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HYPERTONIC NASAL SPRAY
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Discover the benefits of hypertonic saline, how to help prevent nasal infections, how to use Breathe the Sea™ as a prewash and much more!
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Click on the title of any of the research to read complete details.

1.  “Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study.” - Friedman M, Hamilton C, Samuelson CG, Maley A, Wilson MN, Venkatesan TK, Joseph NJ. Int Forum Allergy Rhinol. 2012 Feb 15. doi: 10.1002/alr.21003. [Epub ahead of print]


2. “Usefulness of hypertonic seawater in rhinology”
- Frèche C, Castillo S, de Corbière S et al. - Revue Officielle de la Societe Francaise de ORL, 50(4), 1998.

3. “Efficiency Of Hypertonic And Isotonic Seawater Solutions In Chronic Rhinosinusitis” -
Josip Culig; Marcel Leppée; Andrijana Vceva; Davorin Djanic - Medicinski Glasnik, Volume 7, Number 2, August 2010.

4. “Efficacy Of Hypertonic Seawater Saline In The Treatment Of Persistent Rhinitis/Rhinosinusitis”
- Strnad P. Skoupá J. Cimrová H. Horník P. - Pediatric Clinic, Teaching Hospital, Prague. Pharma Projects s.r.o. Brno. Allergology Office AKI, Brno. 

5. “Hypertonic (3%) vs. Isotonic Brine Nosespray - A Controlled Study”
- Michel O, Dreßler AK - Laryngorhinootologie 2011 Apr;90(4):206-210. Epub 2011 Feb 9.

6. “Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty”
- SüslüN, BajinMD, Süslü AE, OgretmenogluO. - Eur Arch Otorhinolaryngol. 2009 May;266(5):685-9. Epub 2008 Sep 18.

7. “Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis”
- David Shoseyov MD, Haim Bibi MD, Pintov Shai MD, Nurit Shoseyov MD, Gila Shazberg MD, Haggit Hurvitz MD.  - The Journal of Allergy and Clinical Immunology, Volume 101, Issue 5, Pages 602 - 605, May 1998. 

8. “Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis”
- Garavello W, Di Berardino F, Romagnoli M, Sambataro G, Gaini RM, Department of Otorhinolaryngology, University Milano-Bicocca, Monza, Italy. - Int. Arch Allergy Immunol 2005 Aug; 137(4):310-4. Epub 2005 June 20.

9. “A randomized, prospective, double-blind study on the efficacy of Dead Sea salt nasal irrigations”
- Friedman M, Vidyasagar R, Joseph N. -  Laryngoscope 116, 878-882 (2006).

10. “Comparison of intranasal hypertonic dead sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis”
- Cordray S, Hario JB, Miner L. - Ear Nose Throat J. 2005 Jul:84(7): 426-30.

11. “Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial”
- Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R. - J Fam Pract. 2002 Dec;51(12):1049-55.

12.  Nasal saline irrigations for the symptoms of chronic rhinosinusitis
- Harvey R, Hannan SA, Badia L, Scadding G. - Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD006394. DOI: 10.1002/14651858.CD006394.pub2

13. “The use of hypertonic sea-water solution in patients after surgery of the nose and paranasal sinuses”
[English Abstract, Journal Article] - Rapiejko P, Jurkiewicz D - Otolaryngol Pol 2010 Jan-Feb; 64(1):20-30.

________________________________________________________________

1.  “Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis: a randomized, prospective double-blind study.” - Friedman M, Hamilton C, Samuelson CG, Maley A, Wilson MN, Venkatesan TK, Joseph NJ.
Int Forum Allergy Rhinol. 2012 Feb 15. doi: 10.1002/alr.21003. [Epub ahead of print]


Source:
Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, IL; Department of Otolaryngology, Advanced Center for Specialty Care, Advocate Illinois Masonic Medical Center, Chicago, IL.

BACKGROUND: 
Intranasal steroids are 1 of the most frequently prescribed medications for the treatment of chronic rhinosinusitis (CRS), and saline irrigations are commonly used as an adjunct to medical therapy. We aimed to compare the efficacy of Dead Sea salt (DSS) irrigations and DSS nasal spray vs saline irrigations and topical nasal steroid spray in the treatment of symptoms of CRS.

