Download - 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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