Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery

Abstract

Background: Aspirin-induced chronic rhinosinusitis (CRS) is a severe progressive persistent disease, usually associated with nasal polyps (NPs).

Aim/objective: To compare effect of hypertonic (2.3% NaCl) sea water and isotonic 0.9% NaCl on symptoms and endoscopic findings in those patients in the period of 1 month after endoscopic sinus surgery (ESS).

Material and methods: This prospective, randomized study included 30 patients with aspirin-induced CRS undergoing ESS. Patients were divided into two groups of 15 subjects and one of the two nasal irrigation solutions was administered in each group. Intensity of 5 symptoms (nasal obstruction, nasal discharge/postnasal drip, facial pain/pressure, headache and trouble sleeping) and endoscopic findings were assessed during the 1st, 7th, 14th, 21st and 28th days after the nasal packs removal.

Results: We found significantly lower total symptom score (TSS) during the 7th (p = .009), 14th (p = .003), 21st (p < .001) and the 28th day (p = .001), lower total endoscopic score (TES) on the 21st (p = .002) and 28th day (p = .001), lower nasal obstruction, facial pain/pressure, headache and trouble sleeping, and lower nasal mucosal edema, nasal secretion and nasal crusting in patients treated by hypertonic sea water.

Conclusion and significance: Hypertonic sea water should be recommended douching solution in the early postoperative care of patients with aspirin-induced CRS.

Chinese abstract

背景：阿司匹林致慢性鼻窦炎（CRS）是一种严重的进行性持续性疾病, 通常与鼻息肉（NPs）有关。

目的：比较高渗（2.3%氯化钠）海水和等渗0.9%氯化钠对鼻内镜手术后1个月内患者症状和内镜表现的影响。

材料和方法：这项前瞻性随机研究包括30例正在接受ESS的阿司匹林诱导的CRS患者。将患者分为两组, 每组15名受试者, 每组使用两种鼻腔冲洗液中的一种。在移除鼻包后的第1、7、14、21和28天, 评估5种症状（鼻塞、鼻腔分泌物/鼻后滴液、面部疼痛/压力、头痛和睡眠障碍）的程度和内镜检查结果。

结果：我们发现, 经高渗海水治疗的患者在第7天（p = 0.009）、第14天（p = 0.003）、第21天（p < 0.001）和第28天（p = 0.001）的总症状评分（TSS）明显较低；在第21天（p = 0.002）和第28天（p = 0.001）的总内窥镜评分（TES）较低；鼻阻塞、面部疼痛/压力、头痛和睡眠困难较低；鼻粘膜水肿、鼻分泌物和鼻部结痂较低。

结论及意义：在阿司匹林致CRS患者术后早期护理中, 建议采用高渗海水冲洗液。

Keywords:

• Aspirin
• nasal polyps
• nasal surgical procedures
• postoperative care
• sinusitis

Acknowledgments

This investigation was conducted as a part of scientific project of the Military Medical Academy Faculty of Medicine (MFVMA 02/19-21/).

Disclosure statement

The authors declare that they have no conflict of interest.

Additional information

Funding

Dr. Aleksandra Barać received support for research from the Project of Ministry of Education, Science and Technology of the Republic of Serbia [No. III45005].