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Abstract Introduction: High-volume corticosteroid nasal irrigation is a treatment option in patients with chronic rhinosinusitis. In Brazil, alternatives are used to optimize its cost and popularize its use, such as 1% compounded budesonide drops or betamethasone cream, and it is necessary to study these treatment modalities. Objective: To evaluate the clinical response of nasal irrigation with 1% compounded budesonide drops or betamethasone cream compared to nasal sprays utilized in patients with chronic rhinosinusitis. Methods: This was a retrospective observational study with 257 patients. One hundred and eight patients using corticosteroid nasal irrigation (292 treatment cycles) and 149 using corticosteroid nasal spray (300 treatment cycles) were included. Evaluation of subjective improvement, adverse events, exacerbations, and objective assessments with SNOT-22 and Lund-Kennedy endoscopic score were performed, in addition to sub-analyses related to nasal polyps and previous surgery. Results: Corticosteroid nasal irrigation and corticosteroid nasal spray improved the Lund-Kennedy endoscopic score, with more adverse events in the corticosteroid nasal irrigation group. Previous surgery increased corticosteroid nasal irrigation improvement, with greater subjective improvement and fewer exacerbations. 1% compounded budesonide drops were better than betamethasone cream in the Lund-Kennedy endoscopic score, with fewer adverse events. A 1,000 μg dose of 1% compounded budesonide drops was more effective than 500 μg. Conclusion: Corticosteroid nasal irrigation was effective in improving the Lund-Kennedy endoscopic score in chronic rhinosinusitis, especially in patients with nasal polyps and previous surgery, in addition to promoting a higher rate of subjective improvement and fewer exacerbations than corticosteroid nasal spray, but with more adverse events. 1% compounded budesonide drops improved the Lund-Kennedy endoscopic score with fewer adverse events than betamethasone cream, particularly at higher doses (1000 μg).
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Abstract Introduction: Currently, several different concentrations of saline are recommended for use in nasal irrigation. Increasing studies show that nasal irrigation with hypertonic saline is more effective than traditional saline in the treatment of rhinosinusitis, but there have been few systematic analyses of the effect of nasal irrigation with hypertonic saline on chronic rhinosinusitis. Objective: We sought to compare the effects of hypertonic saline and isotonic saline in the treatment of rhinosinusitis in order to provide a reference for clinical nasal irrigation for chronic rhinosinusitis treatment. Methods: Medline, cochrane library, EMBASE, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database, and other databases were searched, and the searching was supplemented by manual searches for relevant references to treatment of rhinosinusitis by saline nasal irrigation. The last retrieval date was March 2018. The included studies were evaluated for quality, and data were extracted for meta-analysis using RevMan 5.3. Results: Seven studies were included. Effects favoring hypertonic saline on nasal symptoms were greater in 4 subgroups. These were (1) patients with nasal secretion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (2) patients with congestion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (3) patients with headache (SMD = 0.82; 95% CI: 0.38, 1.26; p < 0.01), (4) patients with overall symptomatic relief (SMD = 1.63; 95% CI: 0.83, 2.44; p < 0.01). However, no difference was shown in smell improvement (SMD = 0.47; 95% CI: −0.65, 1.59; p = 0.41) and radiologic scores improvement (SMD = 2.44; 95% CI: -3.14, 8.02; p < 0.01). Besides, hypertonic saline showed greater improvement in mucociliary clearance time scores than did the isotonic saline group (SMD = 1.19; 95% CI: 0.78, 1.60; p < 0.01). Hypertonic saline brought greater minor adverse effects. Conclusion: Compared with isotonic saline, hypertonic saline nasal irrigation for the treatment of chronic rhinosinusitis is significantly more effective and has mild side effects in improving nasal symptoms and ciliary movement, but there is no significant difference in imaging findings and smell improvement. Although hypertonic saline is worthy of widespread use in clinical practice, it is still necessary to further study the exact manner and concentration of nasal irrigation.
