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

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

Hypertonic Saline Versus Isotonic Saline Nasal Irrigation: Systematic Review and Meta-analysis

2018 ◽  
Vol 32 (4) ◽  
pp. 269-279 ◽  
Author(s):  
Dichapong Kanjanawasee ◽  
Kachorn Seresirikachorn ◽  
Wirach Chitsuthipakorn ◽  
Kornkiat Snidvongs
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Hypertonic Saline ◽  
Meta Analysis ◽  
Isotonic Saline ◽  
High Volume ◽  
Mean Difference ◽  
Saline Irrigation ◽  
Nasal Irrigation ◽  
Subgroup Analyses

Background Saline nasal lavage is one of the treatments of sinonasal diseases. Evidence from basic research favors hypertonic saline (HS) over isotonic saline (IS) for mucociliary clearance, but evidence from clinical studies is controversial. Conversely, HS may carry greater side effects. Objective To compare the effects of HS and IS nasal irrigation in treating sinonasal diseases. Methods Systematic search with Ovid MEDLINE, Scopus, PubMed, Google Scholar, and Manual additional sources was conducted. Randomized controlled trials comparing HS with IS nasal irrigation in treating any sinonasal diseases, including rhinitis and rhinosinusitis, were included. Data were pooled for meta-analyses. Outcomes were symptom scores, sinonasal outcome test (SNOT), and adverse events. Heterogeneity was explored by subgroup analyses. Results Nine studies (740 patients) were included. HS nasal irrigation brought greater benefits over IS in symptom reduction (standardized mean difference (SMD) −0.58; 95% confidence interval [CI]: −0.76, −0.40); however, no difference was shown in SNOT-20 improvement (mean difference 1.81; 95% CI: −0.68, 4.30). In subgroup analyses, effects favoring HS on symptoms were larger in 4 subgroups. These were (1) patients with rhinitis (SMD −1.09; 95% CI: −1.42, −0.76) compared with rhinosinusitis (SMD −0.37; 95% CI: −0.58, −0.15), P < .01; (2) patients under the age of 18 years (SMD −1.22; 95% CI: −1.53, −0.91) compared with patients over the age of 18 years (SMD −0.26; 95% CI: −0.49, −0.04), P < .01; (3) saline irrigation using high volume (SMD −0.89; 95% CI: −1.18, −0.60) compared with low volume (SMD −0.39; 95% CI: −0.62, −0.16), P < .01; and (4) saline irrigation with hypertonicity of <3% (SMD −1.09; 95% CI: −1.42, −0.76) and hypertonicity of 3%–5% (SMD −1.20; 95% CI: −1.61, −0.78) compared with hypertonicity of >5% (SMD 0.20; 95% CI: −0.15, 0.55), P < .01. Buffered saline and operative status did not have impact. HS brought greater minor adverse effects. No major adverse effects were reported. Conclusion HS improves symptoms over IS nasal irrigation in treating sinonasal diseases. There is no difference in disease-specific quality of life. However, HS brings greater minor side effects than IS.

scholarly journals Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (1) ◽  
pp. 64 ◽  
Author(s):  
Chia-Ling Li ◽  
Hsiao-Chuan Lin ◽  
Chien-Yu Lin ◽  
Teh-Fu Hsu
Keyword(s):  
Allergic Rhinitis ◽  
Hypertonic Saline ◽  
Meta Analysis ◽  
Isotonic Saline ◽  
Nasal Symptom ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Nasal Irrigation ◽  
Symptom Scores

We aimed to explore the efficacy of hypertonic saline nasal irritation (HSNI) for improving nasal symptoms and quality of life, and for decreasing oral antihistamine consumption in children with allergic rhinitis (AR). We conducted a systematic search of PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Chinese Electronic Periodicals Service, and Cochrane Library of Controlled Trials databases for prospective randomized, controlled trials assessing HSNI effects in children with AR and published before December 2017. Two authors independently assessed each trial’s quality and extracted data for a meta-analysis. We included four trails comprising 351 patients. HSNI improved patients’ nasal symptom scores (mean difference 1.82 points after treatment; 95% confidence interval (CI), 0.35–3.30; I2 = 64%; p = 0.02) and a significantly lower rescue antihistamine use rate (risk ratio (RR), 0.68; 95% CI, 0.48–0.95; I2 = 28%; p = 0.02). Analyses comparing HSNI with isotonic saline nasal irrigation (ISNI) showed better nasal symptom scores (mean difference, 1.22 points; 95% CI, 1.01–1.44; I2 = 0%; p < 0.001) in patients in the HSNI group, although the antihistamine use (RR, 0.84; 95% CI, 0.64–1.10; I2 = 0%; p = 0.2) and adverse effect rates were similar between groups. Compared with ISNI, HSNI may be a reasonable adjunctive treatment for children with AR.

