Is nasal saline irrigation all it is cracked up to be?

Abstract

Objective: This review examines the literature regarding nasal saline irrigation in the management of sinonasal disease. We explore the various properties of nasal irrigation solutions and their effects on nasal symptoms.

Data sources: English-language studies identified from MEDLINE and the Cochrane Central Register of Controlled Trials through December 2011.

Study selections: Randomized, controlled trials (RCTs), prospective controlled and comparative studies, and observational studies reporting on the indications, efficacy, and safety of nasal saline irrigation.

Results: Nasal saline irrigation has often been used as both a solo and an adjunctive treatment in sinonasal diseases, including allergic rhinitis and chronic rhinosinusitis. Nasal saline irrigation has contributed to a reduction of inflammation as well as relief of nasal symptoms. Identifying the optimal technique is hampered by the fact that studies have employed various delivery devices and saline compositions, which subsequently have demonstrated different effects on mucus clearance, ciliary beat activity, and inflammatory mediators.

Conclusion: Overall, the data appear to demonstrate some small clinical benefit to nasal saline irrigation. Nasal saline irrigation is well tolerated, with minimal side effects. Further definitive studies are needed to optimize efficacy.