Comparison of Efficacy of Hypertonic Saline Versus Normal Saline in the Treatment of Chronic Rhinosinusitis

Sanal Mohan, S (2012) Comparison of Efficacy of Hypertonic Saline Versus Normal Saline in the Treatment of Chronic Rhinosinusitis. Masters thesis, Thanjavur Medical College, Thanjavur.

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Abstract

AIMS AND OBJECTIVES: 1. Compare the efficacy of hypertonic saline nasal drops versus normal saline in the treatment of chronic rhinosinusitis. 2. Assess the tolerance of hypertonic saline nasal drops. 3. To know the effect of hypertonic saline nasal drops on “quality of life”. MATERIALS AND METHODS: Random evaluation of 50 patients attending the Department of Otorhinolaryngology Thanjavur Medical College Hospital, Thanjavur during the academic period from July 2009 to September 2011, diagnosed as chronic rhinosinusitis in the age group 20-45 years are included in the study. They were divided into two groups. Group A included twenty five patients treated with normal saline 0.9% ten drops three times a day in both nostrils for a period of 4 weeks and the other twenty five cases in group B treated with hypertonic saline 3% ten drops three times a day in both nostrils for the same period. The diagnosis of chronic rhinosinusitis made with two major criteria: nasal obstruction and nasal discharge or post nasal drip. Diagnosis confirmed by clinical evaluation, diagnostic nasal endoscope and CT paranasal sinuses. Treatment outcome evaluated with pre and post treatment CT and scored according to Lund and Mackay staging system . Radiological score was given separately to each sinus film, which was marked with a number by two investigators. The selected patients are explained about the mode of treatment and asked to report every week for a period of 4 weeks. Both normal saline 0.9% sodium chloride solution and hypertonic solution 3% sodium chloride are commercially available and is used as solution A and B respectively. In my study a concentration of 3% saline solution is chosen because it is about the sea water concentration and is considered to be harmless. To avoid aerosol deposition in the lower airways, hypertonic solution is instilled as nasal drops. The drops are instilled into each nostril in sitting or lying down position with the head pulled back or hanging down to allow the secretion to flow downward from the nose without the patient breathing them in. Instillation of drops was chosen over nasal sprays to avoid breathing in solution. The symptoms of the patients are evaluated using Visual analogue score of 0-10 (0=none and 10= most severe) for nasal blockage, nasal discharge, headache, facial pain, smell disturbance and overall symptomatic improvement. This is done once in a week and at the end of the treatment. Patients are querried about the tolerance of the nasal solution by using scores 1=no burning sensation; 2= mild burning sensation; 3=moderate burning sensation; 4= severe burning sensation. INCLUSION CRITERIA: 1. Age, 20-45 years. 2. Sex, both sexes. 3. Patients with nasal obstruction and nasal discharge/ post nasal drip>3 months. 4. Patients treated with antibiotics, β2 agonists, topical steroids and systemic steroids are included in the study provided the treatment is stopped one month prior to study. 5. CT paranasal sinuses with score 4 are included in the study. EXCLUSION CRITERIA: 1.Patients with fever, treated with antibiotics or steroids during the study. 2. Patients with any anatomical defect or mucocele that obstruct the sinuses. 3. Post operative patients, 4. Post traumatic patients. Data was analysed from findings recorded in the pre- designed proforma. Chi-square test was used to find the independence of groups at 5 % level of significance between the groups. Results displayed in the form of tables and charts.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Hypertonic Saline Nasal Drops, Normal Saline, Chronic Rhinosinusitis, Diagnostic Nasal Endoscope, CT Paranasal Sinuses, The Lund And Mackay Staging System, Visual Analogue Score.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 14 Sep 2020 17:10
Last Modified: 14 Sep 2020 17:10
URI: http://repository-tnmgrmu.ac.in/id/eprint/13138

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