COMPARISON OF SALINE, HYALURONIC ACID AND XYLITOL NASAL IRRIGATION SOLUTIONS AFTER ENDOSCOPIC SINUS SURGERY: A PROSPECTIVE RANDOMIZED STUDY
1Şanlıurfa Eğitim ve Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları, Şanlıurfa, Turkey2Mersin Üniversitesi Tıp Fakültesi, Kulak Burun Boğaz Hastalıkları, Mersin, Turkey Objective: To evaluate the effectiveness of saline, xylitol and hyaluronic acid nasal irrigation solutions after endoscopic sinus surgery (ESS) on edema, discharge, crusting, and mucociliary clearance.
Methods: Thirty-four patients who were undergone ESS for chronic sinusitis with or without nasal polyps were prospectively included. Patients were randomly divided into three groups according to the nasal irrigation solutions they used: saline group, hyaluronic acid group, and xylitol group. Nasal obstruction was measured with visual analog scale (VAS). Edema, discharge and crusting levels were scored by nasal endoscopic examination in the first week and first month. Mucociliary clearance was evaluated by applying the saccharin clearance test in the first month.
Results: While there was no difference in crusting between the three groups in the first month, it was observed that there was less crusting in xylitol group than in saline group in the first week (p=0.025). In the saline, hyaluronic acid and xylitol groups, less crusting was observed in the first month compared to the first week (p=0.006, p=0.008 and p=0.014, respectively).
Conclusion: Saline, hyaluronic acid, and xylitol irrigation solutions reduced crusting in patients underwent ESS. Xylitol solution showed this effect in the early period. After ESS, saline, hyaluronic acid, and xylitol solutions can be effectively used for nasal irrigation. Xylitol solutions can be recommended to patients with a history of crusting or prone to crusting in dry climates.
Keywords : Nasal irrigation, saline, hyaluronic acid, xylitol, mucociliary clearance, endoscopic sinus surgery