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. 2019 Jan 9;8(1):64.
doi: 10.3390/jcm8010064.

Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis

Chia-Ling Li  1   2 , Hsiao-Chuan Lin  3 , Chien-Yu Lin  4 , Teh-Fu Hsu  5   6
Affiliations

Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis

Chia-Ling Li et al. J Clin Med. .

Abstract

We aimed to explore the efficacy of hypertonic saline nasal irritation (HSNI) for improving nasal symptoms and quality of life, and for decreasing oral antihistamine consumption in children with allergic rhinitis (AR). We conducted a systematic search of PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Chinese Electronic Periodicals Service, and Cochrane Library of Controlled Trials databases for prospective randomized, controlled trials assessing HSNI effects in children with AR and published before December 2017. Two authors independently assessed each trial's quality and extracted data for a meta-analysis. We included four trails comprising 351 patients. HSNI improved patients' nasal symptom scores (mean difference 1.82 points after treatment; 95% confidence interval (CI), 0.35⁻3.30; I² = 64%; p = 0.02) and a significantly lower rescue antihistamine use rate (risk ratio (RR), 0.68; 95% CI, 0.48⁻0.95; I² = 28%; p = 0.02). Analyses comparing HSNI with isotonic saline nasal irrigation (ISNI) showed better nasal symptom scores (mean difference, 1.22 points; 95% CI, 1.01⁻1.44; I² = 0%; p < 0.001) in patients in the HSNI group, although the antihistamine use (RR, 0.84; 95% CI, 0.64⁻1.10; I² = 0%; p = 0.2) and adverse effect rates were similar between groups. Compared with ISNI, HSNI may be a reasonable adjunctive treatment for children with AR.

Keywords: allergic rhinitis children; hypertonic saline nasal irrigation; nasal irrigation; nasal symptom.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Schematic illustration of the literature search and the study-selection criteria of our study.
Figure 2
Figure 2
Forrest plot of the improvement of nasal symptom scores in the HSNI and control groups. (A) Overall meta-analysis; (B) subgroup analysis comparing HSNI and ISNI groups. HSNI, hypertonic saline nasal irrigation; ISNI, isotonic saline nasal irrigation; SD, standard deviation; IV, independent variable; CI, confidence interval.
Figure 3
Figure 3
Forrest plot of the rates of rescue antihistamine use in the HSNI and control groups. (A) Overall meta-analysis; (B) subgroup analysis comparing HSNI and ISNI groups.
Figure 4
Figure 4
Forrest plot of the adverse effects in the HSNI and ISNI groups.
See this image and copyright information in PMC

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