Abstract
Objective: This study aims to compare the potential
sinus distribution between high-volume nasal irrigation and nasal spray
in chronic rhinosinusitis (CRS) patients who have not undergone sinus
surgery.
Design and Setting: A randomized clinical study was
conducted at
“Blinded
for review”.
Participants: Forty patients undergoing endoscopic sinus
surgery for CRS. Thirty-eight patients met the inclusion criteria and
were randomly assigned to receive nasal irrigation or nasal spray mixed
with fluorescein sodium preoperatively.
Main outcome measures : The primary outcome was the mean
difference in the staining score of fluorescein in all sinuses between
the two groups.
Results: The total staining score of fluorescein in all
sinuses via nasal irrigation was statistically more significant than the
score via nasal spray, with a mean difference score of 2.90, 95%CI:
1.22-4.58, p -value 0.001. The most significantly affected sinuses
were specific to the maxillary and anterior ethmoid sinuses, whereas the
frontal and sphenoid sinuses had the slightest solution distribution
from both techniques.
Conclusion: Nasal irrigation is a potential route to
deliver drugs into the sinus in unoperated CRS patients. However, it is
not considered a superior method to nasal spray at the most challenging
anatomical areas, i.e., the frontal and sphenoid sinuses.
Keywords: Corticosteroid use, Endoscopic sinus surgery,
Irrigations, Topical therapy for chronic rhinosinusitis, Medical therapy
for chronic rhinosinusitis, Nasal polyp, Nasal spray,Chronic rhinosinusitis