A randomized-controlled study comparing the efficacy of positive pressure nasal saline irrigation device versus syringe use in children with acute rhinosinusitis
Objective: To evaluate the efficacy of positive pressure nasal irrigation and the incidence of bacterial colonization found in the irrigation device utilized for nasal saline irrigation in children with acute sinusitis.Methods: We performed a randomized, prospective, controlled study of 80 children with acute sinusitis, aged 3-15 years. Each participant was randomized into one of two groups, one treated with a squeezable bottle and the other group treated with a syringe. A 5S-score and satisfactory score were then assessed. All patients utilized 1.25% buffered hypertonic solution for nasal irrigation twice daily for 2 weeks and received amoxicillin or amoxicillin-clavulanic acid. During this period, all participants recorded a 5S-score, a satisfaction score, resultant side effects and antihistamine use. Parents were instructed to clean the device with soap after each use. Nasal irrigation devices were sent to the microbiological laboratory for bacterial identification.Results: At week two visits, both groups had improvement in their 5S-score and satisfaction score compared to baseline visits. Patients in the squeezable bottle group significantly improved in their 5S-score and satisfaction score compared to those in the syringe group. There were few complaints reported, and side effects were seen equally in both groups. The overall rate of bacterial contamination was found to be around 80%, but this did not translate into higher rates of infection amongst patients. Nasal irrigation with the use of a squeezable bottle was associated with improvement in 5S-score and satisfaction scores when compared to syringe use in children with acute sinusitis. There was no significant difference in bacterial contamination.