Onderzoek

Diverse wetenschappelijke studies tonen de meerwaarde aan van neusspoelen bij neusbijholtenontsteking. Ook in de richtlijnen van de KNO-artsen is te lezen dat bij (chronische) neusbijholtenontsteking neusspoelen met neusdouche en nasaal spoelzout wordt geadviseerd.

Richtlijnen chronische neusbijholtenontsteking (= rhinosinusitis) vanuit de Vereniging voor KNO Heelkunde en heelkunde van het hoofd-hals gebied.

Uitgangsvraag: welke niet-medicamenteuze therapieën zijn beschreven voor chronische neusbijholtenontsteking met of zonder neuspoliepen en wat is hun effect?
Aanbeveling: Bij patiënten met chronische neusbijholtenontsteking zonder neuspoliepen is het wenselijk te starten met het spoelen met een isotone zoutoplossing.

Opmerking: Bij isotone zoutoplossing is de concentratie zout in de oplossing vergelijkbaar is met het zoutgehalte van ons lichaam. Dat is 0,9%. Wanneer u spoelt met NasoFree neusdouche en sachets Dos Medical nasaal spoelzout spoelt u met deze concentratie. 

Spoelen met nasaal spoelzout met xylitol, het antibacteriële middel dat ook is terug te vinden in veel suikervrije kauwgum, helpt beter dan spoelen met zout water bij chronische rhinosinusitis (= neusbijholteontsteking). Doordat het nasaal spoelzout met xylitol van Dos Medical een lekker mint luchtje heeft, geeft het ook een frisser gevoel dan spoelen met alleen zout water.

Prof. Dr. W.J. Fokkens,KNO-arts - AMC Amsterdam

%

% mensen met allergie die door het neusspoelen minder medicatie tegen hooikoorts hoefden te gebruiken

De American Rhinologic Society schrijft het volgende over neusspoelen

INTRODUCTION
Doctors have recognized the benefits of nasal irrigation and have begun to study them to see how well they work and when they should be used. While many questions remain, these studies have concluded that irrigations are beneficial, safe, and well tolerated by patients.

EFFICACY
… A recent review examined eight high quality studies and concluded that salt water irrigations are helpful to patients…

While irrigations help to clear the nose of mucus, they may also help to reduce inflammation. This may result from helping to nose to remove small particles, bacteria, and viruses which can cause allergy and inflammation.

DELIVERY DEVICES

… the positive pressure method had the best delivery to the forehead and cheek sinuses…

…high volume irrigations have also been shown to be better than nasal sprays…

SALINE CONCENTRATION
…Most practitioners suggest using concentrations of saline which are the same as the salt concentration in the body(this is called isotonic)…

…  Other studies have shown that the addition of “buffering agents” to the saline such as sodium bicarbonate results in more improvement in symptoms than salt water alone…

CONCLUSIONS
…Recent research has confirmed that sinus and nasal irrigations with salt water are helpful…

…the high volume and positive pressure methods seem to work the best…

Wetenschappelijk onderzoek toont aan: neusspoelen helpt allergieklachten te verlichten en vermindert het gebruik van medicatie

Nasal irrigation as an adjunctive treatment in allergic rhinitis: A systematic review and meta-analysis
Kristina E. Hermelingmeier, M.D. et al – American Journal Rhinol Allergy. 2012 Sep-Oct; 26(5): e119–e125

Conclusion:
Saline nasal irrigation (= neusspoelen met nasaal spoelzout) using isotonic solution can be recommended as complementary therapy in AR (= allergische rhinitis = de medische term voor hooikoorts of huisstofmijt allergie). It is well tolerated, inexpensive, easy to use, and there is no evidence showing that regular, daily saline nasal irrigation adversely affects the patient’s health or causes unexpected side effects.

Isotonic saline nasal irrigation is an effective adjunctive therapy to intranasal corticosteroid spray in allergic rhinitis. Nguyen SA1, Psaltis AJ, Schlosser RJ. – Am J Rhinol Allergy. 2014 Jul-Aug;28(4):308-11

BACKGROUND: This study was designed to determine if the addition of large-volume, low-positive pressure nasal irrigations delivered with isotonic sodium chloride (hereinafter “saline”) added to intranasal corticosteroid therapy improves quality of life and objective measures of nasal breathing in patients with allergic rhinitis when compared with intranasal corticosteroid alone.

CONCLUSION: Large-volume, low-positive pressure nasal irrigation with isotonic saline is an effective adjunctive therapy to improve quality of life in patients with allergic rhinitis already on intranasal corticosteroid therapy.

The effectiveness of nasal saline irrigation in treatment of allergic rhinitis in children.

Chen JR1, Jin L1, Li XY2.
Int J Pediatr Otorhinolaryngol. 2014 Jul;78(7):1115-8. 

OBJECTIVE:
To evaluate the effect of nasal saline irrigation in the treatment of allergic rhinitis (AR) in children and to assess whether nasal saline irrigation could be used as a complementary therapy for AR in children in combination with the intranasal corticosteroids (INS).

CONCLUSION:
Nasal saline irrigation is well tolerated and benefits the patients with AR, and can thus be considered a good adjunctive treatment option to maintain the effectiveness of the INS at a lower dose, thus resulting in reduced side effects and a decreased economic burden

Lin Chung et.al 2014 Mar;28(5):287-9.
The effect of nasal irrigation in the treatment of allergic rhinitis

OBJECTIVE:
To compare the symptoms and lower airway inflammatory factors of patients with allergic rhinitis (AR), and to observe the effect of nasal irrigation in the treatment of allergic rhinitis.

CONCLUSION:
Nasal irrigation can ameliorate nasal symptoms, improve quality of life, decrease lower airway inflammation of allergic rhinitis patients. Nasal irrigation is an effective treatment of allergic rhinitis. Nasal irrigation combined with nasal steroid can achieve more significant efficacy.

Nasal irrigation in children with symptomatic seasonal allergic rhinitis: A randomized study

W. Garavello, MD, Department of Otorinolaringoiatria, Ospedale nuovo San Gerardo di Monza, Via Donizetti 106, 20052 Monza, Italy

Conclusion:
Moreover, patients were allowed to use oral antihistamines when required and the mean number of drug assumption per week was also calculated. In patients allocated to nasal irrigation, the mean daily rhinitis score was reduced during 5 weeks of the study period. This reduction was statistically significantly different in the 3th, 4th and 5th week of therapy. Moreover, a decreased consumption of oral antihistamines was observed in these patients. This effect became evident after the second week of treatment and resulted in statistically significant differences during the 3th, 4th and 6th week. This study supports the use of nasal irrigation with hypertonic saline in the pediatric patient with seasonal allergic rhinitis during the pollen season. This treatment was tolerable, inexpensive and effective.