scholarly journals Clinical Study on Acupuncture Treatment of Perennial Allergic Rhinitis (PAR) Based on Zelen’s Design

2020 ◽  
pp. 1-10
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Acupuncture Treatment ◽  
Nasal Symptom ◽  
Syndrome Differentiation ◽  
Perennial Allergic Rhinitis ◽  
Total Nasal Symptom Score ◽  
Before And After ◽  
Systemic Symptoms

Abstract Objective: Perennial allergic rhinitis (PAR) is clinically defined as an inflammatory condition of the nose characterised by nasal obstruction, sneezing, itching, or rhinorrhea, occurring for an hour or more on most days throughout the year. The study aimed to evaluate the effectiveness of acupuncture treatment for PAR. Methods: 76 subjects were enrolled with inclusion criteria and randomly divided into the acupuncture group (AG) and drug group (DG) based on Zelen’s design. In AG, Yintang (EX-HN3), LI20 (bilateral), LI11 (left), LI4 (left), ST36 (bilateral) were selected as primary acupoints, and adjunct acupoints were added based on syndrome differentiation. Acupuncture treatment for four weeks was performed once every two days. In DG, Desloratadine Citrate Disodium tablet was administrated orally once every day for four weeks. The variations of total nasal symptom score (TNSS) and overall non-nasal symptom score (TNNSS) were tested within three days before, at Week-4 during, and at Week-4 (follow-up) after the treatment. Results: Thirty-two subjects in the AG and 38 subjects in the DG completed the trial. The differences between TNSS and TNNSS scales in the same groups showed a statistical difference (P<0.05) before, during, and after the treatment. The statistic differences between TNSS and TNNSS in those two groups were not obtained (P＞0.05) before and after the treatment. The differences in those two groups during the follow-up visit were statistically different (P<0.05). Conclusion: Acupuncture could effectively control the nasal and systemic symptoms of PAR, and its effect was more persistent than the administration of Desloratadine Citrate Disodium.

Effects of Virgin Coconut Oil as Adjunct Therapy in the Treatment of Allergic Rhinitis

2016 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Nazli Zainuddin ◽  
Nurul Azira Mohd Shah ◽  
Rosdan Salim
Keyword(s):  
Allergic Rhinitis ◽  
Side Effects ◽  
Coconut Oil ◽  
Test Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Virgin Coconut Oil ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Introduction: The role of virgin coconut oil in the treatment of allergic rhinitis is controversial. Thus, the aim of the present study is to determine the effects of virgin coconut oil ingestion, in addition to standard medications, on allergic rhinitis. We also studied the side effects of consumption of virgin coconut oil. Methods: Fifty two subjects were equally divided into test and control groups. All subjects received a daily dose of 10mg of loratadine for 28 days. The test group was given 10ml of virgin coconut oil three times a day in addition to loratadine. The symptoms of allergic rhinitis were scored at the beginning and end of the study. Results:, the symptom score were divided into nasal and non-nasal symptom scores. Sneezing score showed a significant difference, however the score was more in control group than test group, indicating that improvement in symptom was more in control group. The rest of the nasal symptom and non-nasal symptom score showed no significant difference between test and control groups. Approximately 58% of the test subjects developed side effects from consumption of virgin coconut oil, mainly gastrointestinal side effects. Conclusion: In the present study, ingestion of virgin coconut oil does not improve the overall and individual symptoms of allergic rhinitis, furthermore it has side effects.

Comparison of efficacy and tolerability of oral desloratadine, rupatadine and ketotifen in seasonal allergic rhinitis

2021 ◽  
Vol 4 (3) ◽  
pp. 106-114
Author(s):  
Syed Khadeer ◽  
B Jagannath
Keyword(s):  
Allergic Rhinitis ◽  
Adverse Events ◽  
Nasal Congestion ◽  
Primary Outcome Measure ◽  
Nasal Symptom ◽  
Secondary Outcome ◽  
Open Label ◽  
Non Allergic Rhinitis ◽  
The Individual ◽  
Change In Mean