METHODS:
A total of 145 symptomatic adult patients without acute infection were initially enrolled and 114 completed the study. Patients completed a Sino-Nasal Outcomes Test 20 (SNOT-20) survey (primary outcome metric) and underwent endonasal examination, acoustic rhinometry, and smell testing (secondary outcome metrics). Patients were randomized to 2 groups. The experimental group (n = 59) self-administered hypertonic DSS spray and DSS irrigation; the control group (n = 55) self-administered fluticasone spray and hypertonic saline irrigation and spray. Patients and staff were blinded to group assignment. Outcomes were reassessed at 4 weeks.

RESULTS: 
The 2 groups were homogeneous with respect to pretreatment primary and secondary outcome metrics. Dropout rates were 30% in the DSS group and 36.6% in the control group. Both groups showed significant improvement in mean SNOT-20 scores following treatment; however, the degree of improvement was not significantly different between groups (p = 0.082). There were no significant changes in secondary outcome metrics between the 2 groups.

CONCLUSIONS: 
For patients with CRS, treatment with DSS irrigations and sprays appears as effective for symptom reduction as a combination of hypertonic saline irrigations and sprays and a topical steroid spray.

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1. “Usefulness of hypertonic seawater in rhinology”
- Frèche C, Castillo S, de Corbière S et al. - Revue Officielle de la Societe Francaise de ORL, 50(4), 1998.

Note:  This study was conducted with Sinomarin®, which is the European hypertonic seawater nasal saline product; Breathe the Sea™ is made by the same company from the same seawater location.

Open clinical multicentre study conducted in France on 80 adults with nasal disorders that caused permanent or intermittent nasal obstruction.


Evaluation of Nasal Obstruction
• Complete disappearance 19.8%
• Improvement 57.7%
• Stabilization 21.1%
• Aggravation 1.4%

After 2 weeks of treatment, 2 applications per day, a significant improvement or disappearance of symptoms was observed in more than 75% of the cases!


Clinical Efficacy
• Significant improvement was observed in most etiology of rhinitis cases
• 81% of all cases were rated as satisfactory or above

After two weeks of treatment, a significant improvement or total disappearance of nasal obstruction was seen in 81% of cases for most etiologies of rhinitis cases.


Safety and Tolerance
95% of the people who used Sinomarin® report good or excellent tolerance!

“Use of hypertonic seawater (2.3%) is effective on nasal obstruction (hypertrophic rhinitis, allergic rhinitis, polyposis, vasomotor rhinitis, purulent rhinitis, unspecified rhinitis”

The most interesting point of this study was the disappearance of symptoms in a high percentage of cases at the end of two weeks, even in chronic conditions.  In catarrhal rhinitis, whose duration is shorter, hypertonic seawater nasal spray also prevented the progression of rhinitis.  Results showed that nasal obstruction significantly decreased or disappeared in 78% of patients; tolerance was excellent or good in 95% of patients.

CONCLUSIONS:  Hypertonic seawater nasal spray retains 70% of the components of seawater that include benefits not found in salt.  (Components of Sinomarin® and Breathe the Sea™ are Sodium Chloride  NaCI)) 23.00 g/L, Sulfate 2.30 g/L, Magnesium 1.04 g/L, Calcium 0.31 g/L, Potassium 0.42 g/L, Zinc Traces and Copper Traces.   It allows faster action in edema, an almost constant characteristic of nasal disorders and appears to reduce factors of irritation and related secretions.

See Google English translation from French of the complete study    

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2. “Efficiency Of Hypertonic And Isotonic Seawater Solutions In Chronic Rhinosinusitis” - Josip Culig; Marcel Leppée; Andrijana Vceva; Davorin Djanic - Medicinski Glasnik, Volume 7, Number 2, August 2010.

AIM:  To compare the efficiency of isotonic and hypertonic seawater solutions used for nasal lavage and quality of life of the patients with chronic rhinosinusitis.

METHODS: A random and controlled clinical study was performed. The study included 60 patients with history of chronic rhinosinusitis.  At the beginning of the study, each subject was given a Patient Logbook, which needed to be filled out daily during the 15-day study period. There were three visits per each patient during the study.

RESULTS: Patient Logbook notes showed significant statistical differences in all symptoms in the group of patients using hypertonic seawater solution. However, while the notes showed significant statistical differences in congestion and rhinorrhea, in the group of patients using isotonic seawater solution, other symptoms showed no major changes during the study period.