Resumo Introdução: Atualmente, o uso de várias concentrações diferentes de solução salina é recomendado na irrigação nasal. Um número crescente de estudos mostra que a irrigação nasal com solução salina hipertônica é mais eficaz do que a solução salina tradicional no tratamento de rinossinusite, mas existem poucas análises sistemáticas do efeito da irrigação nasal com solução salina hipertônica em rinossinusite crônica. Objetivo: Comparar os efeitos da solução salina hipertônica com a solução salina isotônica no tratamento da rinossinusite, para fornecer uma referência clínica de irrigação nasal no tratamento da rinossinusite crônica. Método: Foram pesquisados os bancos de dados Medline, Cochrane Library, Embase, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database e outros, e a pesquisa foi complementada por pesquisas manuais de referências relevantes ao tratamento da rinossinusite por irrigação nasal com solução salina. A data da última recuperação de dados foi março de 2018. Os estudos incluídos foram avaliados quanto à qualidade e os dados foram extraídos para a metanálise com o software RevMan 5.3. Resultados: Sete estudos foram incluídos. Os efeitos favoráveis à solução salina hipertônica nos sintomas nasais foram maiores em quatro subgrupos. Esses foram (1) pacientes com secreção nasal (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (2) pacientes com congestão (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (3) Pacientes com dor de cabeça (DMP = 0,82; IC95%: 0,38, 1,26; p ˂ 0,01); (4) Pacientes com alívio sintomático geral (DMP = 1,63; IC95%: 0,83, 2,44; p ˂ 0,01). Entretanto, não houve diferença na melhoria do olfato (DMP = 0,47; IC95%: -0,65, 1,59; p = 0,41) e na melhoria dos escores radiológicos (DMP = 2,44; IC95%: -3,14, 8,02; p < 0,01). Além disso, o grupo solução salina hipertônica mostrou maior melhoria nos escores do tempo de clearence mucociliar do que o grupo solução salina isotônica (DMP = 1,19; IC95%: 0,78, 1,60; p ˂ 0,01). A solução salina hipertônica causou efeitos adversos menores. Conclusão: Em comparação com a solução salina isotônica, a irrigação nasal com solução salina hipertônica para o tratamento da rinossinusite crônica é significantemente mais eficaz e apresenta efeitos colaterais mais leves, melhoria mais acentuada dos sintomas nasais e no movimento ciliar, mas não há diferença significante nos achados de imagem e na melhoria do olfato. Embora a solução salina hipertônica seja digna de uso generalizado na prática clínica, ainda são necessários mais estudos sobre a forma de uso e a concentração ideal da solução nasal.
Subject(s)
Humans , Sinusitis , Rhinitis , Saline Solution, Hypertonic , Sodium Chloride , Chronic Disease , Nasal LavageABSTRACT
Abstract Introduction Nasal irrigation solutions are widely used following endonasal surgery. These irrigation solutions remove infective debris and crusts, reducing the probability of synechia formation, and accelerate mucosal healing. Objective The aim of the present study was to compare the effects of nasal irrigation solutions with different contents following septoplasty and concha radiofrequency. Methods The present study was a prospective, randomized, controlled simple blind study of 120 patients who underwent septoplasty and bilateral concha radiofrequency. Patients were divided into four groups according to the nasal irrigation solution used: tap water, buffered isotonic saline, saline with xylitol, and hypertonic sea water. Patients were examined on the 7th and 15th postoperative days. A saccharine test was applied to determine mucociliary activity preoperatively and on the 7th and 15th postoperative days. Patients were asked about drying and obstruction using a 10 cm visual analog scale. In addition, patients were examined to determine the crusting score. Results There was no significant difference found in the preoperative and 7th and 15th postoperative days' mucociliary clearance times among the four groups. The crusting score was found to be significantly lower in the hypertonic sea water group (p < 0.001). Drying and obstruction on the 7th and 15th postoperative days were found to be significantly more comfortable in the hypertonic sea water group (p < 0.001). Conclusion Hypertonic sea water is the recommended irrigation solution, as it is associated with less crusting, drying, and obstruction in the nose for the postoperative period following septoplasty and concha radiofrequency.
