The Effects of Hypertonic Saline Irrigation on Nasal Mucus Secretion in Patient with Chronic Rhinosinusitis

BACKGROUND AND OBJECTIVES: Various saline solution formulae for nasal irrigation have been used frequently in patients with rhinosinusitis. However, there are not enough scientific evidences supporting the effect of irrigation of the nose with saline solution. We investigated the effects of saline irrigation on mucus secretion, subjective symptoms, and nasal cavity air-space volume changes in patients with rhinosinusitis. SUBJECTS AND METHOD: The nasal cavities of patients with rhinosinusitis were washed with 0.9%, 3%, and 6% of saline solutions consecutively with about 10 minute intervals. Lavage fluids were collected from the ipsilateral sides to determine the concentrations of mucin and lysozyme. Patients recorded subjective symptoms and each patient's nasal cavity air-space volume was assessed by acoustic rhinometry after each irrigations. RESULTS: The sensation of rhinorrhea, pain, and nasal blockage were increased as the concentration of saline increased. The concentrations of mucin increased with the increasing concentration of saline solution. However, the concentration of lysozyme decreased with the increase in the concentration of saline solution. Futhermore, hypertonic saline solution (6%) decreased the air-space volume significantly. CONCLUSION: The saline solution induces mucin secretion but not lysozyme secretion in patients with chronic rhinosinusitis. These changes in the secretion pattern may change the physical properties of mucus. The hypertonic saline solution may increase the edema of nasal cavity and decrease air-space vol