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Impact of pulsatile nasal irrigation on the prognosis of functional endoscopic sinus surgery

Kai-Li Liang, Mao-Chang Su, Hung-Cheng Tseng, Rong-San Jiang
Journal of Otolaryngology—Head & Neck Surgery 2008, 37 (2): 148-53
19128603

OBJECTIVES: Nasal irrigation is a popular adjunctive therapy after sinonasal surgery. The objective of this study was to determine the efficacy of nasal irrigation after functional endoscopic sinus surgery (FESS).

METHODS: Patients with chronic rhinosinusitis (CRS) who underwent FESS were enrolled. The preoperative computed tomography (CT) Lund-Mackay staging, Lund symptom, and endoscopy scores were assessed. All patients received postoperative endoscopic débridement and medical treatment and were randomly allocated to receive nasal irrigation for 3 months or not. The symptom and endoscopy scores were repeatedly measured at 2 weeks and 1, 2, and 3 months postoperatively.

RESULTS: Seventy-seven subjects completed the study. When patients were classified as having either severe or mild CRS (CT score > 12 or < or = 12, respectively), the patients with mild CRS in the irrigation group had a significantly better endoscopy score and symptom score change rates than those in the nonirrigation group (p = .019 and .032, respectively), but there were no significant differences in those outcomes between irrigation and nonirrigation groups in patients with severe CRS.

CONCLUSIONS: Our results showed that nasal irrigation is an effective post-FESS management in patients with mild CRS. However, the efficacy of nasal irrigation in patients with severe CRS needs further investigation.

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