Impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study

2008 ◽  
Vol 123 (5) ◽  
pp. 517-521 ◽  
Author(s):  
A Ural ◽  
T Kocak Oktemer ◽  
Y Kizil ◽  
F Ileri ◽  
S Uslu
Keyword(s):  
Allergic Rhinitis ◽  
Hypertonic Saline ◽  
Mucociliary Clearance ◽  
Chronic Sinusitis ◽  
Acute Sinusitis ◽  
Clearance Time ◽  
Nasal Irrigation ◽  
Before And After ◽  
Saline Solutions ◽  
The Impact

AbstractObjective:To investigate the impact of nasal irrigation with isotonic or hypertonic sodium chloride solution on mucociliary clearance time in patients with allergic rhinitis, acute sinusitis and chronic sinusitis.Patients and methods:Mucociliary clearance time was measured using the saccharine clearance test on 132 adults before and after 10 days' application of intranasal isotonic or hypertonic saline. Patient numbers were as follows: controls, 45; allergic rhinitis, 21; acute sinusitis, 24; and chronic sinusitis, 42. The results before and after irrigation were compared using the Wilcoxon t-test.Results:Before application of saline solutions, mucociliary clearance times in the three patient treatment groups were found to be significantly delayed, compared with the control group. Irrigation with hypertonic saline restored impaired mucociliary clearance in chronic sinusitis patients (p < 0.05), while isotonic saline improved mucociliary clearance times significantly in allergic rhinitis and acute sinusitis patients (p < 0.05).Conclusion:Nasal irrigation with isotonic or hypertonic saline can improve mucociliary clearance time in various nasal pathologies. However, these solutions should be selectively prescribed rather than used based on anecdotal evidence. Further studies should be conducted to develop a protocol for standardised use of saline solution irrigation in various nasal pathologies.

Effect of adjunctive sodium hyaluronate versus surfactant nasal irrigation on mucociliary clearance in allergic rhinitis: a single-blind, randomised, controlled study

2021 ◽  
pp. 1-4
Author(s):  
E Ocak ◽  
S Mulazimoglu ◽  
D Kocaoz ◽  
E Mirici ◽  
E Dagli ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Isotonic Saline ◽  
Sodium Hyaluronate ◽  
Controlled Study ◽  
Control Group ◽  
Clearance Time ◽  
Nasal Irrigation ◽  
Persistent Allergic Rhinitis ◽  
Randomised Controlled

Abstract Objective To investigate the effects of nasal irrigation with sodium hyaluronate and surfactant solutions on mucociliary clearance time in patients with mild persistent allergic rhinitis. Methods A total of 120 patients diagnosed with mild persistent allergic rhinitis were enrolled in this prospective study. The patients were allocated randomly to the surfactant, sodium hyaluronate or isotonic saline (as a control) nasal irrigation group. The mucociliary clearance times and improvements in mucociliary clearance times were compared. Results Improvements in mean mucociliary clearance time were significantly greater in the surfactant and sodium hyaluronate groups than in the control group (p < 0.01). The mean post-treatment mucociliary clearance time of the surfactant group was significantly lower than that of the control (p < 0.001) and sodium hyaluronate groups (p = 0.03). Conclusion Surfactant and sodium hyaluronate nasal irrigation solutions may both be used as adjunctive treatments for allergic rhinitis. Surfactant nasal irrigation resulted in better mucociliary clearance times.

Comparison of Isotonic Seawater Nasal Spray Containing Chamomile Liquid Extract and Other Isotonic Seawater Nasal Washing Solutions for Allergic Rhinitis

2021 ◽  
pp. 000348942110254
Author(s):  
Yavuz Atar ◽  
Semih Karaketir ◽  
Imran Aydogdu ◽  
Hüseyin Sari ◽  
Hasan Sami Bircan ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Clearance Time ◽  
Liquid Extract ◽  
Alternative Treatment Option ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Nasal Mucociliary Clearance