Rhinitis is inflammation of nasal mucosa which characteristically presents as running nose, blocked nose, itching on nose or sneezing. Allergic rhinitis is more common than non-allergic rhinitis. Anti-histamines are the mainstay of SAR treatment. Desloratadine, rupatadine and ketotifen are the commonly prescribed anti histamines in our region. In this study, we have compared efficacy and tolerability of desloratadine, rupatadine and ketotifen in SAR. This was a prospective, randomized, three arm, open label comparative study of desloratadine, rupatadine and ketotifen in SAR, conducted at Department of ENT, Kempegowda Institute of Medical Sciences, Bangalore; between January 2014 and December 2014. Patients’ severity of SAR symptoms were assessed by TNSS, QoL was measured using Medical Outcomes Study questionnaire (SF-12). SF-12 was administered at the start of study and then at the end of study. Adverse effects were monitored during clinical examination at each visit. Study subjects were systemically randomized into three groups – desloratadine (DES), rupatadine (RUP) and ketotifen (KET). Based on the assigned group; desloratadine was given orally in dose of 10mg OD, rupatadine orally 10 mg OD and ketotifen orally 1mg BD. All medications were given for 4 weeks. Follow up was done for all patients every week during treatment period of 4 weeks. The primary outcome measure was change in mean TNSS from baseline; secondary outcome measures were changes in the individual nasal symptom scores, change in the quality of life and tolerability to the study medications. Total 150 patients were recruited for this study, divided into 3 groups. DES and RUP were equally effective but significantly better than KET in improving rhinorrhea, nasal congestion, TNSS and AEC. (p=0.05). All the drugs were equally effective with no statistically significant intergroup difference in improving sneezing, nasal itching and QoL. RUP appeared to have better tolerability as the total number of adverse events were marginally less. DES and RUP are comparatively more effective and faster acting than KET. All the study medications were well tolerated with few mild, self-limiting, transient adverse events requiring no intervention.

An Instant, Safe, Antihistamine, Anti-Inflammatory and Decongestant Polymeric Nasal Barrier to Prevent and To Treat Allergic Rhinitis in Children

2021 ◽  
Vol 7 (5) ◽  
pp. 01-09
Author(s):  
Ravi Shrivastava
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Side Effects ◽  
Symptom Score ◽  
Inflammatory Cytokines ◽  
Nasal Mucosa ◽  
Eosinophil Count ◽  
Allergen Exposure ◽  
Glycerol Solution

Introduction: Allergic rhinitis (AR) in children is a common chronic pathology with a strong impact on patient quality of life. The main physiopathology affects the nasal cavity as a multi-factorial disease involving nasal mucosa damage, nasal inflammation with high concentrations of histamine, pro-inflammatory cytokines such as histamine, TNF-α, IL-4, IL-5, IL-6, IL-10, IL-13, and IgE antibodies on the nasal mucosa. Systemic entry of these proteins through damaged nasal mucosa maintains continued inflammatory and allergen cascades. Therefore, an ideal treatment should be multitarget in order to stop allergen exposure, inflammation, and nasal mucosa barrier degradation, but such treatments are nearly impossible to conceive. We envisaged an osmotic and protective nasal barrier film, not only capable of protecting the nasal mucosa from allergen exposure but also of trapping and neutralizing selected cytokines and cleaning the nasal surface continuously without using any harmful substance for children. Materials and Methods: We associated highly osmotic glycerol solution with specific plant polymers to conceive an osmotic but stable film. As plant polymers (tannins) can bind with selective proteins, a range of glycerol binding non-cytotoxic polymers were screened using the sandwich ELISA method to select those having binding affinity for allergen induced nasal proinflammatory cytokines. After verifying cytotoxicity and irritant potential, a 15-day observational clinical study was performed with approval from the ethics committee on 30 children aged between 4-13, suffering from allergic rhinitis. The test product (TP) was supplied in 15-ml nasal sprays and applied 2-3 times per day for a period of 15 days. Saline solution served as control (CP). The scores of nasal and ocular symptoms, effect on quality of life, eosinophil count in nasal smears, and need for antihistamine treatment was evaluated at the start, at 30 minutes and on days 2, 3 and 15 of treatment. Results: A few specific polymers were able to bind with selected cytokines and histamine at adequate filmogen concentrations. The osmotic film was stable, non-irritant and was able to clean the nasal mucosa continuously for 4-6h after each application. Clinical observations of Total Nasal Symptom Score (TNSS) grouping the scores of nasal congestion, runny nose, sneezing, and itching, revealed a strong decrease right after the 1st treatment in both groups but the reduction was much stronger and faster with the TP. The mean TNSS score reduction was 44.74% in CP vs 83.53% in the TP group after 7 days of treatment (p<0.001). Total Ocular Symptom Score (TOSS) was decreased by 21.13% and 51.41% in CP v/s 35.12 and 99.59% in TP group on days 2 and 7, respectively. Nasal smear eosinophil count was equally strongly reduced in the TP v/s CP group. No treatment-related side effects were recorded in any of the groups. Conclusion: Protecting the nasal mucosa against allergens, neutralizing inflammatory cytokines, and keeping the nasal surface clean with an osmotic polymeric film, constitute a major breakthrough for the treatment of allergic rhinitis in children. This simple but scientific and logical approach should avoid exposing children to chemicals and to their long-term side effects.

