Literature DB >> 23712296

Long-term outcome of once daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis.

Vinh Pham1, Kevin Sykes, Julie Wei.   

Abstract

OBJECTIVES/HYPOTHESIS: Chronic rhinosinusitis(CRS) results in significant morbidity and health care expenditure. Safety and efficacy of nasal irrigation use in the treatment of pediatric CRS have been demonstrated, but long-term outcomes are unknown. We reviewed characteristics and treatment outcomes after 6 weeks of once daily nasal irrigation in pediatric CRS based on computed tomography (CT) scans, and summarized parental reports of subsequent use of nasal irrigation for recurring symptoms STUDY
DESIGN: Retrospective cohort study and cross-sectional survey.
METHODS: Review and survey of 144 pediatric CRS patients diagnosed between July 2003 and January 2012.
RESULTS: One hundred four patients were reviewed. Mean age was 8.0 years, and 65.4% were male. Presenting symptoms included congestion (95.2%), cough (79.8%), rhinorrhea (60.6%), headache (48.1%), and fatigue (40.4%). Comorbidities included positive allergy test (50%), asthma (57.3%), and gastroesophageal reflux disease (28.2%). After 6 weeks, 57.7% of patients reported complete resolution of symptoms. Reductions in Lund-Mackay CT scores were 4.14 and 4.38 on the left and right sides, respectively (P < .001). Of the 54 parents who completed the prospective surveys, 53.7% reported using irrigation again in the past 12 months (median = 1, interquartile range = 3). Only nine patients underwent functional endoscopic sinus surgery (FESS) after the initial 6 weeks. Patients requiring FESS were, on average, 3.6 years older than those who did not receive FESS (P = 0.0005). Median length of follow-up was 48 months (range = 20-113). There were no significant differences in age, Lund-MacKay score changes, and symptom resolution proportions between those who completed the survey and those who did not.
CONCLUSIONS: Nasal irrigation is effective as a first-line treatment for pediatric CRS and subsequent nasal symptoms, and reduces the need for FESS and CT imaging. LEVEL OF EVIDENCE: 2b.
© 2013 The American Laryngological, Rhinological and Otological Society, Inc.

Entities:  

Keywords:  Nasal irrigation; chronic rhinosinusitis; outcome studies; saline irrigation

Mesh:

Year:  2013        PMID: 23712296      PMCID: PMC4395460          DOI: 10.1002/lary.24224

Source DB:  PubMed          Journal:  Laryngoscope        ISSN: 0023-852X            Impact factor:   3.325


  19 in total

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4.  The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict?

Authors:  Claire Hopkins; John P Browne; Rob Slack; Valerie Lund; Peter Brown
Journal:  Otolaryngol Head Neck Surg       Date:  2007-10       Impact factor: 3.497

5.  Incremental health care utilization and expenditures for chronic rhinosinusitis in the United States.

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Journal:  Arch Otolaryngol Head Neck Surg       Date:  2000-11

7.  Safety and efficacy of once-daily nasal irrigation for the treatment of pediatric chronic rhinosinusitis.

Authors:  Julie L Wei; Kevin J Sykes; Philip Johnson; Jianghua He; Matthew S Mayo
Journal:  Laryngoscope       Date:  2011-08-16       Impact factor: 3.325

Review 8.  Role of antibiotics in sinusitis.

Authors:  Rajarsi Mandal; Nimish Patel; Berrylin J Ferguson
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9.  Nasal saline for chronic sinonasal symptoms: a randomized controlled trial.

Authors:  Melissa A Pynnonen; Shraddha S Mukerji; H Myra Kim; Meredith E Adams; Jeffrey E Terrell
Journal:  Arch Otolaryngol Head Neck Surg       Date:  2007-11

10.  Chronic rhinosinusitis in children.

Authors:  Hassan H Ramadan
Journal:  Int J Pediatr       Date:  2011-10-05
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5.  Nasal saline irrigation in preschool children: a survey of attitudes and prescribing habits of primary care pediatricians working in northern Italy.

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  5 in total

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