CONCLUSION:   Hypertonic seawater solution has been proven to be better than isotonic seawater solution in eliminating the symptoms of nasal congestion, rhinorrhea, cough, headache and waking up during the night.

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3. “Efficacy Of Hypertonic Seawater Saline In The Treatment Of Persistent Rhinitis/Rhinosinusitis” - Strnad P. Skoupá J. Cimrová H. Horník P. - Pediatric Clinic, Teaching Hospital, Prague. Pharma Projects s.r.o. Brno. Allergology Office AKI, Brno.  

BACKGROUND: The literature includes reports that the adjunctive use of hypertonic saline solutions in intermittent or chronic rhinosinusitis improves symptoms and reduces the need for medication( 1 , 2 ) , but there has been insufficient investigation of its ability to reduce intranasal steroid (ICS) consumption.

OBJECTIVES:

Primary objective

To demonstrate the efficacy of a hypertonic seawater nasal spray (2.2 %) in chronic or intermittent  rhinosinusitis of allergic or non-allergic origin.

Secondary objectives
To compare the efficacy of a 2.2% hypertonic seawater saline nasal spray versus control group of standard treatments (inhalated corticosteroids, antihistaminics and/or leucotrien antagonists).   To evaluate the impact in reducing ICS use among long-term users.

METHODS: A total of 256 patients were randomized to one of the three treatment groups listed below and followed up for 6 weeks:
- Group 1: standard treatment including I C S . No hypertonic nasal spray.
- Group 2: hypertonic nasal spray added to standard treatment from study entry; ICS discontinued from week 2.
- Group 3: hypertonic nasal spray and standard medication; ICS discontinued from study entry.


CONCLUSIONS:  Hypertonic seawater saline nasal spray significantly improved nasal symptoms and decreased frequency of ICS (intranasal steroid) consumption.  Results showed that concomitant nasal spray application of hypertonic seawater saline provided effective and safe adjunctive treatment to standard medication. It is an interesting finding that hypertonic seawater saline can contribute to ICS dose reduction or even permit intermittent dosing among long-term ICS users.

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4. “Hypertonic (3%) vs. Isotonic Brine Nosespray - A Controlled Study” - Michel O, Dreßler AK - Laryngorhinootologie 2011 Apr;90(4):206-210. Epub 2011 Feb 9.

PURPOSE:  In several in-vitro research studies was shown that hypertonic salt water solution has an enhancing effect on mucociliary beat frequency. Nevertheless nose sprays with isotonic salt water solution are more popular on the market. They are sold as wellness products but also for care and cure of various nose diseases.

METHODS In a randomized double-blind trial with n=20 healthy volunteers the effect of a 7-day application of hypertonic sodium chloride solution (3% NaCl) measured by saccharine-clearance-test (SCT), rhinomanometry and questionnaires was evaluated in comparison to an isotonic salt solution (0,9% NaCl).

RESULTS: The SCT showed in both groups no significant change. In rhinomanometry a significant higher rate of airflow could be measured after a 7 day period of applying hypertonic spray. The volunteers evaluated the hypertonic solution as "more effective" in regard to their nasal airflow.

CONCLUSIONS: Although in this RCT an effect on mucociliary clearance could not be detected after a 7 day application of salt water nose spray, a hypertonic spray showed objectively and subjectively a significant influence on nasal airflow. This effect could be of interest eg. in reducing the use of decongestive nose sprays.

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5 . “Effects of buffered 2.3%, buffered 0.9%, and non-buffered 0.9% irrigation solutions on nasal mucosa after septoplasty” - SüslüN, BajinMD, Süslü AE, OgretmenogluO. - Eur Arch Otorhinolaryngol. 2009 May;266(5):685-9. Epub 2008 Sep 18.

Source
Department of Otorhinolaryngology, Faculty of Medicine, Hacettepe University, 06100, Sihhiye, Ankara, Turkey.

ABSTRACT:
A prospective randomized study was designed to compare the effect of different irrigation solutions on mucociliary clearance and nasal patency and to compare the limitations of the used solutions, such as nasal burning by a visual analog scale. Forty-five patients who underwent septoplasty were divided into three groups postoperatively. Each group was administered with 2.3% buffered hypertonic seawater, buffered isotonic saline solution and non-buffered isotonic saline, respectively, as irrigation fluid. Saccharine test and acoustic rhinometer were used to determine mucociliary activity and nasal patency. Patients were asked about the burning sensation using a 10-cm visual analog scale. There was no significant difference in saccharine clearance time (SCT) on the 5th postoperative day between the three groups (P = 0.07).

