Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis, asthma, and nasal polyposis: a hypothesis generating study.

BACKGROUND Rhinosinusitis is a common, expensive disorder with a significant impact on patients' quality of life. Chronic sinus symptoms are associated with allergic rhinitis, asthma, and nasal polyposis. Saline nasal irrigation is an adjunctive therapy for rhinosinusitis and sinus symptoms. Prior studies suggest that hypertonic saline nasal irrigation (HSNI) may be effective for symptoms associated with allergy, asthma, and nasal polyposis. OBJECTIVE To assess the degree to which subjects using nasal irrigation for chronic sinus symptoms also reported improvements in symptoms related to allergy, asthma, or nasal polyposis. DESIGN Qualitative study using in-depth long interviews of 28 participants in a prior qualitative nasal irrigation study. All participants were receiving daily nasal irrigation. RESULTS Transcripts of interviews were systematically examined. Twelve of 21 subjects with allergic rhinitis spontaneously reported that HSNI improved symptoms. Two of 7 subjects with asthma and 1 of 2 subjects with nasal polyposis reported a positive association between HSNI use and asthma or nasal polyposis symptoms. Transcript content was organized into themes that included: (1) HSNI resulted in improvement of allergic rhinitis and asthma symptoms, and (2) HSNI should be used for symptoms of allergic rhinitis. CONCLUSIONS This hypothesis-generating study offers qualitative evidence that suggests patients with frequent rhinosinusitis and daily sinus symptoms, symptoms of concomitant allergic rhinitis, asthma, or polyposis may improve with HSNI. The parent studies offer strong evidence that HSNI is an effective adjunctive treatment for symptoms of chronic rhinosinusitis. Larger prospective studies are needed in patients with these diagnoses.