Saline irrigation in CRSwNP after surgery
Reviewed by Suki Ahluwalia

This article, largely from Germany, aims to prove the effectiveness of nasal saline irrigation in postoperative patients with CRS with nasal polyps. A prospective, single blinded randomised trial was designed with an irrigation and non-irrigation arm. Patients who underwent sinonasal surgery were examined for nasal symptoms, general quality of life, missed days from work and mucosal condition postoperatively. This study was conducted in six centres and patients were given 250mls of twice daily irrigation plus standard treatment versus postoperative steroids and debridement alone. Compliance was judged by the remaining amount of solution. Data was collected several times over a one-year follow up. The German version of the Juniper Rhinitis QoL questionnaire was used and polyps were graded using the Malm criteria, a score for condition of the nasal mucosa and presence of scarring or adhesions was also given. Days off work post-surgery was also assessed and certificates of absence counted. 174 patents were assessed with 57 in the control arm and 117 in the irrigation arm. Postoperatively nasal symptom scores were roughly equal and then slightly better in the irrigation arm at three months. Irrigation seems to improve nasal symptom score at three months, in particular with post nasal drip but after this period did not show any benefit. No comments were made on the degree, if any, of significance.

Saline irrigations following sinus surgery – a controlled, single blinded, randomized trial.
Giotakis A, Karow EM, Scheithauer MO, et al.
RHINOLOGY
2016;54(4):302-10.