On the 20th day, there was a significant difference in SCT between the hypertonic buffered seawater group and non-buffered isotonic saline (P = 0.003).

Saccharine Clearance Times (SCT) indicative of mucociliary clearance.

Buffered hypertonic seawater improved nasal airway patency more than the buffered isotonic saline (P = 0.004). Buffered hypertonic solutions used after endonasal surgery have been advantageous for both mucociliary clearance and postoperative decongestion.

Nasal patency increase on the 20th operative day with respect to 5th postoperative day, showed significant difference between the buffered 2.3% hypertonic saline compared to non-buffered isotonic saline (P = 0.042).

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6. “Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis” - David Shoseyov MD, Haim Bibi MD, Pintov Shai MD, Nurit Shoseyov MD, Gila Shazberg MD, Haggit Hurvitz MD.  - The Journal of Allergy and Clinical Immunology, Volume 101, Issue 5, Pages 602 - 605, May 1998.

BACKGROUND: Chronic sinusitis (CS) is a common disease in children, especially those with allergies, that is caused by impaired drainage from the sinuses. Hypertonic NaCl solution has been shown to increase mucociliary clearance and ciliary beat frequency.

OBJECTIVE: We performed a randomized double blind study to compare the effect of nasal wash with hypertonic saline (HS) (3.5%) versus normal saline (NS) (0.9%) on CS.

METHODS: Thirty patients with CS aged 3 to 16 years were studied. They were randomly divided into two treatment groups matched by age and severity of the disease. Each individual was treated with either HS or NS for 4 weeks. All patients were evaluated by two clinical scores (cough and nasal secretions/postnasal drip [PND]) and by a radiology score at the beginning of the study and after 4 weeks.

RESULTS: The HS group improved significantly in all scores (average ± SD): cough score, from 3.6 ± 0.51 to 1.6 ± 0.74; nasal secretion/PND score, from 2.86 ± 0.35 to 1.6 ± 0.74; and radiology score, from 8.06 ± 1.28 to 2.66 ± 1.04. The NS treatment group showed significant improvement only in the PND score (from 2.66 ± 0.49 to 1.53 ± 0.83) but no significant change in both the cough score (from 3.53 ± 0.52 to 3.33 ± 0.49) and the radiology score (from 8.13 ± 1.25 to 7.86 ± 0.91). Clinical observation 1 month after the end of the study showed no change compared with the end of the study in both groups.

CONCLUSIONS:  Hypertonic saline nasal wash is an efficient treatment of chronic sinusitis (CS).  Study conducted using nasal saline (NS) vs. hypertonic nasal saline wash (HS) on patients who had been treated with antibiotics, nasal steroids or systemic steroids three weeks or more in the past with treatment stopped for one month. The HS treatment group reported an increase in clear nasal secretions during the first 2 weeks, and all but one had complete freedom from nasal secretion by the third week of treatment. Most of them had improved clinical cough scores (13 of 15) from 3.6 ± 0.51 to 1.6 ± 0.74, improved PND/nasal secretion scores (13 of 15) from 2.86 ± 0.35 to 1.6 ± 0.74, and improved sinus radiology scores (14 of 15) from 8.06 ± 1.28 at the beginning to 2.66 ± 1.04 at the end of the study. 

In conclusion, instillation of 1 ml HS three times a day for 1 month improves the clinical and radiologic status among children with CS. The treatment is tolerable, inexpensive, and effective.


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7. “Nasal rinsing with hypertonic solution: an adjunctive treatment for pediatric seasonal allergic rhinoconjunctivitis” - Garavello W, Di Berardino F, Romagnoli M, Sambataro G, Gaini RM, Department of Otorhinolaryngology, University Milano-Bicocca, Monza, Italy. - Int. Arch Allergy Immunol 2005 Aug; 137(4):310-4. Epub 2005 June 20.

BACKGROUND: Recent but limited evidence suggests that nasal lavage with hypertonic saline may be useful as an adjunctive treatment modality in the management of pediatric allergic rhinitis. The aim of this study was to clarify whether nasal irrigation with hypertonic solution should be routinely recommended to children with seasonal grass pollen rhinoconjunctivitis.