Objective: We aim to demonstrate the effect of an isotonic seawater spray containing chamomile liquid extract on symptoms and nasal mucociliary clearance in patients with allergic rhinitis by comparing it with other isotonic seawater nasal washing solutions. Methods: The study included 123 patients. Based on Allergic Rhinitis and its Impact on Asthma guidelines, mometasone furoate intranasal spray treatment was started for all patients in the group diagnosed with allergic rhinitis. In addition to this treatment, isotonic seawater spray with chamomile liquid extract was added to Group A, isotonic seawater spray to Group B, and isotonic seawater nasal irrigation to Group C. The fourth group (Group D) was given only nasal steroid spray without nasal washing treatment. Before and after treatment in all patients, the Sino-Nasal Outcome Test-22 was performed, and nasal mucociliary clearance times were measured by the saccharin test. Results: The differences in duration of nasal mucociliary clearance and Sino-Nasal Outcome Test-22 values were taken before and after treatment. In Group A, B, C, and D the Sino-Nasal Outcome Test-22 differences were statistically significant ( P ≤.001; P ≤ .001; P ≤ .001, and P = .048, respectively). Only Group A and Group B experienced a significant difference in nasal mucociliary clearance times ( P ≤ .001; P = .010, respectively). When the Sino-nasal Outcome Test-22 score and nasal mucociliary clearance time differences before and after treatment were compared between all groups, the Sino-Nasal Outcome Test-22 score difference was higher in Group A than in Groups B, C, and D, the differences were found as statistically significant ( P = .010; P = .003; P ≤ .001, respectively). The nasal mucociliary clearance time difference was higher in Group A than in Groups C and D, the differences were found as statistically significant ( P = .010; P = .001, respectively). Conclusion: Isotonic seawater spray containing chamomile liquid extract is seen as a good alternative treatment option for allergic rhinitis patients.

Efficacy of Hypertonic Saline Irrigation for Nasal Symptoms in Children with Perennial Allergic Rhinitis: A Randomized Double-Blind Study

2021 ◽  
Vol 104 (10) ◽  
pp. 1570-1577
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Hypertonic Saline ◽  
Symptom Score ◽  
Nasal Congestion ◽  
Nasal Symptom ◽  
Perennial Allergic Rhinitis ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Nasal Cytology

Background: Nasal saline irrigation was an adjunctive therapy of allergic rhinitis (AR). It has been suggested that the use of hypertonic saline (HS) is better than normal saline (NSS) in treatment of AR. Reduction of mucosal edema by hypertonicity induced water transport through nasal mucosa, nasal congestion reduction and mucociliary clearance improvement. Objective: To compare total nasal symptom score (TNSS) between 3% HS and NSS irrigation in perennial allergic rhinitis children. Materials and Methods: The present study was conducted at the Allergy Center of Bhumibol Adulyadej Hospital (BAH), Royal Thai Airforce, Bangkok, Thailand between January and March 2021. Sixty-two perennial AR children were enrolled and categorized in severity level, namely mild, moderate or severe. Subjects were randomized into two groups. Each participant was blind-randomized to nasal irrigation of either 3% HS or NSS twice-daily for 4 weeks by the same investigator. The primary outcome was TNSS improvement between both groups. Secondary outcomes were quality of life, nasal congestion severity improvement, nasal cytology change and side effects. Results: TNSS improvement of 3% HS was more than NSS group (4.03±2.36 versus 2.73±3.06, p=0.034). Nasal congestion was the only symptom that differed significantly between the two groups (1.32±1.01 in 3% HS versus 0.70±1.24 in NSS, p=0.024). Reduction of congestion severity by physical examination, nasal cytology changes and side effects were comparable. Conclusion: Nasal irrigation with 3% HS in children with perennial AR had more improvement than NSS in TNSS., especially nasal congestion. Keyword: Hypertonic saline; Nasal irrigation; Allergic rhinitis; Nasal symptom score

P42 The impact of a change to hospital guidelines on prescribing practices of nebulised 3% w/v ‘hypertonic’ saline

2018 ◽  
Vol 103 (2) ◽  
pp. e1.47-e1 ◽  
Author(s):  
Semple Diarmaid ◽  
McNally Paul ◽  
Fitzpatrick Anne ◽  
Adeyemi Kenny ◽  
McGrory Niamh ◽  
...  
Keyword(s):  
Hypertonic Saline ◽  
Clinical Guideline ◽  
Controlled Trial ◽  
Inappropriate Prescribing ◽  
Prescribing Patterns ◽  
List Type ◽  
Guideline Compliance ◽  
Significant Difference ◽  
Before And After ◽  
The Impact

