Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis

A randomized, prospective double-blind study

Michael Friedman, Craig Hamilton, Christian G. Samuelson, Alexander Maley, Meghan N. Wilson, T. K. Venkatesan, Ninos J. Joseph

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background: Intranasal steroids are 1 of the most frequently prescribed medications for the treatment of chronic rhinosinusitis (CRS), and saline irrigations are commonly used as an adjunct to medical therapy. We aimed to compare the efficacy of Dead Sea salt (DSS) irrigations and DSS nasal spray vs saline irrigations and topical nasal steroid spray in the treatment of symptoms of CRS. Methods: A total of 145 symptomatic adult patients without acute infection were initially enrolled and 114 completed the study. Patients completed a Sino-Nasal Outcomes Test 20 (SNOT-20) survey (primary outcome metric) and underwent endonasal examination, acoustic rhinometry, and smell testing (secondary outcome metrics). Patients were randomized to 2 groups. The experimental group (n = 59) self-administered hypertonic DSS spray and DSS irrigation; the control group (n = 55) self-administered fluticasone spray and hypertonic saline irrigation and spray. Patients and staff were blinded to group assignment. Outcomes were reassessed at 4 weeks. Results: The 2 groups were homogeneous with respect to pretreatment primary and secondary outcome metrics. Dropout rates were 30% in the DSS group and 36.6% in the control group. Both groups showed significant improvement in mean SNOT-20 scores following treatment; however, the degree of improvement was not significantly different between groups (p = 0.082). There were no significant changes in secondary outcome metrics between the 2 groups. Conclusion: For patients with CRS, treatment with DSS irrigations and sprays appears as effective for symptom reduction as a combination of hypertonic saline irrigations and sprays and a topical steroid spray.

Original languageEnglish (US)
Pages (from-to)252-257
Number of pages6
JournalInternational Forum of Allergy and Rhinology
Volume2
Issue number3
DOIs
StatePublished - May 1 2012

Fingerprint

Nasal Lavage
Double-Blind Method
Oceans and Seas
Salts
Steroids
Nasal Sprays
Nose
Therapeutics
Acoustic Rhinometry
Control Groups
Smell
Infection

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Otorhinolaryngology

Cite this

Friedman, Michael ; Hamilton, Craig ; Samuelson, Christian G. ; Maley, Alexander ; Wilson, Meghan N. ; Venkatesan, T. K. ; Joseph, Ninos J. / Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis : A randomized, prospective double-blind study. In: International Forum of Allergy and Rhinology. 2012 ; Vol. 2, No. 3. pp. 252-257.
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Dead Sea salt irrigations vs saline irrigations with nasal steroids for symptomatic treatment of chronic rhinosinusitis : A randomized, prospective double-blind study. / Friedman, Michael; Hamilton, Craig; Samuelson, Christian G.; Maley, Alexander; Wilson, Meghan N.; Venkatesan, T. K.; Joseph, Ninos J.

In: International Forum of Allergy and Rhinology, Vol. 2, No. 3, 01.05.2012, p. 252-257.

Research output: Contribution to journalArticle

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AU - Friedman, Michael

AU - Hamilton, Craig

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N2 - Background: Intranasal steroids are 1 of the most frequently prescribed medications for the treatment of chronic rhinosinusitis (CRS), and saline irrigations are commonly used as an adjunct to medical therapy. We aimed to compare the efficacy of Dead Sea salt (DSS) irrigations and DSS nasal spray vs saline irrigations and topical nasal steroid spray in the treatment of symptoms of CRS. Methods: A total of 145 symptomatic adult patients without acute infection were initially enrolled and 114 completed the study. Patients completed a Sino-Nasal Outcomes Test 20 (SNOT-20) survey (primary outcome metric) and underwent endonasal examination, acoustic rhinometry, and smell testing (secondary outcome metrics). Patients were randomized to 2 groups. The experimental group (n = 59) self-administered hypertonic DSS spray and DSS irrigation; the control group (n = 55) self-administered fluticasone spray and hypertonic saline irrigation and spray. Patients and staff were blinded to group assignment. Outcomes were reassessed at 4 weeks. Results: The 2 groups were homogeneous with respect to pretreatment primary and secondary outcome metrics. Dropout rates were 30% in the DSS group and 36.6% in the control group. Both groups showed significant improvement in mean SNOT-20 scores following treatment; however, the degree of improvement was not significantly different between groups (p = 0.082). There were no significant changes in secondary outcome metrics between the 2 groups. Conclusion: For patients with CRS, treatment with DSS irrigations and sprays appears as effective for symptom reduction as a combination of hypertonic saline irrigations and sprays and a topical steroid spray.

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