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Impact of isotonic and hypertonic saline solutions on mucociliary activity in various nasal pathologies: clinical study

Published online by Cambridge University Press:  28 October 2008

A Ural ,
T Kocak Oktemer ,
Y Kizil ,
F Ileri  and
S Uslu
A Ural*
Affiliation:
Department of Otorhinolaryngology, School of Medicine, Gazi University, Ankara, Turkey
T Kocak Oktemer
Affiliation:
Department of Otorhinolaryngology, School of Medicine, Gazi University, Ankara, Turkey
Y Kizil
Affiliation:
Department of Otorhinolaryngology, School of Medicine, Gazi University, Ankara, Turkey
F Ileri
Affiliation:
Department of Otorhinolaryngology, School of Medicine, Gazi University, Ankara, Turkey
S Uslu
Affiliation:
Department of Otorhinolaryngology, School of Medicine, Gazi University, Ankara, Turkey
*
Address for correspondence: Dr Ahmet Ural, Mamak Cad 43/1 06340, Demirlibahçe, Ankara, Turkey. Fax: +90 312 284 78 07 E-mail: [email protected]
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Abstract

Objective:

To investigate the impact of nasal irrigation with isotonic or hypertonic sodium chloride solution on mucociliary clearance time in patients with allergic rhinitis, acute sinusitis and chronic sinusitis.

Patients and methods:

Mucociliary clearance time was measured using the saccharine clearance test on 132 adults before and after 10 days' application of intranasal isotonic or hypertonic saline. Patient numbers were as follows: controls, 45; allergic rhinitis, 21; acute sinusitis, 24; and chronic sinusitis, 42. The results before and after irrigation were compared using the Wilcoxon t-test.

Results:

Before application of saline solutions, mucociliary clearance times in the three patient treatment groups were found to be significantly delayed, compared with the control group. Irrigation with hypertonic saline restored impaired mucociliary clearance in chronic sinusitis patients (p < 0.05), while isotonic saline improved mucociliary clearance times significantly in allergic rhinitis and acute sinusitis patients (p < 0.05).

Conclusion:

Nasal irrigation with isotonic or hypertonic saline can improve mucociliary clearance time in various nasal pathologies. However, these solutions should be selectively prescribed rather than used based on anecdotal evidence. Further studies should be conducted to develop a protocol for standardised use of saline solution irrigation in various nasal pathologies.

Keywords

RhinitisSalineIrrigationCilia
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 5 , May 2009 , pp. 517 - 521
Copyright
Copyright © JLO (1984) Limited 2008

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References

1 Papsin, B, McTavish, A. Saline nasal irrigation. Its role as an adjunct treatment. Can Fam Physician 2003;49:168–73Google ScholarPubMed
2 Kim, CH, Song, MH, Young, EA, Lee, JG, Yoon, JH. Effect of hypo-, iso- and hypertonic saline irrigation on secretory mucins and morphology of cultured human nasal epithelial cells. Acta Otolaryngol 2005;125:1296–300CrossRefGoogle ScholarPubMed
3 Tomooka, LT, Murphy, C, Davidson, TM. Clinical study and literature review of nasal irrigation. Laryngoscope 2000;110:1189–93CrossRefGoogle ScholarPubMed
4 Talbot, AR, Herr, TM, Parsons, DS. Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 1997;107:500–3CrossRefGoogle ScholarPubMed
5 Hauptman, G, Ryan, MW. The effect of saline solutions on nasal patency and mucociliary clearance in rhinosinusitis patients. Otolaryngol Head Neck Surg 2007;137:815–21CrossRefGoogle ScholarPubMed
6 Garavello, W, Romagnoli, M, Sordo, L, Gaini, RM, Di Berardino, C, Angrisano, A. Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: a randomized study. Ped Allergy Immunol 2003;14:140–3CrossRefGoogle ScholarPubMed
7 Rabago, D, Zgierska, A, Mundt, M, Barrett, B, Bobula, J, Maberry, R. Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial. J Fam Pract 2002;51:1049–55Google ScholarPubMed
8 Rossmann, CCM, Lee, RM, Forrest, JB, Newhouse, MT. Nasal ciliary ultrastructure and function in patients with primary ciliary dyskinesia compared with that in normal subjects and in subjects with various respiratory diseases. Am Rev Respir Dis 1984;129:161–70Google Scholar
9 Sakakura, Y, Ukai, M, Majima, Y, Murai, S, Harada, T, Miyoshi, Y. Nasal mucociliary clearance under various conditions. Acta Otolaryngol 1983;96:167–73CrossRefGoogle ScholarPubMed
10 Sakakura, Y, Majima, Y, Saida, S, Ukai, K, Miyoshi, Y. Reversibility of reduced mucociliary clearance in chronic sinusitis. Clin Otolaryngol 1985;10:79–83CrossRefGoogle ScholarPubMed
11 Prior, MJ, Schofield, K, Boivin, CM, Anderson, P, Drake-Lee, AB. Assessment of mucociliary transport in patients with chronic mucoid rhinitis. Clin Otolaryngol 1999;24:242–6CrossRefGoogle ScholarPubMed
12 Shoseyov, D, Bibi, H, Shai, P, Shosayov, N, Shazberg, G, Hurvitz, H. Treatment with hypertonic saline versus normal saline nasal wash of pediatric chronic sinusitis. J Allerg Clin Immunol 1998;101:602–5CrossRefGoogle ScholarPubMed
13 Georgitis, JW. Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory mediators. Chest 1994;106:1487–92CrossRefGoogle ScholarPubMed
14 Rutland, J, Cole, PJ. Nasal mucociliary clearance and ciliary beat frequency in cystic fibrosis compared with sinusitis and bronchiectasis. Thorax 1981;36:654–8CrossRefGoogle ScholarPubMed
15 Adam, P, Stiffman, M, Blake, R. A clinical trial of hypertonic saline nasal spray in subjects with common cold or rhinosinusitis. Arch Fam Med 1998;7:39–43CrossRefGoogle ScholarPubMed
16 Mangete, ED, West, D, Blankson, CD. Hypertonic saline solution: an effective wound dressing solution. East Afr Med J 1993;70:104–6Google ScholarPubMed
17 Robinson, M, Hemming, AL, Regnis, JA, Wong, AG, Bailey, DL, Bautovich, GJ et al. Effect of increasing doses of hypertonic saline on mucociliary clearance in patients with cystic fibrosis. Thorax 1997;52:900–3CrossRefGoogle ScholarPubMed
18 Majima, Y, Sakakura, Y, Matsubara, T, Murai, S, Miyoshi, Y. Mucociliary clearance in chronic rhinosinusitis: related human nasal clearance and in vitro bullfrog palate clearance. Biorheology 1983;20:251–62CrossRefGoogle Scholar
19 Toskala, E, Nuutinen, J, Rautiainen, M. Scanning electron microscopy findings in chronic sinusitis and in recurrent respiratory infections. J Laryngol Otol 1995;109:509–14CrossRefGoogle ScholarPubMed
20 Daviskas, E, Anderson, SD, Gonda, I, Eberl, S, Meikle, S, Seale, JP et al. Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects. Eur Resp J 1996;9:725–32CrossRefGoogle ScholarPubMed