AimsRecent conclusive evidence has suggested that, contrary to previous limited evidence, there is no benefit to the use of 3% hypertonic saline (3% HS) in the treatment of bronchiolitis in infants.1,2 This led to a change in the clinical guideline during the 2015/2016 bronchiolitis season. We hypothesised that the use of hypertonic saline was preventing the use of other un-necessary treatments and that inappropriate prescribing would increase following the advice not to give hypertonic saline.The primary aim of the study was to determine if the removal of 3% hypertonic saline from the institutional clinical guideline would result in reduced prescribing patterns. A secondary aim was to evaluate the overall prescribing compliance with the guideline including in the prescribing of antibiotics and bronchodilators, and identify if the change in the clinical guideline impacted the prescribing of other agents in children admitted with a diagnosis of bronchiolitis.MethodsData on medical treatments and hospital outcomes were prospectively collected on all infants in the 2015/2016 season both before and after the change in guideline. Details of all medicines prescribed on the patients Medication Record particularly bronchodilators, antimicrobials and inhaled agents were collected. Patient demographics were collected from medical notes. Results were analysed using chi square and Mann Whitney in Excel and Stata.Results128 children (86 before, 42 after the change in guideline) were recruited to the study. Baseline demographics were similar except for a higher proportion of children with RSV in the pre-group. Overall guideline compliance was achieved by 2 infants pre, and 3 infants post guideline change (4%). The use of hypertonic saline decreased significantly after the change in guideline but did not cease (90% pre, 71% post p<0.01). Bronchodilators were used in one in 4 infants and antibiotics in one in 3 infants, and there was no significant difference in these rates before or after the change in guidelines.ConclusionThe change to the guideline reduced the use of 3%HS, however overall guideline compliance in children with bronchiolitis is poor. Hypertonic saline use decreased when the guideline changed but a significant portion of children before and after the guideline change received medications not indicated in the treatment of bronchiolitis, including bronchodilators and antibiotics. It appears that it remains difficult to ‘do nothing’ for bronchiolitis. Poor clinical practice remains and education of clinical staff is necessary in this regard.ReferencesGuidance: Bronchiolitis in children: diagnosis and management, NICE (NG9) Published date: June 2015.Silver AH, Esteban-Cruciani N, Azzarone G, et al. 3% hypertonic saline versus normal saline in inpatient bronchiolitis: A randomised controlled trial. Paediatrics2015;136:1036–1043.

Nasal Mucociliary Clearance in Allergic Rhinitis in Children

2010 ◽  
Vol 3 (2) ◽  
pp. 93-95
Author(s):  
Rupender K Ranga ◽  
Jyoti Yadav ◽  
Jagat Singh
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Pulmonary Diseases ◽  
Healthy Controls ◽  
Clearance Time ◽  
Uncommon Disease ◽  
Significant Impairment ◽  
Nasal Mucociliary Clearance ◽  
Age And Sex

Abstract Allergic rhinitis in children is not an uncommon disease in India. Our objective was to evaluate the effect of allergic rhinitis on nasal mucociliary clearance. The nasal mucociliary clearance time (NMC) was studied using Andersen's saccharin method in fifty controls and fifty age and sex matched patients of allergic rhinitis. The nasal mucociliary clearance time in healthy controls was found to be 5.11 ± 1.51 minutes. A significant impairment (p < 0.01) in nasal mucociliary clearance time of 12.46 ± 3.74 minutes was observed in children suffering with allergic rhinitis, signifying that allergic rhinitis may predispose to sinusitis and pulmonary diseases.

scholarly journals A comparative study to evaluate the effects of intranasal steroid spray, isotonic saline nasal irrigation and combination therapy in patients with allergic rhinitis

2021 ◽  
Vol 7 (6) ◽  
pp. 1004
Author(s):  
Smitha Soubhagya Gangaraju ◽  
Nikitha Pillai ◽  
Vijaylaxmi Manthal
Keyword(s):  
Allergic Rhinitis ◽  
Combination Therapy ◽  
Isotonic Saline ◽  
Treatment Modalities ◽  
Nasal Irrigation ◽  
Intranasal Corticosteroids ◽  
Nasal Symptoms ◽  
Before And After ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Allergic rhinitis (AR) is characterized by inflammatory changes in the nasal mucosa caused by exposure to inhaled allergens. AR clinically having 2 or more symptoms of anterior or posterior rhinorrhea, sneezing, nasal blockage or itching of the nose during two or more consecutive days for more than 1 hour on most days which are caused by allergen exposure leading to an IgE mediated reaction. Nasal steroids and antihistamines are considered as gold standard treatment of choice in moderate to severe AR. This study was taken to evaluate the efficacy of intranasal steroid spray, isotonic saline nasal irrigation, combination therapy and to compare all 3 treatment modalities.</p><p class="abstract"><strong>Methods:</strong> 75 patients of AR who met inclusion criteria were sequentially divided into 3 groups. Group A was intranasal steroid spray, group B was isotonic saline nasal irrigation, group C was combination of both intranasal steroid spray and saline nasal irrigation. Total nasal symptoms score was compared before and after 1 month of treatment.</p><p class="abstract"><strong>Results:</strong> Mean total nasal symptoms score before treatment in groups A, B and C was found to be 13.72, 12.96 and 13.68 respectively and after 1 month of treatment total nasal symptoms score was seen 8.28, 8.76 and 3.72 respectively.</p><p class="abstract"><strong>Conclusions:</strong> The combined use of saline nasal irrigation along with intranasal corticosteroids is found to be more effective in reducing the symptoms of patients with allergic rhinitis when compared to individual therapies.</p>

