PENGARUH IRIGASI SALINE NASAL TERHADAP BERSIHAN JALAN NAPAS ATAS PADA PASIEN RHINOSINUSITIS DI RUMAH SAKIT AMINAH TANGERANG

Rhinosinusitis is an inflammation of one or more mucosal mucosa of the paranasal sinuses, usually accompanied by or triggered by rhinitis. Patients generally experience airway obstruction which can result in changes in breathing pattern and frequency. The administration of nasal saline irrigation aims to reduce the inflammatory response in the nasal mucosa, eliminate excessive mucus secretion, overcome nasal congestion by moisturizing the nasal cavity. This study aims to determine the effect of nasal saline irrigation on upper airway clearance in rhinosinusitis patients at Aminah Hospital, Tangerang. This type of research used a quasi-experimental design with two groups of pre-test-post-test. The sample used in the study was 33 in the intervention group and 33 in the control group and consecutive sampling was used as a sampling technique for the rhinosinusitis population. The research data collection used the observation sheet instrument, and the data analysis used the Mann Whitney test. From the Mann Whitney statistical test on upper airway clearance between the post-intervention and post-control groups, it was found that a significant difference (p = 0.000), it can be concluded that nasal saline irrigation has an effect on upper airway clearance in rhinosinusitis patients. The use of nasal saline irrigation can help in maximizing the treatment program towards a much better healing process in rhinosinusitis patients and recommends its use in the treatment program for rhinosinusitis. Abstrak Rhinosinusitis merupakan peradangan pada salah satu atau lebih mukosa sinus paranasal, umumnya disertai atau dipicu oleh rhinitis. Pasien umunya akan mengalami sumbatan jalan napas yang dapat mengakibatkan perubahan pada pola dan frekuensi pernapasan. Pemberian irigasi saline nasal bertujuan untuk mengurangi respon inflamasi pada mukosa hidung, menghilangkan sekresi lendir yang berlebihan, mengatasi hidung tersumbat dengan melembabkan rongga nasi. Penelitian ini bertujuan mengetahui pengaruh irigasi saline nasal terhadap bersihan jalan napas atas pada pasien rhinosinusitis di Rumah Sakit Aminah Tangerang. Jenis penelitian ini menggunakan quasi-experimental design dengan two group pre test-post test. Sampel yang dipakai dalam penelitian berjumlah 33 pada kelompok intervensi dan 33 pada kelompok kontrol dan consecutive sampling dipakai sebagai teknik pengambilan sampel pada populasi rhinosinusitis.Pengumpulan data penelitian menggunakan instrument lembar observasi, serta analisa data yang digunakan memakai uji Mann Whitney. Dari uji statistik Mann Whitney pada bersihan jalan napas atas antara kelompok post-intervensi dan post-kontrol didapatkan perbedaan yang signifikan (p=0.000), maka dapat disimpulkan bahwa irigasi saline nasal memiliki pengaruh terhadap bersihan jalan napas atas pada pasien rhinosinusitis. Penggunaan irigasi saline nasal dapat membantu dalam memaksimalkan program pengobatan terhadap proses penyembuhan yang jauh lebih baik pada pasien rhinosinusitis dan menyarankan penggunaannya terhadap program pengobatan untuk rhinosinusitis.

Preventive and therapeutic role of nasal irrigation in management of acute respiratory disease during COVID-19 pandemic and beyond

It has long been known, that nasal saline irrigation is a safe and effective method, which is routinely prescribed by otorhinolaryngologists to prevent and to treat a wide range of pathologies. There are a lot of publications on different irrigation techniques and methods. This literature review discusses the key parameters of nasal irrigation, including tonicity, pH, and the additional components, and explains how they affect the effectiveness of the procedure. The vast majority of available publications did not found any possible changes in the effectiveness of solutions with different pH close to neutral meaning. Whereas, the volume of the irrigated solution, increases the efficiency of the irrigation in direct proportion. Thus, the largest distribution area of the solute is noted when washing with a large volume of liquid. Nasal saline irrigation is an effective treatment option for patients with several acute and chronic diseases and for postoperative care after rhinosurgery. Moreover, nasal irrigation might be used as an effective non-specific method for prevention of acute upper respiratory tract infections. Irrigation of the nasal cavity reduces the mucus viscosity and promotes its faster elimination, along with pathogens fixed in it. Additionally, irrigation with isotonic saline solutions increases the hydration of the underlying water base, which enhances the frequency of ciliary beat and reduces the concentration of local inflammatory mediators. COVID-19 pandemic situation due to lack of any specific antiviral drugs dictates the necessity of an effective non-specific preventive option, which could be introduced worldwide. The so-called full volume lavage of the nasal cavity allows for better cleaning of the nasal cavity and effective moisturizing of the mucous membrane. It is the timely cleansing and moisturizing that are most important for maintaining the normal activity of the local protective mechanisms of the upper respiratory tract.

Development of a New Device for Postoperative Self-Irrigation of the Maxillary and Frontal Sinus

Objectives: Nasal saline irrigation is the corner stone of postoperative care after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS). However, intrasinus penetration of the saline solution can be challenging and may require difficult head position, particularly for the frontal sinus. Our aim was to evaluate a novel device for direct intrasinus self-irrigation, usable at home for both maxillary and frontal sinus. Methods: Thirty devices were implemented in 23 patients: in the maxillary sinus for 18 patients and in the frontal sinus for 5 patients. The device was removed after 7 days on average (5-10 days), and nasal saline irrigation was carried on with a squeeze bottle for 6 weeks. Retrospective evaluation of the device included: device-related complication, patient satisfaction, and ostial or middle turbinate synechiae at 3 months. Results: No device-related complication (obstruction, displacement, infection, bleeding) occurred. Twenty-one (91.3%) patients were satisfied with the device. Two patients required the help of a nurse for irrigation. No ostial of middle turbinate synechiae was visualized at 3 months. This new endonasal device enables direct intrasinus self-irrigation after FESS for CRS. Conclusion: This preliminary study showed that this device is safe and easy to use. However, further investigations are required to assess its potential role to reduce the risk of synechiae and revision surgery.