The annoying symptoms of rhinosinusitis are often refractory to treatment, and their impact on patients' quality of life has been well established. However, some encouraging news comes from a study by Rabago and associates, who found that hypertonic saline nasal irrigation (HSNI) improves quality of life in patients with chronic sinonasal symptoms. These researchers conducted a 2-phase study. Phase 1 was a 6-month, structured, intensive, randomized, controlled trial of 76 participants who had had 2 episodes of acute rhinosinusitis or 1 episode of chronic rhinosinusitis per year for 2 consecutive years and whose quality of life was impaired by their symptoms. During this phase, 52 participants used HSNI a mean of 87% of days, concurrent with their established standard-of-care treatment; 24 participants practiced standard-of-care treatment only. Participants completed the Rhinosinusitis Disability Index and a single-item sinus-symptom severity assessment. In phase 2, 54 of the phase 1 participants were assessed over 12 months in an uncontrolled setting. The Sino-Nasal Outcomes Test was added. Results of both phases indicated that HSNI was associated with improved quality of life, reduced symptoms, and decreased use of antibiotics and nasal sprays.