Resumo Introdução Soluções para irrigação nasal são amplamente usadas após cirurgias endonasais. Essas soluções removem os resíduos e crostas, reduzem a probabilidade de formação de sinéquias e aceleram a cicatrização da mucosa. Objetivo O objetivo do presente estudo foi comparar os efeitos das soluçoes para irrigaçao nasal com diferentes conteudos apos septoplastia e turbinoplastia com radiofrequencia. Método O presente estudo foi um estudo cego simples, randomizado, controlado e prospectivo de 120 pacientes submetidos a septoplastia e turbinoplastia bilateral com radiofrequencia. Os pacientes foram divididos em quatro grupos de acordo com a soluçao nasal utilizada: agua da torneira, soluçao salina isotonica tamponada, soluçao salina com xilitol e agua do mar hipertonica. Os pacientes foram examinados no 7° e 15° dias do pos-operatorio. O teste de sacarina foi utilizado para determinar a atividade mucociliar pre-operatoria e no 7° e 15° dias do pos-operatorio. Os pacientes foram questionados sobre a sensaçao de secura e obstruçao nasais utilizando uma escala visual analógica de 10 cm. Alem disso, os pacientes foram examinados para determinar o escore em relaçao a crostas. Resultados Não houve diferença significativa entre o pré-operatório e o sétimo e 15° dias do pós-operatório dos tempos de clearance mucociliar entre os quatro grupos. Verificou-se que o escore em relação a crostas foi significativamente menor no grupo que usou água do mar hipertônica (p < 0,001). As sensações de secura e obstrução nasais no sétimo e 15° dias do pós-operatório mostraram-se significativamente mais confortáveis no grupo água do mar hipertônica (p < 0,001). Conclusão A água de mar hipertônica é a solução de irrigação recomendada, pois está associada a menor incidência de crostas, secura e obstrução nasais no pós-operatório de cirurgia de septoplastia e das conchas nasais com radiofrequência.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Rhinoplasty/adverse effects , Mucociliary Clearance/drug effects , Nasal Lavage , Fresh Water , Nasal Mucosa/drug effects , Nasal Septum/surgery , Postoperative Complications/prevention & control , Saline Solution, Hypertonic/administration & dosage , Seawater , Administration, Intranasal , Double-Blind Method , Prospective Studies , Catheter Ablation/adverse effects , Catheter Ablation/methods , Therapeutic IrrigationABSTRACT
Objective@#To observe the therapeutic effect of simple 3.0% saline nasal irrigation and combined treatment of 3.0% saline nasal irrigation and budesonide nasal spray for vasomotor rhinitis (VMR), and explore the long-term effect for VMR. Through examination of levels of substance P (SP) and mucin (MUC)5B in nasal lavage fluid, the mechanisms of nasal irrigation treatment for VMR was discussed.@*Methods@#One hundred and one patients from Department of Otorhinolaryngology Head and Neck Surgery, Huashan Hospital of Fudan University with VMR were randomly divided into 4 groups. The number of patients was 24 in control group, 25 in budesonide nasal spray treatment group (budesonide group), 25 in nasal irrigation treatment group (nasal irrigation group) and 27 in budesonide nasal spray + nasal irrigation group (combined treatment group). Control patients were left untreated. Budesonide group was under budesonide nasal spray treatment, nasal irrigation group was treated using 3.0% saline with a temperature of 40℃ and combined treatment group was given both treatments. The duration of the intervention period was 3 months (90 days). Visual Analog Scale (VAS) was used to evaluate nasal symptoms, and the health-related quality of life was assessed using the 12-item Short Form Health Survey version 2.0 (SF-12v2). Enzyme-linked immunosorbent assay (ELISA) was used to assess the contents of SP and MUC5B in nasal lavage fluid before and after 3-month treatments in budesonide and nasal irrigation group in the study. MUC5B in nasal lavage fluid after the SP challenge and anticholinergic drug intervention in control group were also evaluated with ELISA.@*Results@#Nighty out of 101 patients completed the study. