From the Guidelines
Nasal saline irrigation is a recommended adjunctive treatment for sinusitis, particularly for acute bacterial rhinosinusitis (ABRS) and chronic rhinosinusitis (CRS).
Benefits of Nasal Saline Irrigation
- Thins and removes mucus, reducing congestion and facilitating drainage [ 1 ]
- Clears proteins that cause inflammation and flushes out irritants and bacteria from the nose and sinus cavities [ 1 ]
- Improves nasal mucosa function and reduces patient-reported disease severity [ 1 ]
Recommended Usage
- Isotonic saline or Ringer’s lactate is recommended for irrigation [ 1 ]
- Large-volume irrigation may be more effective than nasal spray, but there is insufficient data to confirm this [ 1 ]
- Temperature of the solution does not appear to influence the outcome [ 1 ]
Key Points
- Nasal saline irrigation is considered an important aspect of treatment for CRS and should be recommended [ 1 ]
- The evidence base supporting the use of nasal saline irrigation is generally considered weak to moderate, but it is still recommended as an adjunctive treatment [ 1 ]
- Further studies are needed to confirm the efficacy of nasal saline irrigation for sinusitis, particularly for acute post-viral rhinosinusitis [ 1 ]
From the Research
Nasal Saline Irrigation for Sinusitis
- Nasal saline irrigation is a commonly used adjunctive therapy for the treatment of chronic rhinosinusitis, with evidence suggesting its effectiveness in improving symptoms and quality of life 2, 3, 4, 5.
- Studies have shown that nasal saline irrigation can help to thin mucous, improve mucociliary clearance, decrease edema, and reduce antigen load in the nasal and sinus cavities, leading to improved symptoms and reduced disease severity 3, 4.
- The use of hypertonic saline nasal irrigation (HSNI) has been shown to be particularly effective in improving symptoms of chronic rhinosinusitis, with one study finding that 12 out of 21 subjects with allergic rhinitis reported improved symptoms with HSNI use 2.
- Nasal saline irrigation has also been shown to be effective in the treatment of acute sinusitis in children, with one study finding that normal saline nasal irrigation improved symptoms and quality of life in children with acute sinusitis 6.
- The evidence suggests that nasal saline irrigation is a safe and effective adjunctive treatment for chronic rhinosinusitis, with few side effects and a low risk of adverse events 3, 4, 5.
Benefits of Nasal Saline Irrigation
- Improves symptoms of chronic rhinosinusitis, including nasal congestion, rhinorrhea, and facial pressure/pain 2, 3, 4, 5.
- Improves quality of life in patients with chronic rhinosinusitis 2, 3, 4, 5.
- Effective in the treatment of acute sinusitis in children 6.
- Can be used as an adjunctive therapy to other treatments, such as intranasal corticosteroids 5.
- Has a low risk of adverse events and is generally well-tolerated 3, 4, 5.
Methods of Nasal Saline Irrigation
- Can be delivered using a variety of methods, including douche, irrigation, drops, spray, or nebuliser 3, 4, 5.
- Hypertonic saline nasal irrigation (HSNI) has been shown to be particularly effective in improving symptoms of chronic rhinosinusitis 2.
- Large-volume (150 ml) hypertonic saline irrigation has been shown to be effective in improving disease-specific health-related quality of life (HRQL) and patient-reported disease severity 5.