METHODS: Forty-four children with seasonal grass pollen rhinoconjunctivitis were recruited. Twenty-two patients were randomized to receive three-times daily nasal rinsing with hypertonic saline during the pollen season, which lasted 7 weeks. Twenty-two patients were allocated to receive no nasal irrigation and were used as controls. Twenty patients per group completed the study. A mean daily rhinoconjunctivitis score based on the presence of nasal discharge and obstruction as well as ocular symptoms as reddening and itching were calculated for each week of the pollen season. Patients were allowed to use oral antihistamines when required and the mean number of drugs taken per week was also calculated.

RESULTS: The mean weekly rhinoconjunctivitis score in the active group was reduced during the whole pollen period. This difference was statistically significant in week 6 and 7 of therapy. A markedly reduced intake of oral antihistamines was also observed in patients allocated to nasal rinsing, being statistically significant in 5 of the 7 weeks. No adverse effect was reported in the active group.

CONCLUSIONS: This study supports the use of nasal rinsing with hypertonic saline in the pediatric patient with seasonal allergic rhinoconjunctivitis.  This treatment proved to be tolerable, inexpensive and effective.

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8. “A randomized, prospective, double-blind study on the efficacy of Dead Sea salt nasal irrigations” - Friedman M, Vidyasagar R, Joseph N. -  Laryngoscope 116, 878-882 (2006).

OBJECTIVE: The objective of this randomized, prospective, double-blind study was to compare nasal irrigation using hypertonic Dead Sea salt (DSS) solution with hypertonic saline in the treatment of chronic rhinosinusitis and improvement of quality of life (QOL).

METHODS:  With Institutional Review Board approval, 42 adults seeking treatment for chronic rhinosinusitis in a tertiary university-affiliated medical center were studied. After history and endonasal examination, computed tomography imaging, and QOL survey (Standardized Rhinoconjunctivitis Quality of Life Questionnaire [RQLQ(S)]), patients were randomized to self-administered hypertonic saline spray and irrigation twice daily or hypertonic DSS spray and irrigation. Patients were reassessed weekly and at 1 month.

RESULTS: Both groups had similar symptoms and RQLQ(S) scores before treatment and had significant improvement after treatment. However, the DSS patients had significantly better symptom relief and only the DSS group showed improved RQLQ(S) scores.

CONCLUSIONS: A double-blind randomized controlled trial in 57 patients with chronic rhinosinusitis (CRS) unsuccessfully treated with conventional medical therapy demonstrated that nasal lavage for 60 days with hypertonic Dead Sea salt solution led to significantly better improvement compared with conventional hypertonic saline in terms of rhinosinusitis symptoms scores and quality of life.

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9. “Comparison of intranasal hypertonic dead sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis” - Cordray S, Hario JB, Miner L. - Ear Nose Throat J. 2005 Jul:84(7): 426-30.

Source: Academic Programs at Southern Nazarene University, Tulsa, Okla, USA.

ABSTRACT: Intranasal corticosteroids are well known to be efficacious in the treatment of allergic rhinitis. Nasal irrigation with saline, including hypertonic saline, has long been recommended for the treatment of sinonasal disease, and it has been shown to have a positive effect on the physiology of the nasal mucosa. Until now, no study of the clinical efficacy of intranasal hypertonic Dead Sea saline as a monotherapy for seasonal allergic rhinitis has been reported.

We conducted a prospective, randomized, single-blind, placebo-controlled comparison of intranasal hypertonic Dead Sea saline spray and intranasal aqueous triamcinolone spray in 15 patients with seasonal allergic rhinitis. Results were based on a 7-day regimen. Based on Rhinoconjunctivitis Quality of Life Questionnaire scores, clinically and statistically significant (p < 0.0001) improvements were seen in both active-treatment groups; as expected, the corticosteroid spray was the more effective of the two treatments. No significant improvement occurred in the control group.

Our preliminary results not only confirm the efficacy of intranasal corticosteroid therapy in moderate-to-severe allergic rhinitis, they also suggest that the Dead Sea saline solution can be an effective alternative in mild-to-moderate allergic rhinitis, particularly with respect to nasal and eye symptoms. The hypertonicity of the Dead Sea solution may have a positive effect on the physiology of the nasal mucosa by improving mucociliary clearance. In addition, the dominant cation in the Dead Sea solution--magnesium--probably exerts anti-inflammatory effects on the nasal mucosa and on the systemic immune response


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10. “Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial” - Rabago D, Zgierska A, Mundt M, Barrett B, Bobula J, Maberry R. - J Fam Pract. 2002 Dec;51(12):1049-55.

