The Comparison Study of Mucociliary Clearance After Nasal Irrigation with Buffered Hypotonic, Isotonic, and Hypertonic Saline Solutions

Kim, Sung Won; Suh, Byung Do

Abstract

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.