Efficacy of hypertonic (2.3%) sea water in patients with aspirin-induced chronic rhinosinusitis following endoscopic sinus surgery

Acta Otolaryngol. 2019 Jun;139(6):529-535. doi: 10.1080/00016489.2019.1605454. Epub 2019 Apr 29.


Background: Aspirin-induced chronic rhinosinusitis (CRS) is a severe progressive persistent disease, usually associated with nasal polyps (NPs).

Aim/objective: To compare effect of hypertonic (2.3% NaCl) sea water and isotonic 0.9% NaCl on symptoms and endoscopic findings in those patients in the period of 1 month after endoscopic sinus surgery (ESS).

Material and methods: This prospective, randomized study included 30 patients with aspirin-induced CRS undergoing ESS. Patients were divided into two groups of 15 subjects and one of the two nasal irrigation solutions was administered in each group. Intensity of 5 symptoms (nasal obstruction, nasal discharge/postnasal drip, facial pain/pressure, headache and trouble sleeping) and endoscopic findings were assessed during the 1st, 7th, 14th, 21st and 28th days after the nasal packs removal.

Results: We found significantly lower total symptom score (TSS) during the 7th (p = .009), 14th (p = .003), 21st (p < .001) and the 28th day (p = .001), lower total endoscopic score (TES) on the 21st (p = .002) and 28th day (p = .001), lower nasal obstruction, facial pain/pressure, headache and trouble sleeping, and lower nasal mucosal edema, nasal secretion and nasal crusting in patients treated by hypertonic sea water.

Conclusion and significance: Hypertonic sea water should be recommended douching solution in the early postoperative care of patients with aspirin-induced CRS.

Keywords: Aspirin; nasal polyps; nasal surgical procedures; postoperative care; sinusitis.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aspirin / administration & dosage
  • Aspirin / adverse effects*
  • China
  • Chronic Disease
  • Double-Blind Method
  • Endoscopy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasal Lavage / methods*
  • Postoperative Care / methods
  • Prognosis
  • Prospective Studies
  • Rhinitis / chemically induced
  • Rhinitis / diagnostic imaging
  • Rhinitis / surgery*
  • Risk Assessment
  • Saline Solution, Hypertonic / administration & dosage*
  • Seawater
  • Sinusitis / chemically induced
  • Sinusitis / diagnostic imaging
  • Sinusitis / surgery*
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome


  • Saline Solution, Hypertonic
  • Aspirin