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 vs 3.82±0.15, 6.18±0.17 vs 3.92±0.15, t value was 8.193, 10.060, respectively, all P<0.05) and SF-12v2 score increased (146.00±1.23 vs 152.30±0.97, 146.00±1.08 vs 155.40±0.90, t value was 3.982, 6.697, respectively, all P<0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 vs 5.72±0.15, 146.10±1.17 vs 147.00±0.94, t value was 1.038, 0.607, respectively, all P>0.05) after the first month. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 vs 5.05±0.15, 6.18±0.17 vs 5.10±0.12, t value was 3.374, 5.351, respectively, all P<0.05) and SF-12v2 score increased (146.00±1.23 vs 150.90±0.76, 146.00±1.08 vs 153.60±0.94, t value was 3.373, 5.343, respectively, all P<0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 vs 5.78±0.17, 146.10±1.17 vs 148.10±0.80, t value was 0.716, 1.438, respectively, all P>0.05) after the second month. By the end of the third month, in nasal irrigation and combined treatment group, the VAS score was diminished (5.96±0.17 vs 4.80±0.12, 6.18±0.17 vs 4.44±0.13, t value was 5.485, 8.264, respectively, all P<0.05) and SF-12v2 score was elevated (146.10±1.17 vs 150.80±0.96, 146.00±1.08 vs 152.90±0.85, t value was 3.163, 5.008, respectively, all P<0.05), but there were no significant differences in budesonide group (5.91±0.21 vs 5.68±0.18, 146.00±1.23 vs 148.40±0.85, t value was 0.819, 1.587, respectively, all P>0.05). Additionally, SP in nasal lavage fluid decreased and MUC5B showed no statistical changes in budesonide group after three months, however, SP showed no any changes and MUC5B reduced significantly in nasal lavage fluid in nasal irrigation group. Furthermore, the anticholinergic drug could not decrease the concentration of MUC5B after the SP challenge in nasal cavity in control group.@*Conclusions@#The therapeutic effect of simple nasal irrigation with 3.0% saline or combined treatment of 3.0% saline nasal irrigation and nasal corticosteroids is superior to simple nasal corticosteroids. Nasal corticosteroids plays a role in the inhibition of sensory nerve endings in nasal mucosa, but neurotransmitter plays a limited role in the pathogenesis of VMR.
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OBJECTIVE Gestational rhinitis(GR) is a relatively common condition in women during pregnancy.Patients with GR often complain of nasal obstruction and rhinorrhea.The exact mechanism of GR are not clear.Safe and effective treatments for this disease have not been found to date.The aim of this study is to find an appropriate treatment method for GR.METHODS Thirty patients with GR were randomly divided into two groups.There were 15 patients in hypertonic saline group with a mean age of 28.73 years (range 24-31 years),and 15 patients in normal saline group with a mean age of 25.93 years (range 24-31 years).Hypertonic saline group was treated using 3.0％ saline with a temperature of 40℃ nasal irrigation,and normal saline group was treated with 0.9％ saline with a temperature of 40℃ nasal irrigation.The duration of the intervention period was 4 weeks.Visual Analog Scale(VAS) was used to evaluate the nasal symptoms including nasal obstruction and rhinorrhea,and the health-related quality of life was assessed with the 12-item Short Form Health Survey version 2.0(SF-12v2).Contents of histamine(HIS) and acetylcholinesterase(ACHE) in nasal lavage fluid(NLF) was assessed before and after 4-week treatment in the two groups in the study.RESULTS There were 28 patients completed the study.The total VAS scores of nasal symptoms including nasal obstruction and rhinorrhea decreased,and SF-12v2 score increased in the hypertonic saline group after 2-week,3-week and 4-week interventions.Furthermore,ACHE in NLF was also increased after 4-week treatment,but HIS showed no statistical changes.The VAS scores of nasal obstruction and rhinorrhea and SF-12v2 score after 2-week,3-week and 4-week interventions,and the contents of HIS and ACHE in NLF after 4-week treatment showed no statistical differences in the normal saline nasal irrigation group.There were statistical differences in the VAS scores of nasal obstruction and rhinorrhea,SF-12v2 score and ACHE in NLF after 4-week treatment,and no significant differences in the content of HIS in NLF between the 2 groups.CONCLUSION Hypertonic saline nasal irrigation is a safe and effective treatment for GR.
