The Comparative Study of Mucociliary Clearance with Long-term Hypertonic Saline versus Normal Saline Nasal Wash of Normal Person and Patients after Endoscopic Sinus Surgery

Roh, Hwan Jung; Youn, Sang Ho; Kwak, Dong Hun; Lee, Geun Seob; Moon, Hyun Soo; Kim, Sun Woo; Lee, Jong Dam

Abstract

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.