scholarly journals Mucociliary Function: Its Variations with Disease

2016 ◽  
Vol 9 (2) ◽  
pp. 68-73
Author(s):  
Satish C Kumar ◽  
AP Preetham ◽  
Musarrat Feshan
Keyword(s):  
Chronic Rhinosinusitis ◽  
Clearance Rate ◽  
Mucociliary Clearance ◽  
Chronic Sinusitis ◽  
Clearance Time ◽  
Cigarette Smokers ◽  
Mucociliary Function ◽  
Nose And Paranasal Sinuses ◽  
Nasal Mucociliary Clearance ◽  
Nose And Throat

ABSTRACT Introduction This study compares the nasal mucociliary clearance time of patients with chronic sinusitis (pre- and postoperatively) and smokers, with controls, attending the ear, nose, and throat outpatient department at Southern Railway Headquarters Hospital, Perambur, Chennai. Materials and methods Saccharin granule was used to study mucociliary clearance as it is safe, easy, fast, and reliable. A total of 32 patients in each group were studied. In chronic rhinosinusitis patients, the test was done preoperatively and 4 weeks postoperatively. Results The average mucociliary clearance time pre- and post-operatively in chronic rhinosinusitis patients was 29.54 ± 28.68 and 12.17 ± 5.84 respectively. Cigarette smokers had a longer mucociliary clearance time (27.63 ± 21.11) compared with beedi smokers (24.04 ± 24.93). Controls had the fastest mucociliary clearance rate of 9.67 ± 4.62 among the study subjects. Conclusion Surgery for chronic rhinosinusitis improves both the overall symptoms of chronic rhinosinusitis and the protective functions of the nose and paranasal sinuses. Smokers had an impaired clearance rate compared with normals. As age advances, the mucociliary clearance rate becomes slower. How to cite this article Vamanshankar H, Kumar SC, Preetham AP, Feshan M. Mucociliary Function: Its Variations with Disease. Clin Rhinol An Int J 2016;9(2):68-73.

Budesonide vs Saline Nasal Irrigation in Allergic Rhinitis: A Randomized Placebo-Controlled Trial

2020 ◽  
Vol 162 (6) ◽  
pp. 979-984
Author(s):  
Nikitha Periasamy ◽  
Kailesh Pujary ◽  
Ajay M. Bhandarkar ◽  
Naveen D. Bhandarkar ◽  
Balakrishnan Ramaswamy
Keyword(s):  
Allergic Rhinitis ◽  
Clinical Response ◽  
Hypertonic Saline ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Sinus Surgery ◽  
Care Hospital ◽  
Double Blind ◽  
Nasal Irrigation ◽  
Snot 22

Objectives Budesonide nasal irrigation is currently widely used in the treatment of chronic sinusitis typically following endoscopic sinus surgery to improve inflammatory control. Its application in treatment of allergic rhinitis has not been previously studied. This study assesses the subjective and clinical response to budesonide buffered hypertonic saline nasal irrigation and hypertonic saline nasal irrigation in patients with allergic rhinitis. Study Design This is a prospective, single-center, double-blind, randomized placebo-controlled trial. Setting Tertiary care hospital. Subjects and Methods Fifty-two patients diagnosed with allergic rhinitis were randomized into 2 groups to receive either buffered hypertonic saline nasal irrigation with a placebo respule or buffered hypertonic saline nasal irrigation with a budesonide respule. Patients were assessed at baseline and 4 weeks subjectively using the Sino-Nasal Outcome Test–22 (SNOT-22) questionnaire and visual analog scale (VAS). Clinical assessment was done using the modified Lund-Kennedy score. Results The average SNOT-22, VAS, and modified Lund-Kennedy scores improved in both groups ( P < .001). The budesonide irrigation group was found to have significantly better improvement than the saline nasal irrigation group with the SNOT-22 scores ( P = .012) and VAS scores ( P = .007). However, the difference in the clinical response between the 2 groups was not significant ( P = .268). Conclusion This study adds evidence to the use of saline nasal irrigation in allergic rhinitis but also demonstrates efficacy of the addition of budesonide to irrigations. Budesonide nasal irrigation thus appears to be a viable treatment option for allergic rhinitis.

