Efficacy of Hypertonic Saline Irrigation for Nasal Symptoms in Children with Perennial Allergic Rhinitis: A Randomized Double-Blind Study
Kittithat Rattanamaneewong MD¹, Sasawan Chinratanapisit MD¹, Kanika Piromrat MD¹, Nattanee Thambamrung MD²
Affiliation : ¹ Department of Pediatric, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Bangkok, Thailand ² Department of Pathology, Bhumibol Adulyadej Hospital, Royal Thai Air Force, Bangkok, Thailand
Background: Nasal saline irrigation was an adjunctive therapy of allergic rhinitis (AR). It has been suggested that the use of hypertonic saline
(HS) is better than normal saline (NSS) in treatment of AR. Reduction of mucosal edema by hypertonicity induced water transport through nasal
mucosa, nasal congestion reduction and mucociliary clearance improvement.
Objective: To compare total nasal symptom score (TNSS) between 3% HS and NSS irrigation in perennial allergic rhinitis children.
Materials and Methods: The present study was conducted at the Allergy Center of Bhumibol Adulyadej Hospital (BAH), Royal Thai Airforce, Bangkok, Thailand between January and March 2021. Sixty-two perennial AR children were enrolled and categorized in severity level, namely mild, moderate or severe. Subjects were randomized into two groups. Each participant was blind-randomized to nasal irrigation of either 3% HS or NSS twice-daily for 4 weeks by the same investigator. The primary outcome was TNSS improvement between both groups. Secondary outcomes were quality of life, nasal congestion severity improvement, nasal cytology change and side effects.
Results: TNSS improvement of 3% HS was more than NSS group (4.03±2.36 versus 2.73±3.06, p=0.034). Nasal congestion was the only symptom that differed significantly between the two groups (1.32±1.01 in 3% HS versus 0.70±1.24 in NSS, p=0.024). Reduction of congestion severity by physical examination, nasal cytology changes and side effects were comparable.
Conclusion: Nasal irrigation with 3% HS in children with perennial AR had more improvement than NSS in TNSS., especially nasal congestion.
Received 9 March 2021 | Revised 8 September 2021 | Accepted 8 September 2021
doi.org/10.35755/jmedassocthai.2021.10.12573
Keywords : Keyword : Hypertonic saline; Nasal irrigation; Allergic rhinitis; Nasal symptom score