scholarly journals Efficacy and Safety of Bilastine in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis

2022 ◽  
Vol 12 ◽  
Author(s):  
Aranjit Singh Randhawa ◽  
Norhayati Mohd Noor ◽  
Mohd Khairi Md Daud ◽  
Baharudin Abdullah
Keyword(s):  
Allergic Rhinitis ◽  
Symptom Score ◽  
Meta Analysis ◽  
Nasal Symptom ◽  
Comparable Efficacy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Quality Of Evidence

Bilastine is a non-sedating second generation H1 oral antihistamine (OAH) for treating allergic rhinitis (AR) patients. The effect of bilastine has not previously been evaluated in a meta-analysis. The aim of this review was to determine the efficacy and safety of bilastine in treating AR. An electronic literature search was performed using Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Science Direct and Google Scholar up to March 2021. Randomized controlled trials comparing bilastine with placebo and standard pharmacotherapy were included. The included studies must have diagnosis of AR established by clinicians and the outcomes must have a minimum of 2 weeks of follow-up period. The primary outcomes assessed were total symptom score (TSS), nasal symptom score (NSS) and non-nasal symptom score (NNSS). The secondary outcomes were discomfort due to rhinitis, quality of life (QOL) and adverse events. The risk of bias and quality of evidence for all studies were appraised. The meta-analysis was done using Review Manager 5.3 software based on the random-effects model. The search identified 135 records after removal of duplicates. Following screening and review of the records, fifteen full-text articles were assessed for eligibility. Five trials involving 3,329 patients met the inclusion criteria. Bilastine was superior to placebo in improving TSS, NSS, NNSS, rhinitis discomfort score and QOL but has comparable efficacy with other OAHs in TSS, NSS, NNS, rhinitis discomfort score and QOL. There was no difference in adverse effects when bilastine was compared against placebo and other OAHs except for somnolence. Bilastine has fewer incidence of somnolence compared to cetirizine. The overall quality of evidence ranged from moderate to high quality. Bilastine is effective and safe in treating the overall symptoms of AR with comparable efficacy and safety with other OAHs except somnolence. Whilst bilastine has similar efficacy to cetirizine, somnolence is notably less in bilastine.

scholarly journals Study of causal aeroallergens in allergic rhinitis

2019 ◽  
Vol 5 (4) ◽  
pp. 916
Author(s):  
Divya Aggarwal ◽  
Abhilash S. ◽  
Sunil Kapur ◽  
Divya Gupta
Keyword(s):  
Allergic Rhinitis ◽  
Skin Prick Test ◽  
Symptom Score ◽  
Eosinophil Count ◽  
Severe Disease ◽  
Nasal Symptom ◽  
Total Serum ◽  
Serum Ige ◽  
Prick Test ◽  
Absolute Eosinophil Count

<p class="abstract"><strong>Background:</strong> The diagnosis of allergic rhinitis requires a detailed history, thorough clinical examination and identification of aeroallergens by skin prick test. The diagnosis cannot be confirmed on the basis of symptoms alone because both allergic and non-allergic rhinitis can present with similar symptoms. The present study was undertaken to identify the common aeroallergens causing allergic rhinitis and to find any relationship of the severity of patient’s symptoms with raised levels of absolute eosinophil count, percentage of eosinophils in the peripheral blood and total serum IgE.</p><p class="abstract"><strong>Methods:</strong> It is cross sectional study was conducted among 100 patients including both the genders attending out-patient department of ENT. The patients were divided into mild, moderate and severe disease categories based on nasal symptom score (NSS) which was calculated taking into account the severity of four symptoms namely sneezing, watery rhinorrhoea, itching sensation in nose and nasal obstruction.  </p><p class="abstract"><strong>Results:</strong> 76% of patients had moderate nasal symptom score and 42% had symptoms of allergic rhinitis for less than 3 years. The prevalence of skin prick test was strongly positive for pollens (46.19%), followed by dust (16.4%), dust mites (15.7%), fungus (9.7%), insects (9.24%) and epithelia (2.77%). But, among 68 aeroallergens, most common offending allergen was D-farinae (30%). There was no significant relationship found to exist between Eosinophilia, Absolute eosinophil count and serum IgE level with that of nasal symptom score.</p><p class="abstract"><strong>Conclusions:</strong> Skin prick test is the gold standard investigation of choice for definitive diagnosis of allergic rhinitis.</p><p class="abstract"> </p>

