Skip to main content Accessibility help

Effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery: a randomised, controlled study

  • B H K Ng (a1) (a2) (a3), I P Tang (a2) (a3), P Narayanan (a1), R Raman (a1) and R L Carrau (a4)...



Nasal lavage with mupirocin has the potential to reduce sinonasal morbidity in endoscopic endonasal approaches for skull base surgery.


To evaluate the effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery.


A pilot randomised, controlled trial was conducted on 20 adult patients who had undergone endoscopic endonasal approaches for skull base lesions. These patients were randomly assigned to cohorts using nasal lavages with mupirocin or without mupirocin. Patients were assessed in the out-patient clinic, one week and one month after surgery, using the 22-item Sino-Nasal Outcome Test questionnaire and nasal endoscopy.


Patients in the mupirocin nasal lavage group had lower nasal endoscopy scores post-operatively, and a statistically significant larger difference in nasal endoscopy scores at one month compared to one week. The mupirocin nasal lavage group also showed better Sino-Nasal Outcome Test scores at one month compared to the group without mupirocin.


Nasal lavage with mupirocin seems to yield better outcomes regarding patients’ symptoms and endoscopic findings.


Corresponding author

Author for correspondence: Dr Ing Ping Tang, Otorhinolaryngology – Head and Neck Surgery Department, Faculty of Medicine and Health Sciences, University Malaysia Sarawak (‘UNIMAS’), Jalan Datuk Mohd Musa, 94300Kota Samarahan, Sarawak, Malaysia E-mail:


Hide All

Dr I P Tang takes responsibility for the integrity of the content of the paper



Hide All
1Awad, AJ, Mohyeldin, A, El-Sayed, IH, Aghi, MK.Sinonasal morbidity following endoscopic endonasal skull base surgery. Clin Neurol Neurosurg 2015;130:162–710.1016/j.clineuro.2015.01.004
2Balaker, AE, Bergsneider, M, Martin, NA, Wang, MB.Evolution of sinonasal symptoms following endoscopic anterior skull base surgery. Skull Base 2010;20:245–5110.1055/s-0030-1249248
3Talbot, AR, Herr, TM, Parsons, DS.Mucociliary clearance and buffered hypertonic saline solution. Laryngoscope 1997;107:500–310.1097/00005537-199704000-00013
4Brown, CL, Graham, SM.Nasal irrigations: good or bad? Curr Opin Otolaryngol Head Neck Surg 2004;12:91310.1097/00020840-200402000-00004
5Hudson, IRB.The efficacy of intranasal mupirocin in the prevention of staphylococcal infections: a review of recent experience. J Hosp Infect 1996;27:819810.1016/0195-6701(94)90001-9
6Sutherland, R, Boon, RJ, Griffin, KE, Masters, PJ, Slocombe, B, White, AR.Antibacterial activity of mupirocin, a new antibiotic for topical use. Antimicrob Agents Chemother 1985;27:495–810.1128/AAC.27.4.495
7Manoharan, G.Development and validation of a stability-indicating RP-HPLC method for the estimation of mupirocin in bulk and ointment dosage form. Eur J Pharm Med Res 2016;3:470–6
8Uren, B, Psaltis, A, Wormald, PJ.Nasal lavage with mupirocin for the treatment of surgically recalcitrant chronic rhinosinusitis. Laryngoscope 2008;118:1677–8010.1097/MLG.0b013e31817aec47
9Lim, M, Citardi, MJ, Leong, JL.Topical antimicrobials in the management of chronic rhinosinusitis: a systemic review. Am J Rhinol 2008;22:381–910.2500/ajr.2008.22.3189
10Ha, KR, Psaltis, AJ, Butcher, AR, Wormald, PJ, Tan, LW.In vitro activity of mupirocin on clinical isolates of Staphylococcus aureus and its potential implications in chronic rhinosinusitis. Laryngoscope 2008;118:535–4010.1097/MLG.0b013e31815bf2e3
11Desrosiers, M, Bendouah, Z, Barbeau, J.Effectiveness of topical antibiotics on Staphylococcus aureus biofilm in vitro. Am J Rhinol 2007;21:149–53
12Jervis-Brady, J, Boase, S, Psaltis, A, Foreman, A, Wormald, PJ.A randomized trial of mupirocin sinonasal rinses versus saline in surgically recalcitrant staphylococcal chronic rhinosinusitis. Laryngoscope 2012;122:2148–5310.1002/lary.23486
13Raz, R, Miron, D, Colodner, R, Staler, Z, Samara, Z, Keness, Y.A 1-year trial of nasal mupirocin in the prevention of recurrent staphylococcal nasal colonization and skin infection. Arch Intern Med 1996;156:1109–1210.1001/archinte.1996.00040041109010
14Jervis-Brady, J, Wormald, PJ.Microbiological outcomes following mupirocin nasal washes for symptomatic, Staphylococcus aureus-positive chronic rhinosinusitis following endoscopic sinus surgery. Int Forum Allergy Rhinol 2012;2:111–1510.1002/alr.20106
15McCoul, ED, Anand, VK, Bedrosian, JC, Schwartz, TH.Endoscopic skull base surgery and its impact on sinonasal-related quality of life. Int Forum Allergy Rhinol 2012;2:174–81
16Pant, H, Bhatki, AM, Snyderman, CH, Vescan, AD, Carrau, RL, Gardner, P et al. Quality of life following endonasal skull base surgery. Skull Base 2010;20:3540
17de Almeida, JR, Snyderman, CH, Gardner, PA, Carrau, RL, Vescan, AD.Nasal morbidity following endoscopic skull base surgery: a prospective cohort study. Head Neck 2011;33:547–51
18Carr, TF, Hill, JL, Chiu, A, Chang, EH.Alteration in bacterial culture after treatment with topical mupirocin for recalcitrant chronic rhinosinusitis. JAMA Otolaryngol Head Neck Surg 2016;142:138–42
19Kauffman, CA, Terpenning, MS, He, X, Zarins, LT, Ramsey, MA, Jorgensen, KA et al. Attempts to eradicate methicillin-resistant Staphylococcus aureus from a long-term-care facility with the use of mupirocin ointment. Am J Med 1993;94:371–8


Effects of nasal lavage with and without mupirocin after endoscopic endonasal skull base surgery: a randomised, controlled study

  • B H K Ng (a1) (a2) (a3), I P Tang (a2) (a3), P Narayanan (a1), R Raman (a1) and R L Carrau (a4)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed