A preliminary randomised controlled trial evaluating the efficacy of saline douching following endoscopic sinus surgery

Abstract

OBJECTIVE: To assess whether saline reduces postoperative signs following endoscopic sinus surgery (ESS). DESIGN: Within subject, single blinded randomised controlled trial. SETTING: Single secondary referral centre. PARTICIPANTS: Adults undergoing bilateral ESS for chronic rhinosinusitis or nasal polyposis. INTERVENTION: Saline douching of one side of the nasal cavity, three times per day for 6 weeks. MAIN OUTCOME MEASURES: Presence of adhesions, polyps, crusting, discharge or oedema under endoscopic examination at 3 weeks and 3 months postoperative. RESULTS: Twenty-three patients were recruited. Attendance was 22 patients at 3 weeks and 17 patients at 3 months. At 3 weeks saline douching significantly improved the presence of discharge (P = 0.046) and non-significantly improved the presence of oedema (P = 0.059) with minimal difference with regard to polyps (P = 0.32) and no difference with adhesions or crusting. At 3 months there was minimal difference with regard to crusting (P = 0.18) and oedema (P = 0.32) and no difference with adhesions, discharge and polyps. CONCLUSIONS: Saline douching reduces nasal discharge and may improve oedema during the healing phase following ESS which may represent a possible anti-inflammatory role. No long-term effect was found.