Atomized Nasal Douche vs Nasal Lavage in Acute Viral Rhinitis
Open accessAbstract
OBJECTIVE: To evaluate the efficacy of the atomized nasal douche in the restoration of physiological nasal functions in patients affected by acute viral rhinosinusitis, when compared with nasal lavages with isotonic sodium chloride solution. DESIGN: Randomized clinical trial. SETTING: The ENT Department at the University of Siena Medical School. PATIENTS: Two hundred patients affected by acute viral rhinosinusitis were included in the study. INTERVENTIONS: Patients were randomly divided into 2 groups: group 1 patients received an atomized nasal douche, and group 2 patients received nasal lavages with isotonic sodium chloride solution. Patients underwent treatments 4 times per day for 15 days in our institution under our direct control. RESULTS: Atomized nasal douches significantly improved inspiratory and expiratory rhinomanometric resistance (P<.01) and nasal volumes measured by acoustic rhinometry (P<.001). Nasal lavages were unable to modify these variables significantly (P<.3). Only atomized nasal douches were able to normalize mucociliary transport time to a physiological level (P<.001). CONCLUSIONS: The atomized nasal douche demonstrated a better efficacy than traditional nasal lavages with isotonic sodium chloride solution in restoring all the physiological nasal functions. For this reason, and considering ease of use, painlessness, cheapness, and manageability of the instrument, we suggest the use of the compressor-micronizer chamber system (Rinoflow Nasal Wash & Sinus System) as a routine adjuvant to every treatment of acute rhinopathies.
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There was doubt as to randomisation used in Passali 2005.
“Doubt as to randomisation used”
From Saline nasal irrigation for acute upper respiratory tract infections (2015) · cites this paper as Passali 2005
The Methods section (page not available) says patients were “randomly divided into 2 groups” but does not describe how the randomisation was carried out. That omission supports uncertainty about the method used, not a claim that the paper itself questioned whether randomisation occurred. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThe review changed the status of two studies from exclusion due to high risk of bias to exclusion due to not meeting inclusion criteria (Inanli 2002; Passali 2005).
“These include changing the status of two studies from exclusion due to high risk of bias to exclusion due to not meeting the inclusion criteria for this review (Inanli 2002; Passali 2005).”
From Saline nasal irrigation for acute upper respiratory tract infections (2015) · cites this paper as Passali 2005
Passali 2005 failed to meet inclusion criteria because there was no comparison group as a control; both groups received nasal saline via different delivery methods.
“Failed to meet the inclusion criteria, as no comparison group as a control; both groups in the trial received nasal saline via different delivery methods”
From Saline nasal irrigation for acute upper respiratory tract infections (2015) · cites this paper as Passali 2005
Passali 2005 did not describe methods of randomisation and allocation concealment.
“Methods of randomisation and allocation concealment not described”
From Saline nasal irrigation for acute upper respiratory tract infections (2015) · cites this paper as Passali 2005
Passali 2005 did not perform intention-to-treat analysis.
“Intention‐to‐treat analysis not performed”
From Saline nasal irrigation for acute upper respiratory tract infections (2015) · cites this paper as Passali 2005
The Methods section says that 200 patients were randomized and that measured data were analyzed using a t test. It does not say whether the analysis included all randomized patients, so the claim that intention-to-treat analysis was not performed cannot be verified from our copy (searched for intention-to-treat, withdrawals, dropouts, and analysis population). (LLM, conf=0.70)
Experimental — accuracy not yet measured
Passali 2005 had no blinding.
“No blinding”
From Saline nasal irrigation for acute upper respiratory tract infections (2015) · cites this paper as Passali 2005
The Methods section describes random assignment to two visibly different treatments, administered under the investigators’ direct control, but does not state whether participants, treatment staff, or outcome assessors were blinded. A search for blinding and masking found no passage that settles the claim that there was no blinding. (LLM, conf=0.72)
Experimental — accuracy not yet measured
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Research works printed but not linked: 11
- Nuutinen J, Holopainen E, Haaletela T, et al. Balanced physiologic saline in the treatment of chronic rhinosinusitis. Rhinology. 1986;24:265-269.
- Ryan RM, Whittet HB, Norval C, et al. Minimal follow up after functional endo- scopic sinus surgery: does it affect the outcome? Rhinology. 1996;34:44-45.
- Newman SP, Agnew JE, Pavia D, Clarke SW. Inhaled aerosols: lung deposition and clinical applications. Clin Phys Physiol Meas. 1982;3:1-20.
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Cited by
Sorted by citations
Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*
Bousquet, J., Khaltaev, N., Cruz, A. A., Denburg, J., Fokkens, W. J., Togias, A., Zuberbier, T., Baena‐Cagnani, C. E., Canonica, G. W., Van Weel, C., et al. (2008) · Allergy · doi:10.1111/j.1398-9995.2007.01620.x · Cited by 4,729 · see citing works
Saline nasal irrigation for acute upper respiratory tract infections
King, D., Mitchell, B., Williams, C. P., & Spurling, G. K. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006821.pub3 · Cited by 226 · see citing works
- Authors
- Passàli, D., Damiani, V., Passàli, F. M., Passàli, G. C., & Bellussi, L.
- Affiliations
- University of Siena (IT)
- ORCID
- Venue
- Archives of Otolaryngology–Head & Neck Surgery
- Publisher
- American Medical Association (AMA)
- Published
- 2005-09-01
- Volume
- 131
- Issue
- 9
- Pages
- 788
- ISSN
- 0886-4470 (ISSN-L)
- OpenAlex
- W2128915122
- Cited by
- 47
- References
- 0
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 3 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 2 · 2013: 2 · 2012: 2
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Otolaryngology - Head and Neck Surgery (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion, other-oa)
- Use Siena air (University of Siena) (submittedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Epidemiology › Respiratory viral infections research
- Keywords
- nasal irrigation, nasal obstruction, rhinomanometry, acoustic rhinometry, mucociliary clearance, adjuvant therapy
- MeSH terms
- Acute Disease, Aerosols, Common Cold, Female, Humans, Therapeutic Irrigation, Isotonic Solutions, Male, Mucociliary Clearance, Nasal Mucosa, Nebulizers and Vaporizers, Rhinitis, Sodium Chloride, Treatment Outcome, Nasal Lavage Fluid, Rhinometry, Acoustic
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