Smoking and chronic rhinitis: effects of nasal irrigations with sulfurous-arsenical-ferruginous thermal water: A prospective, randomized, double-blind study

Am J Otolaryngol. 2012 Nov-Dec;33(6):657-62. doi: 10.1016/j.amjoto.2012.03.002. Epub 2012 Apr 20.


Purpose: Smoking is a self-destructive behavior that is known to induce remodeling of the lower airways, leading to squamous metaplasia, but little is known about its effects on the nose and paranasal sinuses. Nasal irrigations are often mentioned as measures for treating sinonasal inflammations. The purpose of our study was to compare the effects of nasal irrigations with sulfurous-arsenical-ferruginous thermal water or isotonic sodium chloride solution in smokers with nonallergic chronic rhinosinusitis, based on clinical and olfactory evidence.

Materials and methods: The present study was a prospective, randomized, double-blind study performed in a tertiary academic referral center. Seventy smokers with nonallergic chronic rhinitis were enrolled. Nasal endoscopy, rhinomanometry, nasal cytology, and odor threshold measurements were performed in subjects randomized to daily nasal irrigations with either thermal water or isotonic sodium chloride solution for 1 month.

Results: Immediately after the treatment, the thermal water irrigations revealed a positive pharmacologic action, judging from a tendency toward lower nasal resistances (P = .07) and larger numbers of ciliated cells in the patients treated (P = .003). Endoscopic findings in the thermal water group were still better than in the control group a further 2 months later (P = .03).

Conclusions: Our results indicate that nasal irrigations with thermal water had a good effect on endoscopic objective signs, nasal resistances, and epithelial trophism.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arsenic / administration & dosage*
  • Bridged Bicyclo Compounds, Heterocyclic / administration & dosage*
  • Chronic Disease
  • Double-Blind Method
  • Endoscopy
  • Female
  • Follow-Up Studies
  • Hot Temperature
  • Humans
  • Male
  • Middle Aged
  • Mineral Waters / administration & dosage*
  • Nasal Lavage / methods*
  • Prospective Studies
  • Rhinitis / diagnosis
  • Rhinitis / drug therapy*
  • Rhinitis / epidemiology
  • Rhinomanometry
  • Smell / drug effects
  • Smell / physiology
  • Smoking / adverse effects*
  • Sulfur / administration & dosage*
  • Young Adult


  • Bridged Bicyclo Compounds, Heterocyclic
  • Mineral Waters
  • ferruginine
  • Sulfur
  • Arsenic