed and limited to randomized controlled trials in English. Studies were excluded if symptoms were considered to be acute, if symptom relief was not the primary outcome measure, or if sprays were not the primary treatment being investigated. Results: Of the 42 articles retrieved, 8 met inclusion criteria. The majority of studies showed symptom improvement with use of a nasal saline spray. However, one study showed relief with hypertonic not isotonic saline and found it to be inferior to intranasal corticosteroids. Another study similarly favored hypertonic over isotonic saline while a third found no difference in nasal obstruction but differences in mucociliary clearance, airway patency, and nasal irritation. Saline and antibiotic sprays both improved symptoms and quality of life but saline was superior in reducing congestion while antibiotics was superior in reducing pain. Despite efficacy of the spray, irrigation was a superior method of relief. Conclusion: Nasal saline sprays effectively reduce symptoms of chronic sinusitis. However, saline irrigation and intranasal steroids may still be preferred therapeutic options. Future studies should clarify the relative merit of hypertonic over isotonic saline.
MeSH Headings: (1) sinusitis (2) sodium chloride (3) rhinitis (4) saline solution, hypertonic