Nasal saline for allergic rhinitis: an alternative treatment method
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LETTER TO THE EDITOR Nasal Saline for Allergic Rhinitis: An Alternative Treatment Method TURKER YILMAZ 1 , HANIFI KURTARAN 1 , AHMET KARADAG 2 and NURDAN URAS 2 From the Departments of 1 Otorhinolaryngology and 2 Pediatrics, Faculty of Medicine, Fatih University, Ankara, Turkey Sir, We have taken an interest in a recently published article in your journal by Unal et al (1). In their study, Unal et al. concluded that, in allergic rhinitis, injection of 40 units of botulinum toxin type A (BTX-A) was superior to injection of 2 ml of isotonic saline solution to both nasal cavities as placebo for the management of allergic symptoms. However, we think that the use of isotonic saline solution as placebo is inappropriate. Nasal washing with isotonic saline solution certainly facilitates nasal drainage and cleans the airway of any postnasal discharge; however, it is effective only when applied appropriately (2, 3). As described in the aforementioned studies, five dropperfuls of saline solution were applied to each nostril at least four times a day (2, 3). In the study of Unal et al., the inferior results obtained in the control group may have been due to saline solution not being applied using the technique described above. It is well known that irrigation with saline solution reduces levels of inflam- matory mediators in nasal secretions and indirectly reinforces the clinical efficacy of other treatments for chronic rhinitis. Therefore, nasal washing with saline solution is effective against pathologies of the upper respiratory tract that occur via inflammatory media- tors, namely the common cold, acute and chronic sinusitis and, in particular, chronic rhinitis (2 /6). Given all these factors, we consider that nasal washing with saline solution will be as effec- tive as BTX-A injection if the correct technique is used. REFERENCES 1. Unal M, Sevim S, Dogu O, Vayisoglu Y, Kanik A. Effect of botulinum toxin type A on nasal symptoms in patients with allergic rhinitis: a double-blind, placebo-controlled clinical trial. Acta Otolaryngol 2003; 123: 1060 /3. 2. Ozsoylu S. Nose drops at the common cold. Eur J Pediatr 1985; 144: 294. 3. Karadag A. Nasal saline for acute sinusitis. Pediatrics 2002; 109: 165. 4. Kurtaran H, Karadag A, Catal F, Avci Z. A reappraisal of nasal saline solution use in chronic sinusitis. Chest 2003; 124: 2036 /7. 5. Georgitis JW. Nasal hyperthermia and simple irrigation for perennial rhinitis. Changes in inflammatory media- tors. Chest 1994; 106: 1487 /92. 6. Pichichero ME, Green JL, Francis AB, Marsocci SM, Murphy ML. Outcomes after judicious antibiotic use for respiratory tract infections seen in a private pediatric practice. Pediatrics 2000; 105: 753 /9. Submitted February 13, 2004; accepted March 4, 2004 Address for correspondence: Ahmet Karadag, MD Huzur Mah Ceyhun Atif Kansu Cad 343/11 Nergiz Ap TR-06460 Balgat Ankara Turkey Tel.: /90 312 212 62 62 Fax: /90 312 221 32 76 E-mail: [email protected] Acta Otolaryngol 2004; 124: 1240 # Taylor & Francis 2004. ISSN 0001-6489 DOI 10.1080/00016480410018223 Acta Otolaryngol Downloaded from informahealthcare.com by University of Pittsburgh on 07/07/14 For personal use only.
Transcript of Nasal saline for allergic rhinitis: an alternative treatment method
LETTER TO THE EDITOR
Nasal Saline for Allergic Rhinitis: An Alternative Treatment Method
TURKER YILMAZ1, HANIFI KURTARAN1, AHMET KARADAG2 and NURDAN URAS2
From the Departments of 1Otorhinolaryngology and 2Pediatrics, Faculty of Medicine, Fatih University, Ankara, Turkey
Sir,
We have taken an interest in a recently published
article in your journal by Unal et al (1). In their study,
Unal et al. concluded that, in allergic rhinitis, injection
of 40 units of botulinum toxin type A (BTX-A) was
superior to injection of 2 ml of isotonic saline solution
to both nasal cavities as placebo for the management
of allergic symptoms. However, we think that the useof isotonic saline solution as placebo is inappropriate.
Nasal washing with isotonic saline solution certainly
facilitates nasal drainage and cleans the airway of any
postnasal discharge; however, it is effective only when
applied appropriately (2, 3). As described in the
aforementioned studies, five dropperfuls of saline
solution were applied to each nostril at least four times
a day (2, 3). In the study of Unal et al., the inferiorresults obtained in the control group may have been
due to saline solution not being applied using the
technique described above. It is well known that
irrigation with saline solution reduces levels of inflam-
matory mediators in nasal secretions and indirectly
reinforces the clinical efficacy of other treatments for
chronic rhinitis. Therefore, nasal washing with saline
solution is effective against pathologies of the upperrespiratory tract that occur via inflammatory media-
tors, namely the common cold, acute and chronic
sinusitis and, in particular, chronic rhinitis (2�/6).
Given all these factors, we consider that nasal
washing with saline solution will be as effec-
tive as BTX-A injection if the correct technique is used.
REFERENCES
1. Unal M, Sevim S, Dogu O, Vayisoglu Y, Kanik A. Effectof botulinum toxin type A on nasal symptoms in patientswith allergic rhinitis: a double-blind, placebo-controlledclinical trial. Acta Otolaryngol 2003; 123: 1060�/3.
2. Ozsoylu S. Nose drops at the common cold. Eur J Pediatr1985; 144: 294.
3. Karadag A. Nasal saline for acute sinusitis. Pediatrics2002; 109: 165.
4. Kurtaran H, Karadag A, Catal F, Avci Z. A reappraisalof nasal saline solution use in chronic sinusitis. Chest2003; 124: 2036�/7.
5. Georgitis JW. Nasal hyperthermia and simple irrigationfor perennial rhinitis. Changes in inflammatory media-tors. Chest 1994; 106: 1487�/92.
6. Pichichero ME, Green JL, Francis AB, Marsocci SM,Murphy ML. Outcomes after judicious antibiotic use forrespiratory tract infections seen in a private pediatricpractice. Pediatrics 2000; 105: 753�/9.
Submitted February 13, 2004; accepted March 4, 2004
Address for correspondence:Ahmet Karadag, MDHuzur MahCeyhun Atif Kansu Cad343/11 Nergiz ApTR-06460 BalgatAnkaraTurkeyTel.: �/90 312 212 62 62Fax: �/90 312 221 32 76E-mail: [email protected]
Acta Otolaryngol 2004; 124: 1240
# Taylor & Francis 2004. ISSN 0001-6489 DOI 10.1080/00016480410018223
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