Does Nasal Irrigation Improve Chronic Sinusitis Symptoms?

Advising patients with chronic or recurrent sinusitis to use nasal irrigation was associated with modestly improved symptoms, according to the results of a recent trial.

Chronic rhinosinusitis is experienced by millions of individuals and often compromises quality of life. Steam inhalation and nasal irrigation are often suggested as alternative treatment options to antibiotics, which are frequently ineffective.
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To test the effectiveness of primary care providers advising the use of nasal irrigation or steam inhalation, researchers randomly assigned 871 patients from 72 practices to 1 of 4 advice strategies: usual care, daily nasal and saline irrigation, daily steam inhalation, or combined treatment with steam and irrigation. Participants assigned to nasal irrigation were also given a demonstration video.

After 3 months of follow-up, nasal irrigation was associated with greater reductions in sinusitis symptoms than steam inhalation or usual care. The improvements persisted at 6 months of follow-up. Nasal irrigation was also associated with improvements in the rates of headaches and over-the-counter medication use. The researchers estimated that 13 patients would have to be treated with nasal irrigation in order for 1 patient to benefit. Steam inhalation alone was not associated with any improvements in symptoms.

—Michael Potts

Reference:
Little P, Stuart B, Mullee M, et al. Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial [published online July 18, 2016]. CMAJ. doi: 10.1503/cmaj.160362.