ABSTRACT

OBJECTIVES:  To test whether daily hypertonic saline nasal irrigation improves sinus symptoms and quality of life and decreases medication use in adult subjects with a history of sinusitis.

STUDY DESIGN: Randomized controlled trial. Experimental subjects used nasal irrigation daily for 6 months.

POPULATION: Seventy-six subjects from primary care (n=70) and otolaryngology (n=6) clinics with histories of frequent sinusitis were randomized to experimental (n=52) and control (n=24) groups.

OUTCOMES MEASURED: Primary outcome measures included the Medical Outcomes Survey Short Form (SF-12), the Rhinosinusitis Disability Index (RSDI), and a Single-Item Sinus-Symptom Severity Assessment (SIA); all 3 were completed at baseline, 1.5, 3, and 6 months. Secondary outcomes included daily assessment of compliance and biweekly assessment of symptoms and medication use. At 6 months, subjects reported on side effects, satisfaction with nasal irrigation, and the percentage of change in their sinus-related quality of life.

RESULTS: No significant baseline differences existed between the 2 groups. Sixty-nine subjects (90.8%) completed the study. Compliance averaged 87%. Experimental group RSDI scores improved from 58.4 -/+ 2.0 to 72.8 -/+ 2.2 (P < or =.05) compared with those of the control group (from 59.6 -/+ 3.0 to 60.4 -/+ 1.1); experimental group SIA scores improved from 3.9 -/+ 0.1 to 2.4 -/+ 0.1 (P < or =.05) compared with those of the control group (from 4.08 -/+ 0.15 to 4.07 -/+ 0.27). The number needed to treat to achieve 10% improvement on RSDI at 6 months was 2.0. Experimental subjects reported fewer 2-week periods with sinus-related symptoms (P <.05), used less antibiotics (P <.05), and used less nasal spray (P =.06). On the exit questionnaire 93% of experimental subjects reported overall improvement of sinus-related quality of life, and none reported worsening (P <.001); on average, experimental subjects reported 57 -/+ 4.5% improvement. Side effects were minor and infrequent. Satisfaction was high. We found no statistically significant improvement on the SF-12.

CONCLUSIONS:  Daily hypertonic saline nasal irrigation improves sinus-related quality of life, decreases symptoms, and decreases medication use in patients with frequent sinusitis. Primary care physicians can feel comfortable recommending this therapy.

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11.  “Nasal saline irrigations for the symptoms of chronic rhinosinusitis” - Harvey R, Hannan SA, Badia L, Scadding G. - Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD006394. DOI: 10.1002/14651858.CD006394.pub2

SUMMARY: The use of nasal irrigation for the treatment of nose and sinus complaints has its foundations in yogic and homeopathic traditions. It is often prescribed as an adjunct to other treatments such as intranasal steroids or antibiotics. However, there is significant effort involved in preparing and delivering the solutions. This review summarizes the evidence for the effect of saline irrigations in the management of the symptoms of chronic rhinosinusitis. There is evidence that they relieve symptoms, help as an adjunct to treatment and are well tolerated by the majority of patients. While there is no evidence that saline is a replacement for standard therapies, the addition of topical nasal saline is likely to improve symptom control in patients with persistent sinonasal disease. No recommendations can be made regarding specific solutions, dosage or delivery. There are no significant side-effects reported in trials.  Some evidence suggests that hypertonic solutions improve objective measures.

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12. “The use of hypertonic sea-water solution in patients after surgery of the nose and paranasal sinuses” [English Abstract, Journal Article] - Rapiejko P, Jurkiewicz D - Otolaryngol Pol 2010 Jan-Feb; 64(1):20-30.

CONCLUSIONS: The findings of the present study support the investigators' opinion that the use of hypertonic seawater solution should be recommended for nasal douching after corrective nasal septal surgery (septoplasty), functional endoscopic sinus surgery (FESS) and surgical removal of nasal polyps (polypectomy). The use of hypertonic seawater facilitates maintenance of normal patency of the nasal cavities, reduces the amount of abnormal nasal discharge and crusting and speeds up healing of iatrogenic injuries of the mucous membrane of the nose.

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