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Objective To explore the effect of endoscopic sinus surgery combined with postoperative nasal irrigation on the symptoms improvement and prognosis for patients with allergic fungal sinusitis.Methods The clinical data of 145 patients with allergic fungal sinusitis who had received treatment in our hospital from January 2010 and January 2014 were reviewed.According to different treatment methods,they were divided into two groups,65 cases in the control group was treated with conventional surgical treatment,80 cases in the obeservation group was treated with endoscopic sinus surgery combined with postoperative treatment.The therapeutic conditions of two groups were compared. Results The symptom scores of patients with polyps,edema,rhinorrhea in two groups were decreased compared with those before treatment, and the obeservation group decreased more significantly (P <0.05,P <0.01).After the operation,patients with nasal mucociliary transport rate of two groups were higher compared with postoperative 6 months and 9 months,and the obeservation group improved more significantly (P <0.05).In addition,two groups of postoperative SNOT-20 scores (physiological problems,limitations and affective outcomes)treatment were lower than those before,and the obeservation group decreased significantly than that of the control group (P <0.05,P <0.01).Con-clusion Endoscopic sinus surgery combined with postoperative nasal irrigation can effectively alleviate the symptoms and improve the prog-nosis in the treatment of allergic fungal sinusitis.
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Objective To explore the clinical efficacy of nasal irrigation for pediatric chronic sinusitis. Methods 92 children with chronic sinusitis were selected and randomly divided into treatment group(48 cases) and control group(44 cases) .The two groups were treated with routine clinical basic drugs,and the treatment group took nasal irrigation in addition.The efficacy after 1 month was compared, and then the patients were followed up for 3 months.Results The total effective rate of the treatment group was 91.7% after 1 month,which of the control group was 72.7%.After 3 months,the total effective rate in treatment group was 95.9%,which of the control group was 86.4%.There were statistically significant differences between the two groups in treatment outcomes( P=0.024, 0.011) .Conclusion The therapeutic effect of nasal irrigation for pediatric chronic sinusitis is obvious, safe and reliable.
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Objective To study the curative effect of nasal irrigation combined with backslapping for sputum suctioning on respiratory tract infections in infants . Methods Two hundred and forty-seven infants with respiratory tract infections were enrolled in the study and divided into the control group and the experiment group by the medical record number . On the basis of routine care , the experiment group was treated with nasal irrigation to clear secretions . Result The time for rales and cough disappearing in the experiment group was shorter than that in the control group , and the difference was statistically significant ( P<0 . 05 ) . Conclusions Nasal irrigation combined with backslapping for sputum suctioning can effectively ease the main symptoms and signs , enhance the ventilation function , enhance sleep quality and promote the rehabilitation of the disease .
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PURPOSE: The management of sinusitis in children is controversial. Antibiotic is known as the most essential management. Despite nasal irrigation and nasal decongestant have been used as adjunctive treatments of sinusitis, it is still unclear whether these are effective on sinusitis. Therefore, we used antibiotics with either nasal irrigation and an oral nasal decongestant and tried to estimate the outcome of each case. METHODS: This study was conducted with sinusitis patients who visited our pediatric respiratory disease clinic. They were randomized into 4 groups: Group 1 were treated with a high dose of amoxicillin only; Group 2 were treated with nasal irrigation and a high dose of amoxicillin; Group 3 were treated with a nasal decongestant and a high dose of amoxicillin; and Group 4 were treated with nasal irrigation, a oral nasal decongestant, and a high dose of amoxicillin. Responses to treatment were estimated more than 4 days after the beginning of the therapy in acute or subacute sinusitis, and more than 7 days chronic sinusitis. RESULTS: The responses to the treatments the 4 groups were not comparable. A favorable therapy was not found, regardless of whether a patient had suppurative rhinorrhea, nasal stuffness, typical findings of PNS plain radiograph, or adenoid hypertrophy. CONCLUSION: The use of nasal irrigation or a oral nasal decongestant as an additional therapy to antibiotics for the symptoms of pediatric sinusitis showed no additional effects on sinusitis.
