Chronic rhinosinusitis (CRS) is a long-term inflammation of the nasal passage and sinuses lasting at least 12 weeks. It is a common condition that affects millions of people worldwide, and it can cause a range of symptoms, including nasal congestion, facial pressure or pain, headache, postnasal drip, and loss of sense of smell. Various factors, including allergies, infections, structural abnormalities, and immune system disorders, can cause the condition. Treatment options for CRS include medication, nasal irrigation, and in more severe cases, surgery.
High-volume nasal irrigation and nasal spray are used to deliver drugs to the sinuses of patients with CRS who have not undergone surgery. In a study, researchers aimed to compare these methods' potential distribution and determine which is more effective. The study recruited 38 patients with CRS and randomly assigned them to receive either nasal irrigation or spray mixed with fluorescein sodium preoperatively.
Fluorescein sodium was combined with the nasal spray to allow researchers to visualize and compare the distribution in the sinuses between the two groups of patients. The primary outcome measured was the mean difference in the fluorescein staining score in all sinuses between the two groups.
The results showed that the total fluorescein staining score for all sinuses in the nasal irrigation group was significantly higher than that of the nasal spray group, with a mean difference score of 2.90. The most affected sinuses were the maxillary and the anterior ethmoid sinuses, while the frontal and sphenoid sinuses had minimal staining from both techniques.
The study concluded that nasal irrigation could deliver drugs into the sinuses in unoperated CRS patients. However, it is not considered a superior method to nasal spray in the most challenging anatomical areas, such as the frontal and sphenoid sinuses.
In summary, this study provides evidence that nasal irrigation may help deliver drugs to the sinuses of CRS patients who have not undergone surgery. However, it may not be the best option for the more difficult-to-reach frontal and sphenoid sinuses. Patients with CRS should discuss the various treatment options with their healthcare provider to determine which method best suits their needs.