Effectiveness of the Nasal Irrigation Effectiveness in Treating Allergic Rhinitis in Children 6 to 12 Years Old
Abstract
Nasal irrigation, a nonpharmacological intervention for alleviating nasal symptoms, has yet to gain widespread acceptance among caregivers due to procedural ambiguities and the absence of a standardized protocol. This study aimed to evaluate the efficacy of normal saline nasal irrigation in managing allergic rhinitis among children aged 6 to 12 years.
This prospective, randomized, single-blind trial enrolled children aged 6 to 12 with allergic rhinitis. Patients were randomly assigned to receive either standard care (oral antihistamine and intranasal corticosteroid) or standard care plus nasal irrigation with saline solution. Symptom severity, assessed using the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ) at baseline, 1, and 3 months, included rhinorrhea, nasal congestion, sneezing, pruritus, ocular symptoms, and functional impairment.
The intervention group demonstrated statistically significant improvements in several domains post-intervention. Specifically, a marked reduction in sneezing frequency and nasal cleansing requirements was observed. Moreover, this group reported significantly lower ocular symptoms, including irritation, itching, and watering, relative to the control group. Although overall PRQLQ scores did not differ significantly between groups, the intervention group exhibited lower scores at the 1- and 3-month follow-ups, indicative of enhanced quality of life. These findings suggest a potential beneficial effect of the intervention on participant well-being.
The findings of this study indicate that nasal irrigation with 0.65% saline solution 4 times daily may serve as an effective adjunct treatment for children with allergic rhinitis. This regimen was associated with significant enhancements in both nasal symptom severity and quality of life.
2. Mitsias DI, Dimou MV, Lakoumentas J, Alevizopoulos K, Sousa-Pinto B, Fonseca JA, et al. Effect of nasal irrigation on allergic rhinitis control in children; complementarity between CARAT and MASK outcomes. Clin Transl Allergy. 2020;10:1-1.
3. Bousquet J, Khaltaev N, Cruz AA, et al. ARIA. Allergy 63(suppl 86):8–160, 2008.
4. Bernstein JA. Allergic and mixed rhinitis: Epidemiology and natural history. Allergy Asthma Proceedings. 2010; 31(5):365–9
5. Liva GA, Karatzanis AD, Prokopakis EP. Review of Rhinitis: Classification, Types, Pathophysiology. J Clin Med. 2021;10(14):3183.
6. Goniotakis I, Perikleous E, Fouzas S, Steiropoulos P, Paraskakis E. A Clinical Approach of Allergic Rhinitis in Children. Children (Basel). 2023;10(9):1571.
7. Idani E, Raji H, Maraghi E, Aghababaeian H, Madadizadeh F, Dastoorpoor M. Risk factors associated with asthma among adults in Khuzestan, southwest Iran. Clinical epidemiology and global health. 2020;8(2):350-5.
8. Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: allergic rhinitis executive summary. Otolaryngol Head Neck Surg. 2015;152(14):197-206.
9. Roberts G, Xatzipsalti M, Borrego LM, Custovic A, Halken S, Hellings PW, et al. Paediatric rhinitis: position paper of the European academy of allergy and clinical immunology. Allergy. 2013;68(9):1102–16.
10. Bousquet J, Pfaar O, Togias A, Schünemann HJ, Ansotegui I, Papadopoulos NG, et al. 2019 ARIA care pathways for allergen immunotherapy. Allergy. 2019;74(11):2087–102.
11. Qiu J, Grine K. Complementary and alternative treatment for allergic conditions. Prim Care. 2016;43(3):519–26.
12. Chen JR, Jin L, Li XY. The effectiveness of nasal saline irrigation (seawater) in treatment of allergic rhinitis in children. Int J Pediatr Otorhinolaryngol. 2014;78(7):1115-8.
13. Park DY, Choi JH, Kim DK, Jung YG, Mun SJ, Min HJ, et al. Clinical Practice Guideline: Nasal Irrigation for Chronic Rhinosinusitis in Adults. Clin Exp Otorhinolaryngol. 2022;15(1):5-23.
14. Liu L, Pan M, Li Y, Tan G, Yang Y. Efficacy of nasal irrigation with hypertonic saline on chronic rhinosinusitis: systematic review and meta-analysis. Braz J Otorhinolaryngol. 2020;86(5):639-46.
15. Satdhabudha A, Poachanukoon O. Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study. Int J Pediatric Otorhinolaryngol. 2012;76(4):583-8.
16. Abdullah B, Periasamy C, Ismail R. Nasal Irrigation as Treatment in Sinonasal Symptoms Relief: A Review of Its Efficacy and Clinical Applications. Indian J Otolaryngol Head Neck Surg. 2019;71(Suppl 3):1718-26.