Subject(s)
Child , Humans , Adenoids , Amoxicillin , Anti-Bacterial Agents , Nasal Lavage , Prospective Studies , SinusitisABSTRACT
The Traditional primary purification and detoxification treatment is known as Les Nga. It means the "five therapies". The five therapeutic means of eliminating toxins from the body are Emesis, Purgation, Nasal irrigation, Enema and Bloodletting. These series of five therapies help remove deep rooted stress and illness causing toxins from the body while balancing the three somatic humors. The Les Nga procedures along with its pre-treatments as specified in gSo-ba rig-pa, when provided in the right time and season can help an individual to lead a better life even at an old age. It is suggested that when one undergoes Les Nga therapy for three times annually, in the right seasons, it expels the toxins, revitalizes the body tissues and prevents the body from falling prey to various diseases and keeps an individual healthy during old age. There is a tendency for the rLung to get aggravated in old age and all therapies that are administered should be to prevent the rLung. Les Nga offers one of the most comprehensive methods of removing toxins from the body. They seek to reverse the direction of the diseases. This cleansing process is achieved through several protocols such as special diets, oilation therapy, steam therapy and cleansing therapies. Towards the therapy’s end, special attention is given to purgation, blood donating, or enema therapy. These therapies can help alleviate pain and diseases in human beings and hence may be established in NTMH for the benefit of all citizens.
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BACKGROUND AND OBJECTIVES: Nasal irrigation, a conventional therapy for both surgical and nonsurgical patients with a history of chronic rhinosinusitis, aids in the clearance of secretions, debris, and intranasal crusts. This is important in the postoperative period to reduce the risk of adhesions and to promote ostiomeatal patency. The objective of this study was to compare the effects of a long-term nasal irrigation with hypertonic saline (3.0%) versus isotonic saline (0.9%) in the normal and postoperative group. MATERIALS AND METHODS: We studied the transit time of nasal mucociliary clearance with a saccharine test. In the normal control group I (n = 20), the mean transit times (MTTs) were measured before and after the irrigation with atomized saline of 0.9%, 2%, 3%, 4% and 5% concentrations. In the normal control group Il (n=19), MTTs were measured before and after the atomized 0.9%, 3% saline irrigation for two months. In the postoperative group (n=10), MTTs were measured after the irrigation with saline of 0.9% (right nasal cavity) & 3% (left nasal cavity) for one month. The symptom scores about nasal stuffiness, rhinorrhea and the amount of nasal lavage contents were recorded daily. RESULTS: In the normal control group I, MTT of 3% saline irrigation was significantly shortened than those of isotonic and other hypertonic saline irrigation. In the normal control group II, MTT of 3% saline irrigation was gradually and significantly shortened compared with those of isotonic saline for two months. In the postoperative group, 3% saline irrigation had a significantly shorter MTT for one month and had a significantly more nasal lavage contents during 1st week than isotonic saline irrigation. CONCLUSION: A 3% hypertonic saline would be useful as a long-term nasal washing solution in both surgical and non-surgical patients with a history of chronic rhinosinusitis.
Subject(s)
Humans , Mucociliary Clearance , Nasal Lavage , Nasal Lavage Fluid , Postoperative Period , SaccharinABSTRACT
BACKGROUND AND OBJECTIVES: Nasal or sinus irrigation is the traditional treatment for chronic paranasal sinusitis and is the one of the most important postoperative care for those who have undergone functional endoscopic sinus surgery (FESS). However the bases of any scientific evidence to determine efficacy of different concentrations of saline are lacking. The objective of this clinical study was to determine if nasal mucociliary clearance (NMC) in vivo was improved significantly by the use of differently concentrated buffered saline nasal irrigations. MATERIALS AND METHODS: The acute effect of NMC was measured using saccharin test in 20 volunteers without any significant sinonasal disease on four separate days, involving single administration of each of the followings: 1) atomized 0.65% saline; 2) atomized 0.9% saline; 3) atomized 3% saline; 4) atomized 7% saline. Normal subjects served as their own control using a saccharin test before any nasal irrigation was used, and then used one of four different concentrated saline solutions to irrigate their nose. Comparison of the change of NMC at different concentations was performed by using Wilcoxon signed rank test. RESULTS: When compared to each control, the buffered 3% hypertonic saline improved mucociliary transit time of saccharin (p<0.05), whereas other concentrations of buffered saline had no such effect. CONCLUSION: We concluded that this hypertonic saline should be useful as nasal irrigation solution on medical and postoperative care of chronic paranasal sinusitis.