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Direct maxillary irrigation therapy in non-operated chronic sinusitis: a prospective randomised controlled trial

Published online by Cambridge University Press:  01 September 2021

O Ronen ,
T Marshak ,
N Uri ,
M Gruber ,
O Haberfeld ,
D Paz ,
N Stein  and
R Cohen-Kerem
O Ronen
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
T Marshak
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
N Uri
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
M Gruber
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
O Haberfeld
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
D Paz
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
N Stein
Affiliation:
Department of Community Medicine and Epidemiology, The Lady Davis Carmel Medical Center, Haifa, Israel
R Cohen-Kerem*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
*
Author for correspondence: Dr R Cohen-Kerem, Department of Otolaryngology – Head and Neck Surgery, Carmel Medical Center, 7 Michal Street, Haifa3436212, Israel E-mail: raanan@clalit.org.il Fax: +972 4 825 0970
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Abstract

Objective

This study aimed to compare the effectiveness of pharmacological therapy with and without direct maxillary sinus saline irrigation for the management of chronic rhinosinusitis without polyps.

Methods

In this prospective randomised controlled trial, 39 non-operated patients were randomly assigned to be treated with direct maxillary sinus saline irrigation in conjunction with systemic antibiotics and topical sprays (n = 24) or with pharmacological therapy alone (n = 15). Endoscopy, Sino-Nasal Outcome Test and Lund–MacKay computed tomography scores were obtained before, six weeks after and one to two years after treatment.

Results

Post-treatment Lund–Mackay computed tomography scores were significantly improved in both cohorts, with no inter-cohort difference identified. Post-treatment nasal endoscopy scores were significantly improved in the study group but were similar to those measured in the control group. The Sino-Nasal Outcome Test-20 results showed improvement in both cohorts, with no difference between treatment arms.

Conclusion

Maxillary sinus puncture and irrigation with saline, combined with pharmacological treatment improves endoscopic findings in patients with chronic rhinosinusitis without polyps, but has no beneficial effect on symptoms and imaging findings over conservative treatment alone.

Keywords

SinusitisSino-Nasal Outcome TestTomographyEndoscopyQuality Of Life
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 136 , Issue 3 , March 2022 , pp. 229 - 236
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Dr R Cohen-Kerem takes responsibility for the integrity of the content of the paper

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