scholarly journals Efektivitas salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung penderita rinitis alergi

2018 ◽  
Vol 47 (2) ◽  
pp. 123
Author(s):  
Woro Safitri ◽  
Dwi Reno Pawarti ◽  
Titiek Hidayati Ahadiah
Keyword(s):  
Clinical Trial ◽  
Allergic Rhinitis ◽  
Symptom Score ◽  
Saline Group ◽  
Nasal Symptom ◽  
Control Group ◽  
Mucociliary Transport ◽  
Transport Time ◽  
Total Nasal Symptom Score ◽  
The Mean

Latar belakang: Rinitis alergi (RA) adalah suatu penyakit inflamasi mukosa hidung yang diperantara oleh imunoglobulin E (IgE), setelah mukosa hidung terpapar alergen. Tujuan: Mengidentifikasi efektivitas cuci hidung salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung total (SGHT) pada penderita RA. Metode: Penelitian dilaksanakan pada bulan Juli hingga Desember 2016 di Poli Telinga Hidung Tenggorok – Bedah Kepala Leher Rumah Sakit Dr. Soetomo Surabaya. Uji klinis acak terkontrol pada 2 kelompok dengan desain control group in clinical trial. Pengambilan sampel dilakukan secara consecutive sampling. Uji korelasi yang digunakan adalah uji t berpasangan dan uji Wilcoxon. Hasil: Didapatkan sampel 42 penderita, yaitu 21 penderita pada kelompok loratadin, serta 21 penderita pada kelompok loratadin dan cuci hidung salin hipertonik. Didapatkan rerata penurunan transpor mukosiliar kelompok loratadin dan cuci hidung salin hipertonik lebih bermakna daripada kelompok loratadin (p=0,001). Penurunan transpor mukosiliar kelompok loratadin didapatkan rerata -2,30 (SD=2,77), kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -6,27 (SD=3,91). Penurunan SGHT kelompok loratadin didapatkan rerata -2,48 (SD=1,72), sedangkan kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -4,3 (SD=1,20). Kesimpulan: Penambahan cuci hidung salin hipertonik pada terapi loratadin lebih efektif dibandingkan terapi tunggal loratadin dalam menurunkan transpor mukosiliar dan SGHT pada penderita RA. Kata kunci: Loratadin, cuci hidung salin hipertonik, transpor mukosiliar, skor gejala hidung total, rinitis alergi ABSTRACT Background: Allergic rhinitis (AR) is a nasal mucous membrane inflamatory which mediated by Imunoglobulin E (IgE) after allergen exposure in nasal mucosa. Purpose: To identify the effectiveness of nasal hypertonic saline irrigation on reduction of mucociliary transport time (MCTT) and total nasal symptom score (TNSS) in AR patients. Methods: The was conducted from July until December 2016 in Oto Rhino Laryngology - Head and Neck Surgery of Dr. Soetomo Hospital Surabaya. The study was randomized controlled clinical trials on two groups, with the control group in clinical trial design. Paired t and Wilcoxon test was used as the correlation test. Results: There was 42 patients, 21 patients in loratadine group, and 21 patients in loratadine with hypertonic nasal saline group. The average of mucociliary transport time decrease of loratadine with hypertonic nasal saline group was more significant than loratadine group (p=0.001). The mean of decreasing mucociliary transport time in loratadine group was -2.30 (SD=2.77) and loratadine with hypertonic nasal saline group was -6.27 (SD=3.91). The mean of decreasing TNSS in loratadin group was -2.48 (SD=1.72), and loratadin with hypertonic nasal saline group was -4.3 (SD=1.20). Conclusions: The addition of hypertonic nasal saline in loratadine was more effective, compared to monotherapy of loratadine in decreasing mucociliary transport time and TNSS in patient with AR. Keywords: Loratadine, hypertonic nasal saline, mucociliary transport, total nasal symptom score, allergic rhinitis

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