17. Little P, Stuart B, Mullee M, Thomas T, Johnson S, Leydon G, et al. Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial. CMAJ. 2016 Sep 20;188(13):940-949. doi: 10.1503/cmaj.160362.
18. Wang Y, Jin L, Liu SX, Fan K, Qin ML, Yu SQ. Role of nasal saline irrigation in the treatment of allergic rhinitis in children and adults: A systematic analysis. Allergologia et Immunopathologia. 2020 Jul 1;48(4):360-7.
19. Juniper EF, Riis B, Juniper BA. Development and validation of an electronic version of the Rhinoconjunctivitis Quality of Life Questionnaire. Allergy. 2007;62(9):1091-3.
19- Nur Husna SM, Tan HT, Md Shukri N, Mohd Ashari NS, Wong KK. Allergic rhinitis: a clinical and pathophysiological overview. Front Med (Lausanne). 2022;9(2):874114.
20. Chitsuthipakorn W, Kanjanawasee D, Hoang MP, Seresirikachorn K, Snidvongs K. Optimal Device and Regimen of Nasal Saline Treatment for Sinonasal Diseases: Systematic Review. OTO open. 2022 ;6(2):2473974X221105277.
21. Li CL, Lin H CH, Lin ChY, Hsu TF. Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis. J Clin Med. 2019;8(1):64.
22. Satdhabudha A, Poachanukoon O. Efficacy of buffered hypertonic saline nasal irrigation in children with symptomatic allergic rhinitis: a randomized double-blind study. International Journal of Pediatric Otorhinolaryngology. 2012;76(4):583-8.
23. Nguyen SA, Psaltis AJ, Schlosser RJ. Isotonic saline nasal irrigation is an effective adjunctive therapy to intranasal corticosteroid spray in allergic rhinitis. American journal of rhinology & allergy. 2014;28(4):308-11.
24. Hermelingmeier KE, Weber RK, Hellmich M, Heubach CP, Mösges R. Nasal irrigation as an adjunctive treatment in allergic rhinitis: a systematic review and meta-analysis. American journal of rhinology & allergy. 2012;26(5):e119-25.
25. Xiong M, Fu X, Deng W, Lai H, Yang C. Tap water nasal irrigation in adults with seasonal allergic rhinitis: a randomized double-blind study. European Archives of Oto-Rhino-Laryngology. 2014;271(12):1549-52.
26. Malizia V, Fasola S, Ferrante G, Cilluffo G, Montalbano L, Landi M, et al. Efficacy of buffered hypertonic saline nasal irrigation for nasal symptoms in children with seasonal allergic rhinitis: a randomized controlled trial. International Int Arch Allergy Immunol. 2017;174(2):97-103.
27. Li CL, Lin H CH, Lin ChY, Hsu TF. Effectiveness of Hypertonic Saline Nasal Irrigation for Alleviating Allergic Rhinitis in Children: A Systematic Review and Meta-Analysis. J Clin Med. 2019;9(1):64
28. Dubey KK, Htay MN. Pathophysiology and Non-Pharmacological Management of Al-lergic Rhinitis. Int Arch Public Health Community Med. 2020;4(5):050.
29. Luetzenberg FS, Wei JL. Saline Irrigation in Pediatric Rhinosinusitis. Pediatric Rhinosinusitis. 2020:171-87.
30. Park DY, Lee YJ, Kim DK, Kim SW, Yang HJ, Kim DH, et al. KAAACI Allergic Rhinitis Guidelines: Part 2. Update in Non-pharmacological Management. Allergy Asthma Immunol Res. 2023;15(2):145-59.
31. Head K, Snidvongs K, Glew S, Scadding G, Schilder AGM, Philpott C, et al. Saline irrigation for allergic rhinitis. Cochrane Database Syst Rev. 2018 22;6(6):CD012597.
32. Garavello W, Somigliana E, Acaia B, Gaini L, Pignataro L, Gaini RM. Nasal lavage in pregnant women with seasonal allergic rhinitis: a randomized study. Int Arch Allergy Immunol. 2010; 151(2):137-41.
33. Principi N, Esposito S. Nasal irrigation: an imprecisely defined medical procedure. International journal of environmental research and public health. 2017 May;14(5):516.
34. Sikorska-Szaflik H, Sozańska B. Quality of life in allergic rhinitis-children’s and their parents’ perspective in polish urban and rural population. Health Qual Life Outcomes. 2020;18(1):1-8.
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Keywords | ||
Allergic rhinitis Nasal irrigation Normal saline Pediatric |
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