Impact of Nasal Irrigation With Iodized Table Salt Solution on Mucociliary Clearance: Proof-of-Concept Randomized Control Trial

2019 ◽  
Vol 34 (2) ◽  
pp. 276-279
Author(s):  
Ibrahim Sumaily ◽  
Ibrahim Alarifi ◽  
Raseel Alsuwaidan ◽  
Lojain Alsiwat ◽  
Saad Alsaleh
Keyword(s):  
Salt Solution ◽  
Mucociliary Clearance ◽  
Controlled Trial ◽  
Iodized Salt ◽  
Table Salt ◽  
Nasal Wash ◽  
Nasal Irrigation ◽  
Adults And Children ◽  
The Mean ◽  
Saline Solutions

Introduction Saline nasal irrigation is a common recommendation shared between the majority of clinical guidelines for sinusitis and rhinitis in adults and children. Studies involving homemade saline have typically involved the use of noniodized salt. However, the literature does not contain any descriptions for the use of iodized table salt in homemade saline solutions. Objectives To study the usefulness of iodized salt in homemade saline and its impact on mucociliary clearance (MCC). Methods Only healthy volunteers were enrolled in this randomized controlled trial. The sinonasal outcome test (SNOT)-22 and rhinoscopy were used to rule out any clinical evidence of sinusitis or rhinitis in the enrolled subjects. The saccharine clearance time (SCT) was used to evaluate MCC at baseline. Each candidate received 2 different nasal wash solutions—one containing iodized salt and the other containing noniodized salt—on different days. Visual analog scale pain scores were recorded while using each type of nasal wash. The SCT was assessed after each wash. Results Thirty-eight healthy candidates (18 men and 20 women) were enrolled in the study. All subjects were in their 30s. The mean baseline SCT was 10.92 minutes. The use of the noniodized salt solution led to a nonsignificant change ( P = .139) in mean SCT (9.68 min). In contrast, a significant change ( P = .035) was observed in mean SCT after the use of the iodized salt solution (9.06 min). However, the mean postirrigation SCT was not significantly different between solutions ( P = .31). No significant differences were observed in pain/discomfort experience between solutions. Conclusion MCC improved with both solutions. Interestingly, the improvement was significant, when the iodized salt nasal irrigation solution was used. This finding contradicts the conventional recommendation against the use of iodized salt in nasal rinse solution. Moreover, this solution was well tolerated. Further studies regarding the long-term safety are recommended.

TO ASSESS AND COMPARE THE EFFICACY OF TREATMENT OF ALLERGIC RHINITIS USING THREE DIFFERENT SALINE PREPARATIONS.

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Amit Kumar ◽  
Satyendra Sharma
Keyword(s):  
Allergic Rhinitis ◽  
Hypertonic Saline ◽  
Normal Saline ◽  
Post Treatment ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Medical College ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Efficacy Of Treatment

Aim: to assess and compare the efficacy of 3% hypertonic saline irrigation with 0.9% normal saline and 0.5% diluted betadine saline irrigation. Materials and Methods: present prospective comparative study was conducted on 60 randomly selected patients confirmed of allergic rhinitis visited the department of ENT, Nalanda Medical College and Hospital, Patna, Bihar, India. Patients were divided into three groups. The outcome between pre and post treatment was compared. Results: Females outnumber males. Within each group pre and post treatment showed statistical significant difference but between three groups no statistically significant difference is seen in outcome. Conclusion: reports outcome following nasal irrigation in all the three treatments was found statistically significant but between the treatments no statistically significant difference observed. Keywords: nasal irrigation, rhinitis, 3% hypertonic saline, 0.9% normal saline, 0.5% diluted betadine saline

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