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A novel form of nasal irrigation for chronic sinus symptoms: Results of an open label pilot study

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A novel form of nasal irrigation for chronic sinus symptoms: Results of an open label pilot study Stephanie Treffert University of Wisconsin School of Medicine and ... – PowerPoint PPT presentation

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Title: A novel form of nasal irrigation for chronic sinus symptoms: Results of an open label pilot study


1
A novel form of nasal irrigation for chronic
sinus symptoms Results of an open label pilot
study
  • Stephanie Treffert
  • University of Wisconsin
  • School of Medicine and Public Health
  • Primary Investigator David Rabago MD
  • Department of Family Medicine
  • September 15, 2011

2
Beyond the Neti Pot?
3
Cultural Medical History
  • Used for centuries in Ayurvedic tradition
  • Medical references since 1890s
  • Used as Post-Op adjunctive care after nasal
    surgery
  • Initially, anecdotal evidence in sinusitis and
    other URIs
  • Currently, 13 randomized controlled trials

4
Anatomy
5
Proposed Biological Rationale
UR/Sinus Disease ? Mucus viscosity ? Mucus
Clearance Inflam mediators ? Inflammation ?
Edema
Nasal Irrigation ? Mucus viscosity ? Mucus
clearance Removal of mediators ? Inflammation
(?) ? Edema (?)
6
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7
Specific Aims
  • Improvement in SNOT-20 score
  • Global impression of change in Sx (Likert)
  • Physical ease, comfort, and convenience
  • Adherence
  • Side Effects
  • Other therapies
  • Satisfaction
  • Antibiotic use

8
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9
Subject Participation
  • Diagnosis of Chronic Sinusitis
  • Moderate to severe symptoms at start of
    survey based on inclusion survey
  • Longitudinal study following compliance and
    satisfaction metrics for six months
  • Required to complete surveys at Baseline, 1, 3
    and 6 months

10
Methods
  • Inclusion Criteria refractory Chronic
    Rhinosinusitis
  • moderate-severe daily impact
  • Multiple assessments
  • Inclusion Screening
  • General Health Survey
  • Enhanced SNOT-20
  • Compliance Calendar

11
Study Design
  • Longitudinal Study Routine care
  • daily nasal irrigation
  • Concentration 0.9 normal saline
  • Volume 8 ounces per nostril
  • Instructed on use

12
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13
General Health Survey Results
  • Beginning of study
  • On SF-V12 asked to rate various parameters
  • General health, stress, weekly exercise, previous
    nasal irrigation use, relevant past medical
    history
  • Follow-up
  • Physical ease, comfort, convenience and comfort
  • Side Effects- minimal

14
SNOT-20 Results
  • There was a statistically significant drop in
    SNOT-20 symptom scale scores from baseline to
    follow-up
  • 16 drop over 6 months (plt.001)

15
Future Studies
  • Strengths
  • Representative population
  • Statistically significant numbers
  • Improvements
  • Fewer metrics
  • Sample size
  • RCT new vs. old

16
Thanks! Questions
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