The Korean Society of
Otorhinolaryngology-
Head and
Neck Surgery and Korean Rhinologic Society appointed a
guideline development group (GDG) to establish a
clinical practice guideline, and the GDG developed a
guideline for
nasal irrigation for
adult patients with chronic
rhinosinusitis (CRS). The
guideline focuses on
knowledge gaps, practice variations, and clinical concerns associated with
nasal irrigation.
Nasal irrigation has been recommended as the first-line
treatment for CRS in various guidelines, and its
clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent
nasal irrigation method. Several databases, including OVID
Medline, Embase, the Cochrane
Library, and KoreaMed, were searched to identify all relevant
papers using a predefined search strategy. When
insufficient evidence was found, the GDG sought
expert opinions and attempted to fill the
evidence gap. Evidence-based recommendations for practice were ranked according to the American College of
Physicians grading system. The committee developed 11 evidence-based recommendations. This
guideline focuses on the evidence-based
quality improvement opportunities deemed the most important by the GDG. Moreover, the
guideline addresses whether
nasal lavage helps treat CRS, what type of rinsing
solution should be used, and the
effectiveness of using additional medications to increase the
therapeutic effect.